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A Code of Conduct for Health Insurance Companies

In the never-ending debate about national health care, the most common refrain is “our health care system is broken.” That is immediately followed by never-ending government solutions to “fix” said system at an estimated cost of trillions of dollars. Rarely mentioned in these expensive, government-knows-best debates, however, is any discussion of free-market, non-legislative solutions to the problem.

Right now the insurance industry is the only part of the health care system which doesn’t have to abide by any code of conduct or ethics. And, as many of us who have dealt with health insurers can attest, it shows.

So the best prescription for what ails the health care system today would be a better informed consumer. And consumers have a new champion in that regard in the form of a new group called the Alliance for Patient Access, “a national network of physicians with the shared mission of ensuring and protecting patient access to approved medical treatments and therapies including prescription pharmaceuticals, biologics, and medical devices.”

The group is currently circulating an online petition encouraging the American Medical Association (AMA) “to expeditiously develop the Health Insurer Code of Conduct and call upon health plans to voluntarily adopt the Code of Conduct” when it meets later this fall.

Quite simply, this Code, as is being proposed and introduced by the New York delegation at the upcoming the AMA convention, “would benefit patients, physicians, and other health care providers by challenging health plans to modify their restrictive practices without the need for legislative or judicial intervention. In addition, the Code would “provide consumers with an additional tool for comparing health plans during enrollment periods.”

No more waiting until after you get sick to find out exactly what your costs will be.

No more finding out after you go to the drug store for your medications that your prescription isn’t covered.

No more paying for top-quality coverage and finding a top-quality doctor only to find out later that your insurance company will only pay for the treatment some bureaucrat at the health insurance company thinks you need.

And no more operating in the dark about what secret deals your insurer may have worked out with your doctors and hospitals regarding your care; deals which give bonuses to doctors if you don’t get certain tests or are prescribed brand-name drugs.

These deals are reportedly far more common than the public is aware. The same doctor you are paying to give you the best treatment, and the same insurer that you are paying to make sure that you have access to the best treatment, often have entered into undisclosed agreements which give the doctor bonuses if the doctor saves the insurance company money.

And maybe, to be fair, these deals do help keep your premiums down. Nothing wrong with that. In fact, keeping costs down means more of us can afford to buy our own health care instead of having a “government option” forced down our throats at costs which could bankrupt our country.

But shouldn’t you, the patient, know about any such arrangements before the fact so that you can make a fully informed decision?

That’s exactly what the Health Insurer Code of Conduct is all about. There is nothing in the proposed Code which prohibits insurers from working to reduce costs though all available means. It simply requires full and honest disclosure.

Nothing spurs competition more than letting consumers shop for the best buy for the buck. This is a simple formula that works well in our capitalistic system. Informed consumers with viable choices result in a more cost-effective system. Inject some greater transparency into the health care system and we all benefit.

So let it be written; so let it be done.