Sunday, September 16, 2007

Open Enrollment - Picking Health Insurance As If Your Life Depended On It

It's that time again, and every year I dread this activity almost as much as April 15, or trying to find my wife the "perfect" Christmas gift. Typically, autumn is open-enrollment time for choosing a health-insurance plan. Though we gripe about increasing out-of-pocket costs, for most of us, health insurance is a hassle, a formality and not worthy of much attention.

But we could be dead wrong. Unlike other products and services we purchase, health insurance makes it difficult for consumers to adequately determine whether it is worth their hard-earned dollars. As a result, many of us chose the plans based on cost or whether our doctors participate in the plan. This ignorance could cost you your life.

The National Committee of Quality Assurance estimated that in 2005, 83, 000 Americans (nearly twice the number who died of breast-cancer) died prematurely -- because the simple things like controlling high blood pressure, lowering cholesterol and managing diabetes to levels recommended by the American Heart Association or the American Diabetes Association were not done.

The performance gap between the top 10 percent of health plans with the national average on measures like breast-cancer screening, advising patients to quit smoking, immunization rates for flu shots, exceeded 20 percent. For the airline industry, banking, and manufacturing, the quality gap was less than 1 percent. Would you be worried about flying if you knew the safety performance between the best and average was 20 percent. When it comes to health care, consumers erroneously assume that all health plans are created equal.

An additional frightening fact is that only 25 percent of all insured Americans have health plans that voluntarily provided their performance data for review by the NCQA . Only this recently have PPOs (preferred provider organizations) started to submit their performance on these basic, yet important preventive measures. It is possible that you still have a chance of not knowing whether you're choosing a poor-quality health plan this year.

What can you do? You aren't completely powerless. First, check out the NCQA website and see if your health-plan options are accredited and approved by NCQA for providing high-quality health care. If not, consider talking to your human resources department and getting NCQA accredited programs on your roster next year. It's your money. Don't you deserve the best value and quality?

Next, take charge of your health now, get the overdue preventive screening tests done, and work with your doctor on getting the right treatment, not necessarily the newest.

Finally, do the boring but simple stuff: Get control of your blood pressure, lose weight, lower your cholesterol and stay active. These interventions really do save lives. With hard work and some luck, you might just be around long enough to see an American health-care system that is known not as the most expensive, but the best at promoting a healthy and productive quality of life for us all.

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