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On the Third Hand: Exchange System 2.0

By Allison Bell

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The health insurance exchange in Vermont is one of the ones having technology problems.

On the one hand, in the long run, one small state’s ability to get an insurance sales website to work probably has little or nothing to do with whether the idea of having a public health insurance exchange, or any kind of health insurance exchange, is a good or bad idea.

But, of course: Vermont is one of the states that’s been famous about beating up on agents and brokers. It now requires all individuals and small groups to buy coverage through its Vermont Health Connect system. It hasn’t even tried to sugar coat its disdain for the ruffians who dare to help people buy health coverage: It magnanimously granted brokers the privilege of charging consumers $20 per person, per month, for their services, but that’s it.

Now, of course, we see stories about how Vermont still has no system in place for give the consumers who bought qualified health plans (QHPs) through the state’s exchange to make changes online.

Whether someone likes PPACA, thinks it’s a communist plot, or is actually a communist and wants a single-payer system for health care (or, maybe, for all goods and services), it seems as if the logical response to the problems facing a state like that is to think: Ha ha ha. Losers.

But, on the other hand, even nice states can have exchange system problems. Health policy makers throughout the country might be starting to think about what the PPACA Public Exchange System 2.0 might look like.

See also: PPACA version 1.5: The state editions

I was thinking the right kind of replacement might be highly mobile, rather than desktop-based.

Maybe it could be based on existing advice delivery units that use natural-language processing, learn for themselves, have the ability to hold fluid conversations with consumers, have the ability to adapt on the fly, and have the ability to meet state licensing exams. Maybe the units would also be able to tell consumers about life insurance, disability insurance and even something about personal property-casualty lines, and maybe they would volunteer for civic groups. 

Maybe they would read LifeHealthPro.com articles (or, at least, try to, when they have a few seconds to catch their advice unit breath).

The advice units would collect a variable charge of, say, a few percent of premiums — in line with what the PPACA Exchange System 1.0 managers charge for their enrollment and administrative services.

On the third hand: Wherever on Earth could health policymakers find such a flexible, affordable advice unit system? Guess I’ll have to call a health insurance broker to find out…