Would you purchase a new phone without knowing its data plan? For almost everybody, the answer is an obvious “no.” We simply cannot make a good choice if we don’t know how much coverage the phone will offer, or how much money it will end up costing us.
Unfortunately, this type of blind decision is exactly the sort that many could face when purchasing a plan in the new health insurance marketplaces — assuming Healthcare.gov will remedy the basic functionality issues that have dogged it in the weeks since launch.
Beginning January 1, 2014, everyone will be required by law to have health insurance; the marketplaces will help consumers find and purchase new plans. But what happens then? Are there easily available doctor appointments covered by these plans, or will patients come up empty-handed when seeking care? Is an insurer’s online directory up-to-date or wildly inaccurate? Which plans have better customer service and which have none?
As patients, it’s vital to know the level of care access an insurance policy will actually provide. Without this basic consumer information, your brand new insurance card is like a mystery phone. All you can do is carry it in your pocket and hope that it gives you the coverage you need, when you need it, at a price you can manage. In reality, it may fail you when you need it most.
This is the opacity American patients have become accustomed to, and it is deeply problematic. Healthcare is perhaps the most important service we consume — but as consumers, we are far less well-informed than when we shop for travel, leisure, electronics, cuisine, et cetera.