Health care: A change in the right direction

Winston Churchill said, "There is nothing wrong with change, as long as it's in the right direction." This past summer, Congress embarked on an effort to change the way health insurance companies operate and make improvements in our nation's health care system. As Montana's Insurance Commissioner, I believe this effort is a fundamental change in the right direction.

Our health-insurance system is broken; that's the message I hear from consumers, the medical community and, yes, even those in the insurance industry. The statistics concur. Recently, the respected American Journal of Medicine released a study showing 62 percent of all bankruptcies filed in 2007 were medically related. In fact, the article states, "Most medical debtors were well educated, owned homes, and had middle-class occupations. Three-quarters had health insurance."

A family lives behind each of those bankruptcies and deserves more than political bickering on the left and right — they deserve real change. From my perspective as Insurance Commissioner, the reform proposals in Congress will protect Montana families from losing everything to a broken system.

I believe we can agree on many of the important changes being proposed, which will make a real impact — rate authority for my office, a ban on pre-existing condition denials of coverage, and forbidding companies from denying or rescinding coverage to individuals based on their health status.

Montana is one of the states where the Insurance Commissioner does not approve rates for health insurance. Under proposed regulations, my office will finally be able to deny excessive rates for health insurance.

Second, the most discussed and agreed upon provision of reform measures is to make clear that no Montanan can be denied health insurance or charged more because of a pre-existing health condition. My office deals with appalling cases where patients are denied coverage of needed care because their insurance company determines the condition is pre-existing. No longer will consumers suffer the frustration of this practice. And, finally, health insurance policy rescissions for seriously ill policyholders will be restricted.

Will these changes make a difference? Absolutely. Just ask Katie Gibson, of Belgrade, how her life would have been different under such reforms. Katie is a recurrent cancer survivor who was told in 1995 her illness was terminal. After a decision to make a career change, she struggled to find new insurance due to a pre-existing condition.

Eventually, she found new coverage with a professional association, but months later she and her husband were informed that the cost of the policy was being increased beyond what they could afford. Obtaining new insurance coverage was not easy for Katie, as one insurance company after another refused to cover her because of her medical condition.

After finding her next policy, she was still nervous, so she waited a month before canceling her old policy. Everything seemed fine, but when she filed her first claim several months later, the new insurance company called to say they were rescinding her coverage back to the date of issue.

So now, not only was Katie without insurance, her record indicated a long lapse in coverage. Not even the high-priced association plan would take her back. Katie was in a situation of having major medical problems and no insurance coverage.

Katie's nightmare would not have happened under the reforms proposed by Sen. Max Baucus. When Congress acts and our office begins implementing these important changes, we will level the playing field for Montana families by making sure that health insurance rates are fair and ending those practices that allow insurers to take advantage of Montana insurance consumers. In my view, that's a change in the right direction.

Monica Lindeen is the Montana Commissioner of Securities and Insurance.