Task Force Fights For Information On Managed Care

Should state law require managed care insurers in Washington to spell out in plain language just what is covered in their plans and what is not?

A bill introduced in this session of the legislature directed the State Insurance Commissioner to get the necessary details from insurers and publish a “Comparative Shoppers Guide on Available Managed Care Health Coverage Plans.” Republican Sen. Alex Deccio, chair of the Health & Long Term Care Committee in which the bill was introduced, canceled hearings on the bill.

Now, a broad coalition of consumers and health care groups who call themselves the Washington Managed Care Model Legislation Task Force vow to bring back the bill next session, and make it into law.

Spearheading the effort are volunteers of the American Association of Retired Persons.

“I am reasonably intelligent,” says Maxine Davis, a Spokane member of the AARP’s State Legislative Committee. “But I have a deuce of a time trying to figure out which managed care plan to select. A great many of our more elderly citizens are completely lost trying to compare coverages.

“Our idea is a chart that states not only what a plan covers, but what it doesn’t,” Davis says. “Sometimes things are disallowed that people aren’t told about at all, or that are excluded in tiny print that escapes those who need most to see it.

“We want something simple, instead of having to read this book and that brochure, refer to this chart and that table, and try to piece together a comparison that may be misleading and incomplete.

“A lot of older people on fixed incomes have to make extremely hard choices between food and medicine. For them, the right choice can be a matter of life and death.”

Ruth Scarborough, Vancouver, co-chair of the legislative task force, says most of the information sought is already being supplied in some form by companies to one regulatory agency or another.

“Our legislation would just get all together in one place - the consumer guide,” she said. “It would enable us to sit down and figure out where we fit into the managed care system. Surely, that’s not too much to ask.”

Reed Hansen, a member of AARP’s State Legislative Committee and its Health Care Subcommittee, has broad experience with the senior health care issues. “Much of the frustration with managed care today can be traced to the fear and uncertainty created by these extremely complex and confusing insurance plans,” says the retired Pullman economics professor. “Older persons desperately need a consumer guide to help them make the right choices.

“Without reliable, accurate and comprehensive consumer data in usable form, intelligent managed care purchases are simply not possible,” said Hansen, “and older consumers can be badly exploited.

“I don’t think anyone wants that, which makes this legislation vitally important,” said the Pullman seniors advocate.

Robert Lynch of Olympia, coordinator of AARP’s Capital City Task Force and one of six unpaid volunteer lobbyists for the consumer protection measure, said, “Insurance companies won’t like it.” They’ll claim it’s just another layer of regulation and cost.

But the current effort to help managed care purchasers figure out just exactly what they can expect to receive for their money is unconscionable, he says. “We are better informed to comparison shop for a car or a dishwasher,” he points out, “than we are to buy the health care on which our live and those of our loved ones depend. That’s simply unacceptable.”

The task force continues to recruit other support groups throughout the state. “We hope to represent no fewer than a million members of various organizations when we lobby this measure next session,” said Lynch.

“We have a very aggressive schedule between now and next January, and we are very stubborn,” said Lynch. “It may be we won’t get it past the insurance companies next time around. But we won’t let it go - people deserve this life and death information.”

“Hey listen,” said Scarborough, “it’s going to be a long battle. But we are going to get this done.”

, DataTimes MEMO: Associate Editor Frank Bartel writes on retirement issues each Sunday. He can be reached with ideas for future columns at 459-5467 or fax 459-5482.

The following fields overflowed: CREDIT = Frank Bartel The Spokesman-Review