Real Grassroots and Why the folks in DC are Underestimating the Support for Reform with Public Health Care

We just went through open enrollment on my health insurance. I probably have what get's labeled in the media these days as "really good health insurance". But before the annual 'open enrollment', every year businesses have to go back and renegotiate health insurance coverage, securing rates and renegotiating what is covered and what isn't.

In a perfect world (like the one portrayed in the media-spin of the anti-healthcare reform), the open enrollment transition would be seamless, but in reality, it isn't. Even as you move from coverage year to coverage year, aspects of your insurance coverage changes.

Consider this quote from an actual letter that I received today:

Our records indicate that you recently filled a prescription for Fill-in-the-blank-medicine. You will need to discuss one of the different prescription options listed above with the health care professional who wrote your prescription. He/she has been notified of this change.

Just for fun, I'm going to list some of the arguments that that this letter debunks.

• We don't want health care reform because we don't want the government coming between you and your doctor.
• What difference does it make? The medicines are all the same, right?
• "We appreciate the opportunity to serve you and strive to provide the best customer service and the highest quality benefit plans for you and your family members." (quote from the first paragraph of the letter)

Imagine if you were a manufacturer, and once a year, your supplier said, "I've decided to switch you from 10mm bolts to 7/16" bolts. They are almost the same size. You won't be able to tell the difference."

Why It's Viral and the Folks in DC Don't Get It
One letter, one medicine, one time. That's my story today. But think about how many people get these, have gotten these letters -- not just at open enrollment, but also when they get a new prescription. For me, it was frustrating enough to prompt me to write this post. It wasn't frustrating enough to publish a blog saying Fill-in-the-blank health insurance provider sucks. But I haven't had to talk to them on the phone yet. I haven't had to go through customer service, trying to explain why, after years of taking these medicines, this one works and the other one doesn't -- having to prove it to them, once again. Just like the other medicine and the last insurance company. Or the time before that.

Now imagine how many people have been affected by this same kind of thing. Or worse. Sure, it may just be a minor nuisance, but it's one of those straws that add up in terms of brand perception. And, in that way, there's an aspect of the whole health insurance that gets grouped together into a collective brand. And while twenty years ago, there was probably a percentage of people who were willing to buy into the idea that "the industry may be bad, but mine's okay", what we've seen play time and time again is that they really are all the same. At least in terms of their bad behavior.

On one level, forcing you to switch medicines could be put on the level of a restaurant that only carries Coke or Pepsi. You can probably put up with that choice for one meal, but if you've gained any sense of connection to your brand (assuming that the products were essentially equal), you're still likely to be resistant to being forced into a long term switch. Now imagine if you had worked with a 'highly trained, soft drink professional' who carefully matched your drink to a list of requirements. In that scenario, most people won't just be 'slightly irritated', they'll be building a level of anger and resentment that will be hard to quell.

What's more, think about the underlying reason for imposing this switch. It isn't because the product that you're choosing is no longer available or difficult to get. In fact, it isn't done with any sense of customer focus or customer awareness -- it's done simply because they have negotiated better rates with a different set of medicines and they can earn larger profits by forcing a switch. And they are going to force this upon you because you don't have a real choice.

Closing Thoughts
If the health insurance industry was really a competitive marketplace and their goal was to "win" customers, then you would probably have a handful (or at least one) insurance company with a standout reputation and brand ID. As sucky as most airlines treat customers, you still hear about standout companies like Singapore Airlines, companies that deliver on their 'commitment to customer service' message, that really WOW customers and generate real word of mouth.

For the health insurance industry, people are like gasoline in your car -- an expendable resource designed to take you to a destination (destination profits). If you know one that's generating real WOM buzz, let me know -- I'd love to find out that I'm wrong. Ultimately though, I don't think that there is an organization like that -- and I think the awareness of that fact is much broader than people realize. And that's why, when this current 'racket' with the health insurance industry starts to collapse, it's going to fall hard. Whatever they do, they haven't done anything to earn any brand loyalty.