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Wednesday, February 13, 2008

No national health care plan can succeed unless it bans this

Posted by Jill | 7:30 AM

This is the problem with giving insurance companies a seat at the table, as Barack Obama wants to do, and this is the problem with for-profit insurance companies having any role whatsoever in any kind of national health care plan:

Citing an effort to hold down costs, health insurance giant Blue Cross wants doctors in California to report conditions it could use to cancel new patients' medical coverage, it was reported Tuesday.

The state's largest for-profit health insurer is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," the Los Angeles Times reported on its Web site.

"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," according to the letter obtained by the newspaper.

One of the conditions noted in the letter that could force a new patient to be dropped by Blue Cross - pre-existing pregnancies.

WellPoint Inc., the Indianapolis-based company that operates Blue Cross of California, said it was sending out the letters in an effort to keep costs at a minimum.

"Enrolling an applicant who did not disclose their true condition (and the condition is chronic or acute), will quickly drive increased utilization of services, which drives up costs for all members," WellPoint spokeswoman Shannon Troughton said in an e-mail to the newspaper.

"Blue Cross feels it is our responsibility to assure all records are accurate and up to date for HMO providers," she said. "We send these letters to identify members early on in the process who may not have been honest in their application."

Troughton added doctors are not required, but rather can volunteer, patients' information to Blue Cross.

Doctors were unhappy about the letter, warning that some patients might hide any medical history that could affect their prospects of receiving health insurance.

"We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Association.

Dr. Frankenstein's unfortunate (and yes, hilarious) name aside, this is reprehensible on the part of California Blue Cross. It's hardly surprising, though, because for-profit corporate health coverage providers are by definition about cost-cutting and not about providing care. That maximizing profit is their primary mission is the 800-pound gorilla in the room that no one who thinks that these companies ought to have a role in providing health care coverage seems to want to address.

The patient is at the low end of the health care totem pole. If it isn't hospitals judging your ability to pay (and do YOU believe that care won't be withheld if you can't?) it's insurance companies asking your doctors to rat you out for any of their laundry list of pre-existing conditions, including pregnancy.

This system is broken. It's broken beyond the ability of tweaking around the edges to fix. And it's certainly broken in terms of believing that a for-profit model can possibly work where if you need care, you need it. And I have no confidence that either of the Democratic candidates for president are going to do much about it.

Labels: corporatism, greed, health care

1 comments

1 Comments:

Anonymous said...

Disgusting.

I mean, where to begin?

2/13/08, 8:31 AM