ANNAPOLIS – Senate Finance Committee leaders clashed with insurance industry representatives Thursday over legislation that would require health insurers to inform consumers more specifically about their plans and business practices.
“I think there is a wealth of information available to the consumer,” Pam Metz of the Maryland Association of Health Maintenance Organizations testified during a hearing.
Devin Doolan of Blue Cross/Blue Shield of the National Capital Area called the bill an “overreaction.”
The bill’s sponsors, Sen. Tom Bromwell, D-Baltimore County, and Sen. Arthur Dorman, D-Prince George’s, challenged claims that the bill is unnecessary and would go too far. Information vital to consumers making health care decisions is now difficult or impossible to obtain, they said.
“I’m not buying, `It’s not a problem,'” Dorman told the opposition. “And that’s what you’re selling.”
Said Bromwell, “I think we know more when we are buying a car than we do about our health care sometimes.”
Under the bill, insurers would have to disclose how they choose and reimburse health providers.
They would also have to reveal the proportion of premiums spent on staff salaries, marketing and advertising, and shareholder dividends. Consumers should know if a company’s executives are earning salaries in the tens of millions, Bromwell said.
The plans’ terminology would have to be defined, Bromwell said.
“I wonder how many people outside this committee know what `capitation’ is,” he said, referring to the fixed payments doctors receive for serving multiple patients.
Capitation policies may put doctors under pressure to withhold treatments once the cost of their patients’ care reaches the pre-set reimbursement level, critics say. The Bromwell-Dorman bill would require that capitation plans be spelled out.
Under the proposal, insurers also would have to inform consumers of the risks doctors assume and the bonuses and discounts they receive.
Insurance company lobbyists said the bill would unfairly burden them. Much of the information required would paint an incomplete picture of complicated plans, they said.
“You need to be mindful… [that] the level of detail required by this bill may end up counterproductive,” said Metz, of the HMO association. “You would confuse [consumers] with information as opposed to assisting them.”
“My objection is I don’t know that the consumer wants to know” about some business practices, said James Doyle Jr., lobbyist for Aetna Life and Casualty.
A provision forbidding managed care organizations from restricting what their physicians tell patients drew praise from Vikram Khanna, a health policy analyst who helped develop the bill. Such anti-“gag rules” have passed in several states, including Virginia, Khanna said.
Insurers may say they do not order that information be withheld, Khanna noted, but “if that’s true, this is an important dose of preventive medicine.”
Another supporter said the bill might also lower legal system costs. “There would probably be less litigation in the health care field because [consumers] have all the facts,” said Charles Culbertson of Health Care for All, a consumer group. -30-