A few paces from Chicago’s Magnificent Mile where holiday shoppers were at the ready with their credit cards, consumer advocates were recounting how another kind of debt runs up.

The stories being told at the consumer liaison session of the National Association of Insurance Commissioners’ winter meeting last month were not ones of “comfort and joy”–but of people cobbling together enough just to keep health care coverage.

The stories are heart wrenching and embody our worst fears: cancer patients who have to interrupt chemo and radiation treatment because they couldn’t make ends meet; marginally insured citizens who are on a health care gangplank hoping they can make the leap to state health pools; and those who don’t make the leap and go without.

Cynics listening to these stories could argue that they are the extremes, the hard-luck cases that punctuate the majority who have some form of health care coverage. Perhaps they are right.

But then again, perhaps they’re not. Consumers are concerned about paying their health care bills. A December 2005 study by the Kaiser Family Foundation, for instance, found that 23% of respondents had trouble paying medical bills within the past year. Of these, 61% had health insurance.

At the Health Insurance and Managed Care “B” Committee, Karen Ignagni, president and CEO of America’s Health Insurance Plans, outlined a blueprint to address “health care challenges.”

Ignagni urged state policymakers to allow for greater flexibility in product designs and to harmonize regulations to create greater competition.

The issue of health care was raised at the commissioners’ roundtable session at the winter meeting and no doubt will continue to come up in 2006.

The new Medicare prescription drug plan alone is keeping many commissioners busy trying to answer questions or at least direct consumers to where they can get answers.

Jorge Gomez, Wisconsin insurance commissioner, said his department is receiving complaints about the new PDPs and how they are being cross-marketed with other products. The dialogue between the NAIC and representatives of the Center for Medicare & Medicaid Services is a positive and will continue in 2006, he said.

Other commissioners are weighing in on how to start tackling the health care issue.

Sandy Praeger, Kansas insurance commissioner and NAIC vice president, said that if the system of state regulation can be streamlined so that competitive, new products can be brought to market more quickly, then that will be a concrete way regulators can help alleviate the rise in health care costs.

Joel Ario, Oregon insurance administrator, said making health care costs more transparent is one way to start talking about the cost and availability of health care.

This collective awakening to the health care crisis on the part of state regulators is welcome. As the regulators closest to health care consumers, insurance commissioners bring valuable experience and knowledge to the table.

But now it’s time for action: more streamlined regulation; greater partnership with consumer advocates and the health care industry; and stricter enforcement of bad actors.

Talk by itself is just not going to do much for the hard-luck stories that are becoming way too common.