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For Snafus, Obamacare Has a Role Model

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ZOCALO PUBLIC SQUARE-The nation’s new health insurance exchanges, the online marketplaces for medical coverage that are an integral part of Obamacare, opened for business last week. 

Immediately the trouble began. Web pages went blank. Attempts to enroll in coverage were delayed, or altogether stymied, as sites crashed. Critics of the law pounced. “Too many unanswered questions and too many unsolved problems,” said U.S. Senator Orrin Hatch, Republican of Utah. 

 

Yet there’s another way to see these growing pains: as evidence not of change but of continuity for consumers of health insurance in America. With each misstep, government officials are simply catching up to the record of headache-inducing frustrations produced by the longstanding private medical insurance system. 

Whether you’re one of the 50 percent or so of Americans who already have private health insurance (mostly through an employer, as I do) or one of those who may now turn to the exchanges to buy coverage, the bureaucracy is often maddening. Sure, the Affordable Care Act may seem opaque and unwieldy, but make no mistake: Employer-provided healthcare—which offers plans by the very same companies now on the exchanges—is equally Byzantine. No wonder that only 22 percent of American consumers reported themselves as satisfied with the healthcare system in a 2012 survey from the Deloitte Center for Health Solutions

A few weeks ago I had an all-too-typical experience. My insurance company, Anthem Blue Cross, sent me a letter saying, “It has come to our attention that we have been paying for certain … drugs that are not covered under your existing benefit plan.” Going forward, the letter added, my doctor would need to prescribe something different, or I’d have to start paying for these particular medications myself. 

And when would this kick in? According to one part of the letter, January 1, 2014. According to a different part of the letter, right away. 

It concluded with the sentence I’ve come to dread most: “If you have any questions or concerns, please call the customer service number on your ID card.” 

Bravely, I did. Forty-five minutes later, I had yet to talk to an actual human being. Finally, at the 50-minute mark, a customer-service representative showed up on the line. She was cheerful and peppy. 

I was not. 

The Anthem representative was unable to clarify anything in the letter and asked if she could put me on hold while she did a little research. I said OK, but I made a special plea: to call me back if we somehow got disconnected. Just a week before, on another Anthem call—concerning a paid claim that Anthem said was unpaid—I’d gotten cut off after an hour or so on the phone. She assured me that she’d call me back, if need be. 

Ten minutes later, the representative returned to tell me that the answer to when Anthem would stop covering my prescriptions was neither January 1 nor immediately. It was December 1. 

Where did this new date suddenly come from? She couldn’t explain. I asked to speak to her supervisor directly. She countered with a classic chess move: I was put on hold for another 15 minutes. Then: “Thank you for calling Anthem Blue Cross. Goodbye.” The line went dead. Checkmate. 

Despite my plea and the representative’s promise, no one from the company called me back. I have yet to find the stomach to phone Anthem again. 

Sure, the implementation of the Affordable Care Act is hitting some bumps, especially in its early days. But before critics falsely brand these as the inevitable consequence of a “government takeover” of our healthcare system, let’s remember that when it comes to medical coverage, bureaucratic snafus are hardly the province of Obamacare alone.

 

(Randye Hoder is a Los Angeles-based writer who regularly contributes to The New York Times’ Motherlode blog. Her articles have also appeared in the Los Angeles Times, The Wall Street Journal, Slate, and other publications. This piece was posted first at ZocaloPublicSquare.org  … connecting people and ideas.)

-cw

 

 

 

CityWatch

Vol 11 Issue 82

Pub: Oct 11, 2013

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