Health insurance does not provide a guarantee against financial jeopardy in the event of sickness or injury, according to a new report by the Access Project and Brandeis University.
Widespread debt and access problems experienced by insured patients "represent major product failure," the authors said. The insurance industry is plagued with confusing and complex policies, routine denial of claims that should be paid and poor customer service, they said.
Among the findings: confusing insurance company policies and procedures leave patients in debt, reluctant to seek healthcare and vulnerable to scams. Shifting costs of care to patients through high deductibles, co-insurance and less-comprehensive coverage creates access and financial consequences, the report also found.
The authors said the affordability of health insurance should be judged not just on premiums but also on the costs that people will face if they get sick. Insurance companies are not being held accountable; reliance on private insurance to advance universal coverage may not solve the problems of medical debt and access to care, according to the authors. The findings are consistent with other national research and reports, the authors said.
The report was based on in-depth interviews with 45 people in seven states.