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Exchange Builders Confront the Terror

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Many consumers really, really hate shopping for health insurance, according to Lynn Quincy, a senior health policy analyst at Consumers Union.

The Institute of Medicine, Washington, a federal advisory panel, has included a summary of a presentation by Quincy in a preliminary account of a recent conference on health insurance distribution exchange construction.

Quincy talked about health insurance shopping phobia.

The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for states to set up health insurance exchanges, or Web-based health insurance supermarkets, for individuals and small groups by 2014. Massachusetts and Utah already have state-organized exchanges, and several private companies have set up online health insurance supermarkets.

IOM conference speakers discussed ways to help consumers understand and make meaningful comparisons of health plan options.

Quincy said Consumers Union, Yonkers, N.Y., has conducted two studies on how consumers react to proposed health insurance disclosure forms and a third study on how consumers react to efforts to explain how much “actuarial value” a plan provides.

Consumers Union found that “consumers dread shopping for health insurance,” staff members of the IOM’s parent, the National Academy of Sciences (NAS), Washington, write in the summary of Quincy’s presentation.

When Consumers Union conducted one study, “one participant became so anxious that he almost left upon learning that the focus group session related to health insurance,”  the NAS staff says. “One focus group participated stated, ‘I think medical insurance is probably one of the hardest things for me that I shop for. And I think it’s one of the hardest things to figure out what’s covered.’”

Quincy said exchange designers have to try to minimize the aspects of the experience that cause dread.

Quincy said consumers also have trouble understanding the difference between using health coverage as a form of prepaid health care and using health coverage to insure against unexpected crises.

Consumers’ level of insurance ignorance means exchanges will have to work hard to provide basic insurance education in manageable bites, Quincy said.

She said exchange builders could demonstrate the value of health insurance by, for example, showing how much health care really costs and how much a health plan would pay for a consumer who was facing a very serious illness.


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