Ken Block: A Painful Lesson in Rhode Island Health Insurance
My dermatologist dumped me this past Monday.
I was fairly new to her practice. Due to too many sunburns as a youngster, I need to see a dermatologist every three months. My previous dermatologist of many years had left the state, leaving me scrambling to find a doc who could take me right away. Many dermatologists don’t take new patients or make you wait a year for your first appointment.
My dermatologist dumped me because my health insurance carrier changed from Blue Cross/Blue Shield of RI (BCBSRI) to United Health Care (UHC). On the day of my appointment, the receptionist took one look at my sparkling new health card and snarkily informed me that her office does not accept UHC coverage.
The fact that a doctor’s office accepts insurance coverage from one carrier and not another is understandable. It is a bit bewildering that a doctor’s office would not accept coverage from one of the largest insurance carriers in the United States — one of only three operating in the state.
As an employer, I was forced to change from BCBSRI to UHC due to cost; my annual renewal premium jumped almost 25% with BCBSRI. I asked for quotes from three carriers for my eight employees. Tufts is newly returned to the market after an absence of many years and came in 5% higher than BCBSRI, which in turn came in 5% higher than UHC.
How is it possible that a state-chartered non-profit like BCBSRI comes in higher for annual premiums than a for-profit carrier? You have to figure that the for-profit outfit is looking for 20% margins or so, which should translate into a significant rate advantage for the non-profit, and therefore a far less expensive cost for the purchaser of the insurance. Is the brand new skyscraper being constructed in downtown Providence for BCBSRI being financed by what I can only call over-charging for their services?
A large chunk of this year’s premium increase was courtesy of our General Assembly, which decided to abolish the “healthy company” discount given to companies that used their health insurance less frequently than “less healthy” companies.
Isn’t the whole point of insurance to price a policy based on the likelihood of that policy being used or not? Now, the pricing for all small businesses in RI, regardless of carrier, is determined based on the entire pool of covered employees of small businesses. Call this semi-socialized health insurance — whose net effect was a monster price hike for my company’s coverage.
The General Assembly has passed mountains of health insurance regulations, many of which directly interfere with an insurance company’s ability to operate profitably in the state. This is one of the main reasons that Rhode Island has such a lack of competition among carriers. This lack of competition leads to uncompetitive pricing and heavy-handed doctor tactics like refusing the insurance coverage of a large percentage of the population.
Our system of health coverage in this state is extraordinarily broken and is yet another disincentive for companies investigating moving to our state. The beaches aren’t the only place to be burned in Rhode Island.
Ken Block is the chairman of the Moderate Party of RI