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Sunday, August 9, 2009

Consumer protections lost in health care debate

WASHINGTON – It's one issue in the health care debate

that nearly everyone — even the insurance lobby — seems to agree on: Better consumer protections are needed to end the nightmare of not being able to get covered for a treatable, if costly, illness.

Yet such practical considerations are being overlooked in a debate that's become a passionate argument about the government's reach and role in medical matters.

Experts say the bills before Congress include significant consumer protections that would end denial or cancellation of coverage for medical reasons, from high cholesterol to cancer.

Insurers no longer could base premiums on a person's medical history, although they still could charge more to 50-year-olds than to people in their 20s.

People buying their own policies, and those working for small businesses, would gain many of the advantages employees of Fortune 500 companies now have. That would eliminate "job lock," the fear of leaving employment that provides medical benefits.

"It would bring insurance and insurabilty standards into line with medical practice and with the way people live their lives," said Dallas Salisbury, president of the nonprofit Employee Benefit Research Institute. "When people are in the doctor's office, they're worried about that day's issue. You're not thinking, 'If I take this pill for my cholesterol, will it cause me to be denied insurance coverage in the future?'"

If President Barack Obama's effort to remake the health care system implodes, chances are slim that such protections could be enacted on their own. What consumer groups call discrimination by insurance companies, the industry sees as self-defense against people who put off getting coverage until they're seriously ill.

Major insurers will accept a rollback of the industry's restrictive practices only if they're guaranteed that all Americans would be covered — a central goal of Obama's approach and a potential financial boon to the industry.