The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Agents Need to Deliver Value — And Let People Know About It

Posted by Alan on September 29, 2007

It’s not that anyone wants to do away with agents. OK, let me rephrase that. Single payer advocates would like to do away with agents. They also want to do away with insurance companies, too, so it would be wrong to take this personally. Most of the folks working on health care reform don’t think that way. In fact, part of the problem is they don’t think think about agents — and the value we add to the system — much at all. As a result, a lot of the reform proposals out there are likely to eliminate agents and brokers from certain market segments,  or at the very least, greatly diminish what we can contribute. This isn’t intentional, but it could be the result. And, of course, from the squirrel’s rabbits point of view, whether the truck runs them over intentionally or inadvertently, it’s still roadkill.

But it’s not only the truck’s fault. As insurance professionals we need to take responsibility for selling our value. And for earning it every day in our interactions with our clients.

Ross Pendergraft, who is Media Relations Chair for the Los Angeles Association of Health Underwriters recently circulated an email which is spot on, so much so, I’ve reprinted it below. (For those who aren’t aware of the background, Oprah devoted a recent show to health care reform. Her guests included Michael Moore, director of the film Sicko,and Karen Ignagni, president and CEO of America’s Health Insurance Plans, a trade organization. NAHU is the National Association of Health Underwriters, a professional organization representing insurance agents and brokers). 


After viewing The Oprah Winfrey Show, “Sick in America: It Can Happen to You,” I have a NAHU challenge. The America public needs to know that there are Health Insurance Agents able to assist people with their insurance claims especially when they are too sick and vulnerable.

Case in point: 1. The Oprah show highlighted three individuals with severe medical conditions, each having a battle with their insurance carrier. There was not one single mention that a Health Insurance Agent could have assisted these individuals with their ordeal. 2. Karen Ignagni, president of America’s Health Insurance Plans, in her commanding performance supporting the health insurance industry, never once mentioned anything about a Health Insurance Agent and the support the agent could have provided.

I would encourage everyone to read the transcript from the show (Summary of Oprah program, “Sick in America: It Can Happen to You) and, better yet, to watch the show.

When I watched the movie Sicko I was extremely disturbed by the many half-truths that Michael Moore broadcast leaving me very little respect for Mr. Moore. However, I have to say after watching Oprah, I found myself starting to resonate with some of the beliefs that Michael Moore has with regards to our country’s health care problem.

Rather than accept my comments, go to the Oprah Message Board and see what the American public has to say after viewing the show. I would also encourage all health insurance agents to respond to the Oprah show.

I love this from the show: Although Karen Ignagni admits that America’s current health care system has its faults, she says a government takeover is not the answer. “There’s no perfect system. What we need to do is craft something that’s uniquely American. We have to take responsibility in insurance plans of doing a better job dealing with mistakes, dealing with people who are falling in the cracks, good physicians and good hospitals,” she says.

Ross Pendergraft


Agents can make a huge difference in the health care outcomes for their clients. We serve as counselors when consumers shop for coverage and advocates when they encounter problems. Both NAHU and CAHU strive hard to get this message out to decision makers and opinion shapers. The reality is, however, that every agent needs to take responsibility for delivering this message. It starts with asking the question, “Do I add value to the products I sell?” If the answer is “yes,” then make sure your clients — and their legislators — know (CAHU’s current Operation Drumbeat communication provides a sample letter your clients can use as a starting point). If the answer is “no,” then it’s time to turn your business over to an agent who can provide meaningful services to your client or to change your ways before legislators, inadvertently or not, changes your business for you.


5 Responses to “Agents Need to Deliver Value — And Let People Know About It”

  1. Matt said

    I am new to Insurance and from what I see Brokers and Agents are a great asset to any business that needs insurance. We are knowledgeable and try to help people. Not every broker, just like not ever doctor, is going to excel at not wasting time, effort and oxygen.

  2. Mike Lugo said

    I am sure Dr. Ammon could say the same about some of his fellow colleages!

    As is true with any profession, there are a few bad appples, but the vast majority of agents bring a great deal of value to the delivery of health care.

    In the USA, one size does not fit all. The private sector delivers a system that addresses the fact people want choice!! Every family, business or individual who purchases insurance has a variety of different needs when it comes to their insurance program. The agent helps the consumer sort thru the many options that are available throgh a competitive market. They also stay involved by assiting their customers when they have a question or issue that may come up with their plan.

    The Agent is the one person that usually is entrusted to make sure that promises that are made are promises that are kept. Try getting the same level of service and involvment from any government run system.

    Dr. Ammon, quite the contrary, we are not behind the scenes as you suggest, we are out front making sure our clients are being taken care of and given the proper advice and counsel when it comes to their insurance coverage.

    If you are not getting that kind of service, maybe you need a new agent. That is what I do when my Doctor does not meet my expectaions, I find a new one who “is not a waste of my time, effort and oxygen”

  3. Too bad Dr. Ammon feels that way about agents. I can’t imagine most of my clients would defend his view of our business. When a client who has always had an HMO asked me to help, I switched him to an HSA plan with a family out-of-pocket maximum of $3.000. This resulted in a savings of $11,000 in premium. Even maxing out the out-of-pocket he was $8000 ahead. He bought lunch.

    Another example: a client’s employee called to ask if the policy would cover replacing a leg prosthesis because her’s was wearing out. I got a claims manger on the phone to inquire about exceptions. We had her physician carefully word a statement as to a change in her structure and got the claim paid.

    Stanford hospital was going to sue a client because he gave them the wrong ID card. His company just changed carriers. They said they only bill once. I got a supervisor on the phone and told them it made no sense to send it to collection and discount the claim where they could collect it all by resending to the right carrier. I saved Stanford money and kept the client’s credit rating high.

    I coached my next door neighbor on how to negotiate with a CalPers carrier to allow him to be treated out of state for multiple myeloma. His plan didn’t allow for out-of-state treatment. He’s currently being successfully treated at the University of Arkansas’ Multiple Myeloma Center.

    There are many more instances where I intervened on the behalf of both individual and group clients. I’m keeping this short but may provide more at another time. We may not matter to Dr.A but we matter to thousands of people who cant fend for themselves.

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  5. Based on my experience, most agents add very little value and are generally a waste of time, effort and oxygen. Being so behind the scenes, they suck a significant amount of money out of the health care system returning little. However, they provide access to a system of coverage less political than a single government payer, so they are a necessary evil. As a physician who has worked in both Canada and the US, I made the decision that an insurance master was less evil than a government one.

    The insurance sector needs reform as much anything in health care.

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