Study: U.S. Health Plans 'Average'

Friday, June 9th 2000, 12:00 am
By: News On 6

WASHINGTON (AP) — Americans generally give their health insurance plans good marks, even though about half report problems ranging from minor billing difficulties to being denied treatment, a new survey showed.

More people in managed care plans with lots of restrictions reported problems than people with traditional health insurance, according to a survey of 2,500 people released Wednesday by the Kaiser Family Foundation.

The report comes as Congress decides whether to pass legislation giving patients a stronger hand in dealing with health plans and managed care organizations. The Senate was expected to debate a patients' bill of rights on Thursday.

Nearly 90 percent of people in the study rated their health plans as average or better and over 80 percent said dealing with their plans had been positive.

Only 7 percent gave their plan a ``poor'' or ``failing'' grade and 15 percent said dealings with the plans had been negative.

The study suggested that people in managed care plans with lots of restrictions were less upbeat about their insurers than those in traditional fee-for-service health insurance plans.

Forty-four percent of people in plans that charged more for using outside doctors, required referrals for specialists and made beneficiaries choose primary care physicians gave their insurers a ``C'' or less. Fifty-three percent gave them an ``A'' or ``B.''

That compared with 74 percent of people with traditional insurance who gave their plans an ``A'' or ``B.'' About 24 percent rated traditional insurers as average or lower.

When it came to encountering problems with health plans, people in strict managed care plans reported more difficulties, with 62 percent saying they had a problem within the past year, compared to 49 percent in less strict managed care plans and 32 percent in traditional plans.

Drew Altman, president of the Kaiser Family Foundation, said the survey shows that the debate over patients' rights is ``grounded in real patient experiences, not just anecdotes,'' but noted that many problems are ``more hassle than horror story.''

Karen Ignani, president of the American Association of Health Plans, an HMO trade group, said the survey's findings were welcome ``because they offer health plans valuable information that they can use in identifying areas that need further attention.''