My wife recently gave birth to our son. That spectacular event triggered a flurry of communications from our health plan — namely, plan statements. Plan statements get mailed following a provider visit. They explain what procedures were performed, what the provider billed the plan, and what the consumer’s cost is (if any).
Up until recently we really didn’t pay much attention to our statements as we rarely visit the doctor. But after the birth, larger bills started to float in — it was time we looked closer.
For ten minutes I stared at one said statement and couldn’t make heads or tails of it. My plan’s statements are filled with so much jargon and cryptic codes that each one comes with a whole extra page of definitions. Even with this extra glossary, I still needed to call customer support to get help understanding the statement in question. After twenty minutes of going through my statement line-by-line I found that at least half of the information I had questions about wasn’t even relevant to me. One is left with the cynical feeling that these statements are intentionally complex to deter members from questioning their content and accuracy. Customer loyalty is based on trust. Mine was shaken.
I found myself asking “who do these companies think their customers really are?”
Today it’s not cost effective for me to express my displeasure by walking my business elsewhere to a plan that not only sends statements I can understand, but maybe has better coverage too. Shopping for health insurance is a luxury that most individuals can’t afford. A large majority of us go through our employers — with the cost of health care rising, it’s really the most affordable option.
In this type of environment, where companies don’t have to compete as fiercely for consumer loyalty, it’s the consumer who loses.
As bad of a rap the health industry seems to get, apparently 70% of us are happy with our plans. However, not surprisingly, studies show that we want more control. According to a Deloitte report, consumers have indicated that if the pricing was compatible, 46% would prefer to shop for their own insurance rather than go with their employer’s. And while happy, 52% of us admit to not understanding our coverage.
For the moment, with the healthcare system set up the way that it is, the power primarily rests with the insurance companies. Let’s assume that one day that changes. Websites would surface that would let consumers rate, review, and compare plans and their related providers. Insurers would have to step up and provide better services and communications. Plan statements might actually start to get written in plain English; maybe they’d even have useful information like a running total of your deductible.
Most of the conversation around healthcare reform rightfully revolves around cost. If and when this future state is ever achieved, we might also finally find ourselves in the position of buying a product that we can actually understand.