A View From Massachusetts...

...on the matter of signing up for health insurance via the new exchanges.

Some years back the family and I moved back to the States after a few years living in Scotland. We were young, but we had children and figured we should look into getting health coverage. (I won't even go into the shock to the system is was to have to exchange the NHS for the American... well, lack of a viable system. That's another discussion.) At that point, all we could do was get online and on the phone, calling up the companies directly. Little did I know what I was inviting.

For weeks after we got bombarded by phone calls, emails and promotional material, all trying to win us over to one plan or another. It was kinda crazy. For one, it was impossible to really tell the different plans apart and to have any idea what was in them. For another, the waste of it all was staggering. Long phone conversations that left me none the wiser. Big, glossy, photograph-heavy tomes filled with smiling people and promises of benevolent care. I couldn't help wondering how much money they were spending on all of it, and couldn't help feeling that all of it was unnecessary and wasteful.

Who did we chose? Well, we didn't. It was all too expensive for us at the time, and I didn't trust any of the plans would be there for us if we really needed them. We went uninsured for several years, until we moved out of state and were insured through several teaching jobs that I took over the next three years.

But eventually I left those and we came back to MA. A new MA, one in which Mitt Romney's healthcare reforms were in effect. Now I had to deal with the exchanges, and I had no choice but to be covered one way or another. I wasn't thrilled, but...

Man, was it clearer and more reassuring to go through the exchanges. All the information was in one place. All of it easier to understand and compare. Not hard sells and glossy photos and grand promises... Just information about what was offered, what it cost and what the details were. For a moment there I felt like they'd hired someone from Britain to design the website - meaning it made sense, was clear and un-intimidating, and actually tended to answer the questions I had.

I still think it's unfortunate that a for-profit business serves as the middle man between people and the healthcare they need, but if that has to be the law of the land I can attest to how much more efficient the system is with a bit of reasonable government oversight. At least I understand what I'm signing up for, and it feels like there's greater accountability from the insurers since the information is presented publicly and for all.

I don't know how the new exchanges are going to work nationwide, but if they're anything like my experience here... well, it ain't the system I would choose, but it's a lot better than the status quo.