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Saturday, December 5, 2009

What my Mortgage Refinance experience will teach us about Health Care Reform

Both of my dedicated readers (Hi Mom and Dad) may remember my experience refinancing our house and the lack-of-value-chain that the participants created. One link that I forgot to mention was the assessment process. Previously, the assessed value of the house always seemed to be exactly what the lender needed to justify the loan. Now, there is a third party system that schedules the assessments and keeps the lender at arm's length. This system was created per regulations by some entity to address abuses.

Apparently, it doesn't work that well. My lender complained about it and I wound up having two assessors call me to schedule times and some confusion was created. Further confusion was created when one of the third parties that scheduled the assessment told me that they hadn't been paid yet. However, I had been charged for the assessment by a different entity and my lender said they would figure it out. Based on the confusion from two assessors calling me, I actually think the wrong third party got paid. However, the technical term for that is "Not my problem."

A new regulated entity usually has some problems in the beginning that need to be worked out. Unfortunately, there is never a honeymoon period with new regulations where the impacted parties snuggle in bed together until the early afternoon. Even programs that involved giving away money like cash for clunkers or the first home buy tax credit had complaints about processing and turn-around times.

This is a long of making the point that when health insurance reform smacks us all across the face in 2013 or 2014, there will be an adjustment period. Someone will think they should have their dental implants covered and won't get them. Others will think that they should be paid for services and won't get paid for a while. The Health Care Exchanges that will open the much anticipated market bazaar for small groups and individuals will probably have the purchasing experience of a bizarre bazaar. The Exchanges are where previously uninsured individuals can use their government subsidies to buy insurance for the probably the first time in a long time so difficulties with navigating the Exchange will be heard loudly. Frustration is the gap between expectations and reality and expectations will be high. Reality will be lower and it will sound like long awaited health insurance reform is a clunker.

Therefore, we need to adjust our expectations about health care reform and give it time to work out the kinks. The last large government-pushed health care reform was the Medicare Modernization Act that brought seniors Part D or prescription drug coverage that was implemented in 2006. Today 90% of seniors are satisfied with this plan. This is up from 80% the year after it was first launched.

Despite a higher satisfaction rates than most Apple products have, the initial launch was almost a disaster. There were long wait times on the phone and confusion about whether drugs were still covered by Medicaid, the state program, for low income seniors. I was working overtime as a Spanish interpreter helping Spanish speaking seniors and health plan customer service speak to each other about prescription drug coverage. These calls involved my interpreting a long list of drug and dosage to help seniors find the drug plans that worked best for them. Try figuring out how to say Atenolol in Spanish or English. These calls were long (45 minutes) and painful to all involved. Although the start was as inauspicious as some new reality TV programs, the program was ultimately successful.

Health insurance reform is likely something that will be my problem and I'm getting ready for the disaster of a launch. However, it will be better than our current system.

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