In an earlier post, we had touched upon health insurance and how it has created a doubt in the minds of consumers. Here, we re-visit this topic for a better understanding.
Let me quote verbatim from a few websites, a couple of relevant but contradictory perspectives. 1st, from the point of view of a consumer in the US -
“… My ideal world. Insurance companies are judged by honest third party intermediaries. Insurance companies compete like heck to make customers satisfied. Insurance companies monitor doctors…. and require evidence-based medicine… companies which fail at these pursuits go bankrupt or exile their CEOs to Greenland. Every year prices would fall in real terms, quality would improve, and coverage would be expanded.”
Another consumer responds. “The insurance industry may be the only private-sector institution that I trust less than government. In auto insurance, I find that unless I change providers every few years, my premiums just get ratcheted up for no reason. I think that life insurance is a huge rip-off, particularly considering that it starts out with a tremendous tax advantage.
I do not trust my fellow consumers to understand the concept of insurance well enough to make (force) insurance companies offer products that make sense. Too many consumers think that good insurance is something that provides payouts for small problems rather than protection against rare catastrophes.
In fact, as I have pointed out before, most people do not want insurance of any sort. They get homeowners' insurance to satisfy the mortgage lender. They get car insurance to satisfy the state. They get health insurance only when they think their employers are "giving" it to them. The insurance industry is heavily regulated, and it has gotten quite cozy with that arrangement.
My wife recently sought information on long-term care insurance. What I concluded is that we would be trading one risk for another. Now, we face the risk that long-term care would eat up our savings. If we had insurance, we would face the risk that the insurance company would not pay a claim, because of how it reads the fine print in the contract. I'd rather take the risk I understand …….than the risk I do not understand…….
I think that meaningful innovation in health care is more likely to come from Wal-Mart than from Aetna. …Wal-Mart is likely to be thwarted by the credentials lobbies. If practice regulations and licensing were not a factor, Wal-Mart could rely less on formal schooling and more on internal training for its medical workers. Then you would see real improvements in quality and reductions in cost.”
Counter perspective from a CEO of a new Indian Health Insurance company
“1. What are the major hurdles in the Industry in India in terms of customer perceptions and attitudes? Consumers are increasingly concerned about their health and rising healthcare costs…. this is an opportunity…. Awareness and knowledge levels of health insurance or products remain low…..Customers may not understand the benefits and the value proposition of the policy they are purchasing….not sold or serviced responsibly…..companies need to be more simple and transparent in their processes.
2. How can companies overcome these hurdles? Health insurance requires detailed explanation compared to other financial products….. Hence, need a personalized approach to help consumers make an informed decision…..by presenting information and product options in a simplistic manner…..products in turn need to be more comprehensive, transparent with minimal fine-print……Companies need to address issues related to servicing and low product innovation to successfully tackle these hurdles.
3. What kind of innovative approaches should Insurance companies adopt for a competitive edge? Approach built around service experience.…Companies have to take cognizance of the habits and needs of the consumer and build in better service delivery for both selling & servicing.
4. What role can employees in the health insurance industry play in educating the customers about health insurance? Customer service excellence holds the key….delivered by trained and motivated people, backed by technology…….
5. What are the challenges that you foresee in the Indian Health Insurance sector? …..many challenges... lack of data availability on disease and usage patterns of different socio-economic segments….most important challenge for India is the current low levels of awareness about the category among Indian consumers.”
Our take – Nobody talks about involving the various stake-holders in the process – our experience suggests that whenever you go to a hospital for treatment, response to a harmless question “Do you have insurance?” reveals two sets of charges for the same treatment! Also, should there be a stricter screening of the insured at the outset for a better assessment of the risk, which should lead to better pricing of risk? Also, given the criticality of the exercise to all concerned, is there a case for more appropriately qualified agents, instead of the prevailing “all are welcome” policy? This last measure can be furthered by structuring incentives on the basis of evidence of better disclosures measured by the claims track evidenced over long periods of time.
The key to innovation is in creating win-win solutions for all stakeholders. BTW, have you come across an agent who specializes in health insurance or a doctor who is dedicated to health insurance services? Let us know.
No comments:
Post a Comment