Don’t let the insurers stop health reform

When my wife and I moved to the Danville area from Massachusetts six years ago, our health insurance premiums went up 40 percent, with an actual decrease in coverage and quality.

By the third year, the premium was double. As a Richmond native who’s spent more than 40 years as an actuary in the insurance industry, I have seen how insurers restrict access and cherry pick whom to cover and what claims to contest. I have come to realize that reforming our health care system is not just an economic or business issue, it’s also a moral one. My business sense and my faith tell me that we need health care access for all.

An investigation by the U.S. Senate Committee on Commerce, Science & Transportation this past spring revealed how some of the nation’s biggest health insurers were underpaying millions of valid insurance claims, forcing patients to make up the difference. The Wall Street Journal reported June 25 the payment data would be scrubbed to remove high-cost items and then questionable statistical models were used to give insurance companies their own rate estimates. The investigation covered two-thirds of the health insurance market. Patients and providers had suspected this for years, but now we have the facts to prove it.

A June 17 Los Angeles Times article reported how the U.S. House Committee on Oversight and Government Reform found the country’s largest health insurers had targeted policyholders with breast cancer, lymphoma and more than 1,000 other conditions and tried to cancel their coverage, a practice known as rescission. Health insurance employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

It is clear such practices have deeply hurt American families. A recent study by researchers at Harvard University found medical bill-related bankruptcies have increased from 55 percent of all bankruptcies in 2001 to 62 percent in 2007. What is most worrying is that health insurance didn’t help these people avoid financial distress. About 78 percent of bankruptcy filers burdened by health care expenses in 2007 were insured. The fact that, despite having health insurance, people are still being forced into bankruptcy shows just how broken our health care system is.

The health insurance industry is not evil. Their job is to make a profit and they do this by restricting care and access. But, our health care system should reflect certain values and priorities. We need to increase the availability and affordability of health insurance for the over 1 million Virginians without health insurance. We also need to strive to make health insurance affordable for those of us already insured but struggling to finance the rising premiums and cost sharing. It can be done.

To help make this happen, I enthusiastically support and endorse a Faithful Vision for Health Care in Virginia, a vision currently being promoted by the Virginia Interfaith Center for Public Policy: Health care is a shared responsibility that is grounded in our common humanity. Health care must be affordable for all. It should be a fundamental right in a healthy, flourishing society. Providing access to health services that provide necessary care and contribute to a healthier population is not only the right thing to do, but it will also reduce the costs of health care for all Virginians by reducing chronic conditions that increase the cost of health insurance.

These are the values that our health care system needs to embody, both at the national level and here in Virginia. Virginians are struggling to pay health care costs and make ends meets. Many think we cannot afford health care reform at this time. But having seen first-hand the difficulty millions of Americans have in getting health insurance, I believe now is the time to fix the system and provide quality, affordable health care options for all Americans.

* Games is a retired actuary with more than 40 years of experience in the insurance industry and is a fellow with the Society of Actuaries. You can find out more about the Faithful Vision for Health Care at http://www.virginiainterfaithcenter.org.