The health care reform debate rages on in Washington, D.C. News and advocacy on the issue is everywhere. The most recent coverage I’ve seen revealed the Senate Finance Committee rejected at least two “public option” provisions to legislation. By the time this column is printed, I am certain several new developments will have taken place. Students of politics might argue that the entire health care issue is a red herring, focusing the public and policymakers on an issue that is less urgent than, say, our economy or a war… but that discussion I’ll leave for another time.

Having recently undergone a scheduled surgery, my personal observations as a patient affirm the need for health reform in our industry, and I feel I am somewhat qualified to communicate them. From the outset, I should share that I believe every citizen should be afforded health insurance of some sort. I am fortunate to be able to afford excellent coverage, for which I am grateful, but everyone deserves to have his or her basic needs met.

Yet, it’s a complicated system. PIA of New York recently asked agents their opinion on the reform effort and the response was fervent. The association’s community message boards at www.pia.org lit up with member agents voicing their opinions for and against politicians, reform and a public option.

“As a taxpayer, I know I cannot afford for the government to get involved in the Health Care crisis. If you think there are layers of bureaucracy now, wait till the government takes control. And then look at efficiencies! Is the government efficient at anything other than spending money it does not have? Please ... do not let the government take control of health care. We cannot afford it …,” said one agent post on the Web site.

On the other hand, another poster said this: “I feel there should be public and private options. There has to be an option for the uninsured to obtain reasonable coverage at a reasonable premium.”

Generally, everyone who spoke out on the PIA message boards is concerned about a messy bureaucracy, too much federal oversight and additional financial burdens on the already over-taxed small businesses. PIA National President Kenneth R. Auerbach, Esq., even weighed in on the community message boards, urging prudence in any reform. PIA National agrees with the idea that clients need better, cost effective care, but worries that the insurance industry is being blamed for opposing certain proposals—I presume—just because we are businesses.

My own experience navigating the health care system demonstrated to me just how complex it is. First, in this era where privacy is an ever-growing concern, I encountered the HIPPA waivers, which medical offices demand of patients at every junction of a medical process, and the need for tort reform. Prior to my surgery, I saw nearly 10 different specialists, and it’s because our society has become overly litigious that the threat of medical malpractice suits has turned the Hippocratic Oath into the Cover-Your-Butt Oath. Doctors understandably are practicing defensive medicine, which adds only to the cost of medical care. I went from doctor to doctor, co-pay to co-pay. At each visit, I was required to supply my name; date of birth; social security number; driver’s license; and some even asked for my mother’s maiden name. (“What if you don’t know your mother’s maiden name?” I wondered. I guess you are left for dead.)

Inefficiencies are rampant in the health care system. With the multiple doctors I saw before my surgery. I know I was given unnecessary tests. At one office visit, a specialist prescribed four tests for me; as he wrote his four prescriptions, I noticed documents on his office wall indicating his practice owned the MRI; the physical therapy unit and other technical practices to which he might send a patient for further tests or procedures. Owning such equipment is expensive and I couldn’t help but sense a conflict of interest. I refused to go to his particular MRI service as a matter of principle, but conceded the convenience for the others.

Most doctors are pretty straight, but the system as a whole is incredibly convoluted, with obstacles at every turn. No wonder the idea of “patient advocates” is so appealing. A story published a few weeks ago in The New York Times highlighted the increasing momentum of patient advocates as a career and option for patients seeking help. It talked about clinical advocacy and how this field is growing because people find it difficult to deal with the insurance process and experience confusion about claim issues. The paper profiled a retired couple on Medicare who paid $200 an hour, out of pocket for a “patient advocate.” The Times reported that some lawmakers believe improving the coordination of care would reduce costly and often unnecessary treatments and therefore are considering formalizing this role.

So it was amazing to me, when PIA pointed out that initial reform proposals, including so-called health insurance exchanges would have barred the participation of all licensed insurance agents, instead utilizing unlicensed individuals or community groups with no expertise in health insurance. Subsequently, an amendment was passed that gives explicit authority to insurance agents to sell insurance in any exchange that the legislation may create. Imagine: Individuals and businesses able to seek advice about insurance through unlicensed patient advocates, individuals or community groups, but not educated, regulated and licensed agents!

“We find it incredible that any of the healthcare bills would attempt to ban the participation of licensed, professional, independent insurance agents,” Auerbach said. “In no other area is being certified and licensed considered a disqualifying factor. That’s like saying physicians cannot have medical accreditation, attorneys cannot be members of the Bar or auto mechanics cannot be certified technicians … Professional, independent insurance agents already help their customers navigate the health insurance choices that are currently available to them. The added complexity of a reformed system will make such assistance even more critical.” Amen.

I’m happy to report that an amendment was introduced in The House, sponsored by Reps. Charlie Melancon (D-La.), Mike Ross (D-Ar.), Baron Hill (D-Ind.), Jim Matheson (D-Utah), Zack Space (D-Ohio), John Barrow (D-Ga.) and Bart Gordon (DTenn.), to ensure that agents and brokers can participate in the process. First hurdle overcome. But this example makes clear that we, as an industry must pay attention to this reform debate; and also how fortunate we are to have our associations keeping watch.