To the Editor:
On August 17 the Providence Journal reported that the Office of the Health Insurance Commissioner (OHIC) approved rate increases for the health insurance companies in the state of Rhode Island. A more in depth article regarding this topic was printed in the Warwick Beacon on Thursday, August 31st. I suppose that it should be no surprise to employers and consumers that premiums are going up yet again. We have all seen our premiums for health insurance increase year after year. Additionally, we have seen our coverage for care diminish over the years, and our deductibles increase. In the Beacon’s article, the insurance commissioner states “there was no fluff.” I beg to differ with that statement, and here is why:
l “Requested increases were largely made to cover projected increases in the medical expenses of insured members “particularly prescription drug costs and the use of outpatient services.” This quote from the Commissioner makes no sense. First, how can prescription drug costs be going up? We all know that if we require a prescription that we have to get a generic prescription, otherwise, the insurance company will deny coverage for brand name drugs. Additionally, specific to the use of outpatient services, how does that factor in as they are the cheapest type of treatment?
l “With the state’s aging population, Ganim doesn’t hold out hope for a reduction in rates.” Again, I am perplexed by this quote. The premiums that are increasing are for the commercial population. This has nothing to do with Medicare. Additionally, just because a population is “older” does not mean that naturally need to be sicker.
l “Primary care investments, particularly in the patient-centered medical home model have led to reductions in inpatient admissions and have improved the quality of care.” This statement absolutely makes no sense. If your inpatient admissions have gone down, and the quality of care has improved, then the rates should be trending downward not upwards.
l When referring to patient centered medical homes (PCMH), the commissioner explained the “home” as centered on primary care physician who, with other group of other professionals can tailor a plan to maintain good health and avert most costly intervention. So certainly the average employer or consumer would not even understand what this means. At the end of the day, a PCMH is the coordination of care, which is a standard of care, and should be happening anyway. Additionally, we already had that model in Rhode Island; remember RIGHA?
l “We view a strong primary care infrastructure as necessary to improving quality and affordability.” Well, this is certainly true, however, why is it that the primary care physicians have been and continue to be poorly paid by health insurance companies?
Rhode Island consumers and employers please do not be fooled by the explanation given for the rate increase. In essence, this is another back-handed tax to all of us as the insurance will pass this cost down to us. Health insurance companies increase rates, for one reason only, and that is profits.
Diane L. Marolla, LICSW