It’s no secret that consumer groups do not want insurance companies governing the new health insurance market in North Carolina that will be established as part of national health reform. The bill currently moving through the House establishing this market, called a health benefits exchange, allows insurers on the governing board. But there are much deeper problems with this bill and with this process.
It is the opinion of most people who do not profit from the health care system that the exchange should be governed by independent experts. We want the smartest people in the room making decisions about how to structure this new insurance market.
Instead of this model, House Bill 115 stacks the exchange’s governing board with powerful interest groups. Moreover, it essentially excludes the best health policy minds in the state.
There are seats on the exchange board for the hospital association, the medical society, insurance companies, insurance agents, a few consumers, the Chamber of Commerce, and NFIB. The only two dedicated experts on the board must have specialized knowledge of health information technology and rural health. There is no conflict language guaranteeing that these experts are independent. They could work for insurance companies.
North Carolina has the nation’s most impressive collection of health policy thinkers. Our state has some of the nation’s best public health programs and law schools and medical schools. Instead of drawing on that deep well of talent, House Bill 115 allows influence peddlers to run the exchange. There are no available board seats for people like Pam Silberman or Mark Holmes or Mark Hall, just to name a few top experts at random.
I think that is the worst part of this health exchange debate. We used to get calls from around the country asking about the NC Institute of Medicine or Community Care of North Carolina or Project Access. Now people who have read 115 call and ask what happened.
I have to tell them that I’m not entirely sure.