Thanks to kaisernetwork.org :
Fifty-five percent of members from 107 commercial health plans nationally said they do not understand “critical details” of their coverage, including prescription drug benefits, finding the proper physician and appealing coverage denials, according to the 2008 National Health Insurance Plan study released Wednesday by J.D. Power and Associates, Bloomberg/Arizona Daily Star reports.
There’s nothing new here in this report only a little surprise that the number is that low! Many factors contribute to this situation of course:
- complicated health care insurance payment mechanisms
- legal nature of the language of health benefits
- complex medical terminology
- constantly changing benefits, regulations and laws
- consumer complacency in knowing their health benefits
- unrealistic notions of what coverage means
When you put it all together, the average citizen confronts a confusing array of overlapping and conflicting jargon of the highest order, presented at a time when he or she is usually least able to comprehend it all, that is, when sickness or injury calls. Blame a fragmented health care industry, an oppressive health care legal canon only the Pope could appreciate, the ever-expanding medicalization of ordinary life and the omnipresent fiscal risks to all stakeholders — I could go on — and you get the picture of why most people eventually surrender to fate and circumstance.
When the system does work, it does so against the odds and as a result of people in all corners of the health care industry continuing their struggle simply to do the right thing.
