State's insurance superintendent cites need to change how industry operates

SKOWHEGAN -- Closer oversight of companies and better information for consumers -- those are among the goals from the top state official who oversees Maine's insurance industry. Without any changes, more and more people will not have the safety net they need, and that could be a matter of life and death, Mila Kofman said. "How will we explain this to future generations? To our grandchildren?" Kofman said. "There is no transparency in private health coverage. Consumers don't have enough information to make informed choices." Kofman, superintendent of the Maine Bureau of Insurance, delivered her remarks during a keynote address Sunday night at the fourth annual convention for Kennebec Valley Organization, held at the Centenary United Methodist Church in Skowhegan. About 30 people attended the event, and Kofman urged audience members to be activists on health-care issues. Kennebec Valley Organization includes religious congregations, labor union locals and community and small business groups, and its members have been pushing for the very changes Kofman talked about. Kofman's agency aims to protect the public through regulation and oversight of the insurance industry, examining companies' finances, products and policies. Before she was appointed the state's insurance superintendent in March, Kofman was an assistant research professor at the Georgetown University Health Policy Institute, leading studies on problems within the health care industry. During her talk, Kofman noted there are an estimated 47 million uninsured people in the United States and 20,000 people die each year of preventable deaths. She rattled off a laundry list of problems with private health insurance: It's largely unaffordable for lower- and middle-income people; consumers don't have access to full copies of a policy before they enroll; policy language is confusing; and benefits can be cut back even after enrollment. What to do? Expanding Maine's public insurance under Dirigo Health is probably unlikely because of state budgets shortfalls, Kofman said. But her agency will focus on several legislative initiatives, including: • Requiring insurance companies to provide full coverage contracts before enrollment and posting it on their Web sites. • Conducting a regular analysis of whether companies are complying with current laws and standards. • Investigating whether companies are unfairly targeting the elderly. To highlight the problems with private insurance, Kofman also used an example that she recently encountered: A patient with cancer needed chemotherapy treatment that cost $5,500 for a single injection. The patient's insurance covered only a maximum $1,500 each day. "If you ask me, that's not real insurance; that's not real coverage," Kofman said. "It won't save your life." Scott Monroe -- 487-3288, 861-9253 smonroe@centralmaine.com published in Morning Sentinel Monday, November 17, 2008