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Consensus Commentary

Jul 28, 2004

Health insurance firms must undergo changes
Ventura County Star

by Leigh Williford

As I have followed the merger between WellPoint Health Networks Inc. and Anthem Inc., I have realized that these two companies are not the only abusers in the health insurance industry. Every person who pays for health insurance with any carrier, even Medicare, is affected.

We all pay exorbitant premiums that include overpriced deductibles, co-insurance and co-payments. Yet, we receive less-than-adequate benefits, and we will not get the medical treatment needed because we do not have the money.

How many of you have had to change doctors because the one you had and trusted no longer contracted with your health insurance company and going out of "network" would cost a small fortune?

Do some of you ask yourself, should I fill this prescription or eat? What about, can I live a little longer without getting that treatment because I just cannot afford it right now?

Doctors suffer as well. I am not only a patient, I am also employed in the medical field. So I see the destruction that health insurance companies and Medicare are doing not only to policyholders but also to providers of service.

The policyholder pays huge amounts of money to the health insurance company with the understanding that this money is being used to pay the provider. But health insurance companies are notorious for holding on to the money, earning interest on it. I know because professionally I interact with them every day.

We are being led to believe there is a healthcare problem in this country, when in fact this country has excellent healthcare, with new challenges being met every day.

If Anthem has $16 billion and CEO Leonard Schaeffer is getting $82.3 million plus stock options as severance on top of $11.6 million last year in bonuses, the problem is not with healthcare.

The problem is with health insurance company executives and the dollar. It is about us overpaying for the product they sell and getting less- than-satisfactory benefits in return.

It is about us paying huge premiums, co-insurance, co-payments and out-of-pocket costs while our doctors have to fight to get paid and sometimes lose or get paid less and executives of these companies reap all the money, our money.

This is also about public apathy. I find it very frustrating that Americans just do not care, and will not educate themselves to understand the whole picture. Are you now asking yourself, "How can they do this?" The answer is because nobody says they can't.

I don't accept this and neither should you. All Americans need to start caring about what health insurance companies are getting away with. The "I don't care" attitude is simply not acceptable.

Whether you have an HMO, PPO or Medicare, you have a voice. You need to start using it. Regulations need to be made across the board, not only in California, but also in America. This country needs to wake up, stop being victims and realize we are not getting what we pay for.

An example needs to be made. The health insurance industry needs to be made to change. Pick up the phone, write a letter or send an e-mail to the governor, your congressman, your state senator and Assembly person, the newspapers.

Tell them: "My issues are high-priced executives; high premiums with lousy benefits; blatant excuses for not paying providers."

Ask them: "Who regulates what a health insurance company can charge in premiums versus how much of my money these overpriced executives are stuffing into their pockets? Are you the person who has the power, ability and courage to change the business standards of health insurance companies?"

Someone needs to step up to the plate and take a risk at making a difference. This country was formed in unity and needs to stand united.

-- Leigh Williford lives in Simi Valley.