Friday, July 17, 2009

Agents vs Carriers

[Welcome Industry Radar readers!]

As an insurance agent, one of the most frustrating parts of the whole health care reform "debate" is that no one is asking for our opinion. Yet ours is a unique and valuable perspective: we represent consumers and insurers, and access providers. We help clients (consumers) navigate the various pathways toward deciding on a plan, and are there as an advocate come claims time.

But no one invites us to the table.

Some will claim - incorrectly - that we already have a seat there because (some) carriers and their advocacy group (AHIP) are represented. They will be wrong.

Let's take the latest from Anthem (a Blue Cross/Blue Shield company). In an email I received today, they reported on the latest in the debate, and claimed to be "deeply disappointed with the legislation progressing in Congress. Both the bill proposed by House Democrats and the bill passed by the Senate HELP Committee miss the opportunity to address the underlying cost drivers in our health care system."

And they're correct, as far as it goes. Moving health care financing decisions from carriers to the gummint does nothing to address the fundamental disconnect between consumers and providers.

They also objected to the employer mandate and revisions to Medicare reimbursement schedules. There followed a laundry list of other issues, but there was not a single mention of how the agents who represent Anthem will be outlawed under the new plan. This makes sense, of course, since the carriers aren't prohibited from offering plans through the as-yet-to-be-defined Exchange system. But consumers will lose counselors and advocates: have a claims problem? Call the gummint hotline. As anyone who's stood in line at the DMV or called the IRS can attest, this is a recipe for disaster and disappointment.

But there's no reason for the carriers to care what happens to agents. After all, the government will become the agent, and there's no pesky commissions to be paid or questions to be answered. The problem is that, once you've sold your (corporate) soul to the government, you may not like the results.
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