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Startup business helps individuals understand health care issues

If you've lost your health insurance in a layoff . . . • If you're confused about which retirement health plan you should take . . . • If you're buried under hospital bills and don't know what to do next . . . • Steve Luptak feels your pain. • Better than that, Luptak might be able to help.

Luptak is a member of a growing cottage industry. He has started a business — which he wants to turn into a nonprofit agency — to help people navigate the confusing waters of health insurance and health care costs.

"Every part to the health care financing encounter has high-paid consultants working for them — insurance companies, hospitals, HMOs — and I've worked for some of them over a 35-year career," Luptak said. "But there's usually nobody representing the consumer with the same level of advocacy."

Filling a need

After retiring from a health care industry job a few years ago in Memphis, Luptak started helping, for a fee, people who had problems getting health insurance or negotiating medical bills. By charging those who could afford to pay, he was able to help others for free. He's trying to duplicate that concept now in Kansas City. Mo., where he and his wife moved recently to be closer to his mother-in-law, who has Alzheimer's.

"I'm doing a lot of pro bono work to get off the ground, and that's okay for a while, anyway. I consider this my mission," Luptak said of his startup, Healthcare Advocacy. (You can find him online at www.HealthcareAdvocacy.org.)

"I've gotten to be very efficient at analyzing health insurance," Luptak said. "For a basic fee of about $200, I can do an initial evaluation — what coverage do you have? What coverage do you need? Or I can charge a contingency fee if I negotiate down your medical bills and get hospitals or insurance companies to write off some of your debt."

Providing such services to consumers isn't nearly as lucrative as consulting for corporate clients, "but there's a desperate need for what I do," Luptak said. "Most people just don't have the background to understand the complicated fine print of insurance policies and hospital billings."

'An insane system'

Luptak said he sees a lot of need among workers who have been laid off and don't know what options exist to maintain health insurance. For many, he said, COBRA, even though it's expensive, is the answer.

"My experience is that many, many people can't get coverage on their own on the open market because of pre-existing conditions," he said. "Unless you're a young person with virtually no health history, you might have horrible trouble finding something affordable."

Luptak said the seeds of his "mission" were planted several years ago when he was an expert witness in a lawsuit against an insurance company. The insurer had rescinded a woman's health insurance retroactively when she filed claims connected to ovarian cancer.

"The case basically was laughed out of court because the insurance company said she'd lied on her application, that she'd failed to list that she'd had acne.

"They canceled her policy and refunded several hundred dollars of premium rather than paying hundreds of thousands for her ovarian cancer treatments.

"It became clear to me that this is really an insane system that's evolved to a race toward the bottom — the bottom line. The goal has become profits and return on investments rather than helping people, and I want to help change that."

Startup business helps individuals understand health care issues 01/30/09 [Last modified: Friday, January 30, 2009 11:02am]
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