August 21, 2009-Bismarck Tribune Editorial

Small groups of North Dakotans are taking part in an experiment that has them building insurance packages from scratch, choosing benefits from a menu that’s linked to cost. In the experiment, people are surveyed about “coverage for doctor and hospital visits, prescription drugs, eye exams and teeth cleanings.” Once the individual choices are made, the group then develops a list of benefits that covers the entire group.

This speaks to the mandates the North Dakota Legislature has placed on health insurance companies and policies offered in the state. It goes to the kind of possible policies in the “exchanges” being considered as a part of health care (insurance) reform. It puts the consumer in a stronger position in the discussion about what health care might look like in the future, in a very practical, grounded sort of way. This is a kind of health care discussion that makes sense.

Members of the state Legislature’s interim Industry, Business and Labor committee plan to go through the exercises when they meet next month.

The experiment, sponsored by the North Dakota Insurance Commissioner’s office, was used extensively in Montana to evaluate Insure Montana, which provides state subsidies for small businesses that want to buy insurance coverage. It has also been used in Minnesota. The experiment Choosing Healthplans All Together was developed by faculty members at the University of Michigan and the National Institute of Health.

Understanding how the benefits and costs within health insurance policies fit together gives consumers power. It sets the stage for choice. Too often people have to take the health insurance policy offered them, or that they can afford, without really addressing their needs. It’s something to keep in mind as the discussion goes forward.

And, it will be good for legislators to get a look at the consequences of mandates.

CHAT may be a gamish experiment, but what it can reveal seems important, especially during the present debate over health care reform. The Tribune has written that health care reform needs to control costs and decrease the number of people without insurance. So far on the national stage cost control has not gotten enough attention. The people who take part in the CHAT experiment will be addressing those cost issues head on.