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Major American health insurance companies are sweating bullets these days. With a potential public option for health care on the table from President Obama, the big agencies that provide coverage would have serious competition should his plan be signed into law.

Which is exactly why the President wants to provide such a plan. But now it's getting even worse. According to The Washington Post, a recent report released by the staff of Senate Commerce Committee finds that health insurance companies have "forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid."

How so? Mostly it involves those consumers who pay extra for the luxury of going outside their network for doctors and treatments. Insurance companies usually pay a percentage for what they call "usual and customary" rates for services.

And of course, they get to decide what is "usual and customary," which tends to be quite a bit lower than it should be when major health insurance companies are footing the bill.

This is just one more reason why consumers have to pay close attention to every detail when it comes to their health and health insurance coverage.

Whether or not a public plan will be devised by the end of the year remains to be seen, but let's hope that if it does, it won't involve lengthy and complicated application forms, or long-winded agreements that can leave consumers in the dark and out of luck.