Friday, January 31, 2014

A Health Insurance Horror Story

We can send men to the moon. We can drop rovers on Mars with pinpoint accuracy. We created a national highway system that is the envy of the world. We can send emergency aid around the world immediately when it is needed and we can fight two wars at the same time and our public is barely aware. It is proven that government can do big things successfully so how is it with three years of planning before rolling out that the Affordable Care Act (ACA) also known as Obama Care is such a bungled mess? Seriously, this isn’t some rant against the ACA or how it should have never been placed. That part is over, it is the law of the land and we need to live with it. However, I am responsible for protecting my clients and taking care of them and I do not know how to do that right now. I am ticked off at how poorly this whole plan was put in place and the total lack of follow through.

We have clients that we represent that paid their premium in November and December and still do not have their insurance ID cards! A telephone call to the insurance company is a two to three hour ordeal and if you get through it is generally someone who can’t answer your question and refers you to the website. We have clients who need service but we can’t find doctors who will perform the procedure because contracts with physicians, clinics and hospitals are still not settled!

The insurance carriers in our area of California get a (C) grade point for preparation. They certainly could have done better and the number one issue is staffing. The carriers are way behind in processing new applications and do not have the resources to answer the phones. They knew that there was going to be a huge surge last minute – what were they thinking? However, as hard as it is to believe I am going to defend these insurance carriers because what most people do not know is that right up until the middle of December the government was still changing the requirements of the carriers with regard to the ACA.

I know that my mom would tell me “Son, this too shall pass” (one of her favorite sayings when I was growing up) and I know that she is right. Eventually the insurance carriers will get caught up, they will answer their phone calls, our clients will get their ID cards, find doctors who can help them and I will be able to help my clients.

I hope that when this mess is over that someone creates a business case study that examines the steps that led to this fiasco. The only way forward is to learn from our mistakes and not make the same mistakes again.