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More Observations on the Future of Health Insurance in America

Conclusion: The Future of Health Insurance in America Page 2

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Third, it's become clear that there is an enormous need to provide a mechanism so that individuals who lose their jobs or who develop serious illnesses or conditions, are guaranteed the opportunity to continue health insurance coverage on a permanent basis. COBRA and the Portability and Accountability Act meet that need to some extent at this point, but they represent only a partial solution to the problem.

Fourth, we're coming to realize the importance of finding a way to improve communication between insurers and consumers. At times, statements in letters and EOBS (Explanation of Benefits Statements) from insurers are so complex and so confusing that it's almost impossible for consumers to fully understand them. That complexity makes it extremely difficult for consumers to resolve health insurance problems, and to meet insurance company requests for additional information or documentation.

Fifth, we've become aware of the need to simplify the rules that govern the Medicare program, and of the need to improve communication between Medicare and Medicare beneficiaries.

Sixth, there's growing agreement that our current paper-based health insurance claim-filing and processing system is inefficient, time-consuming, frustrating, and enormously expensive. The current system requires consumers and medical personnel to spend countless hours filling out claim forms, photo copying medical bills, and filing claims. In addition, it requires consumers to call or write to hospitals, testing centers, or doctors' offices to obtain copies of itemized bills, operative reports, doctors' letters, or other types of documentation when claim problems occur. In many cases, the current system also places the individual consumer in the middle, between the insurance company and the provider.

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