Strongly Worded

Focus on Health Insurance

I love focus groups. Love, love, love them. I've entered myself into the database of a locally-based market research company, and I get fairly frequent calls in which I am screened for participation in groups about things like shaving products and online "gaming". Usually, I don't make the cut (because of demographics or shaving habits or whatever), but I have gotten paid upwards of $75 to discuss my opinions on printers, migraine medications, and, most recently, health insurance.

In my view, health insurance companies and drug manufacturers are Twin Sources of Evil. Thus, I do have some ethical qualms about taking money from them. I want to share my strongly worded views on their sneaky, greedy ways, and I feel entitled to their money since they take so much of mine on such a regular basis (I calculated yesterday that I spend over $2,000 a year on health care). However, I acknowledge that these companies conduct all these focus groups precisely because they want to find ever more sneaky ways to screw over health consumers everywhere.

So. Last night I joined nine other people to discuss the relative merits of four health plan "concepts". "Concept A" would allow the "member" to pay a LOWER premium if (s)he chooses from "a select group of practitioners chosen for their efficiency and high quality". OR (s)he could elect to pay MORE money in order to access a larger group of "lower quality" physicians. The focus group leader spent a lot of time trying to explain that this is, in fact, logical, since it is clearly cheaper to see "higher quality" physicians who have "better health outcomes" and design treatment plans with shorter hospital stays, reduced chance of complications, and "specialty expertise".

Umm ... do we know where this is going? Isn't it abundantly clear that "select, higher quality" is insurance-speak for "physicians who agree to comply with our stingy and overbearing policies"? It's like Starbucks talk. Call it Venti if you want, but we all know it's just a fancy word for small.

The "Concepts" got ever more preposterous. Concept C allowed for a choice of "only the best of the 'higher quality' physicians", and included the provision of "wellness plans" that would "help the member set and meet health-related goals". Meaning, Big Brother insurance company is now getting information about how well the "select physician" is doing and adding another task (the Wellness Plan) for him/her to accomplish during the 4-minute "high efficiency" office visit.

And the kicker: a Concept in which the member can choose among "a select" group of hospitals, but pays less if (s)he elects for the one that charges the least. Also, in case the "best" option is deemed a "Center of Excellence" outside of the state, the insurance will pay for transportation/lodging costs of the member and his or her family. So in other words, the insurance company can broker bulk rates for certain procedures, nation-wide, and send its members to a "Center of Excellence" across the country if that proves to be the most economical option. What's next? Roundtrip airfare to India, where health care is really cheap?

The horrible thing about this (OK, one of the countless horrible things), is that the people in the group got excited about the generosity of the insurer who would send them and their families across the country for the "best care". A lot of the people in the group thought it would be helpful to have the insurer "work with the physician" to help implement their "Wellness Plans." And when the focus group leader pushed on cost sensitivity, asking whether we would suck up all this nonsense if it would cost 5%, 10%, or 15% less than what we are currently paying, a lot of the people said that they would.

I kept insisting that I hated all of it, and that I would go to another insurer before choosing one of the Concepts. But then I realized that most employers don't offer a choice of insurance companies, and so I'd be forced to pick a lesser of these evils. How scary is that?

Posted by Dori at 9:15 AM