How Blue Cross and Blue Shield of Nebraska
Really Cares for Its Customers (See Update below!)
[Update: A sense of fairness moves me to note that BC/BS did eventually call me back, and that they have offered me a different kind of policy that will cost less. I haven't yet had a chance to study it in detail, and this gesture does not change my general point below: health insurers have more power than the people they insure, and the representatives we elect and pay are acting more in their interests than ours. Nevertheless, I thank BC/BS for responding to my inquiry. --CFN]
In the state whose Democratic senator will likely decide the fate of healthcare reform for years to come, insurer Blue Cross and Blue Shield has helpfully released a report on the effects of reform. Costs would "soar" the insurer claims, hurting young people and small businesses.
BC/BS of Nebraska CEO Steve Martin is quoted in the Lincoln Journal Star as saying, "Our concern is that current legislation will make the problems worse for many Nebraskans."
Oh, really? That Steve Martin -- such a comedian. Here's the joke: I am a Blue Cross/Blue Shield of Nebraska customer, and guess how much my premium is going up next month: 41 percent.
What's that? Oh, I'm being told that I have the wrong Steve Martin pictured above. Here's Steve Martin of BC/BS of Nebraska:
But he's still got to be joking. See, there's more: mine is a high-deductible health insurance account. Like most people with this type of account, I never reach my deductible. I pay every penny of the cost of health care. So the cost of folks like me to the system: nada, bupkis, in short, zip. And for this, I get a 41 percent rate increase.
But it gets better. Thinking this must be a mistake, I called BC/BS to ask if this wasn't a mistake. We all know that healthcare costs are rising faster than inflation, but 41 percent? I thought maybe they got the numbers turned around; maybe it was supposed to be a 14 percent increase. That would still be more than seven times the current national rate of inflation, but at least it would be only double the rate of healthcare inflation.
I reach a customer service representative and after going through a nearly endless list of questions about who I am, I explain my concern. She listens and says she'll need to check with a supervisor. I'm put on hold for about 10 minutes, and then flipped over to voicemail. There, I leave my name and number and ask the supervisor to call me back. He or she never does.
So today, I call again, go through the same list of questions, explain my concern, and eventually reach a supervisor. She is very polite and tries to placate me by assuring me that it's not personal. I assure her that I'm paranoid, I'm just pissed off. I have reason to suspect that the insurers are gouging the public, including me, just in case they don't get their way with the legislation that now rests in Senator Ben Nelson's hands. I tell her that I'm willing to hear an explanation of why the rates of those of us who have this type of plan are going up by such an absurd amount.
She frets a bit and then decides to call in heavy artillery: the guys from "Proposals" who draw up the rates. They confer for awhile, and then I get this explanation: they haven't been able to add any new younger customers to the pool of high-deductible insured, so those of us in it have to bear the costs of those who blow through the deductible and actually draw down insurance benefits.
Since I am in my fifties, I'm at the high end of the range of increase. I'm willing to accept that, but it turns out I'm not even a standard deviation away. The average increase for people in this pool is between 37 and 38 percent.
Do you see what's wrong here? Insurance is supposed to spread risk. If only people who expect to get sick and have big medical bills get insurance, then of course costs will skyrocket. And those who don't expect to get sick and so go uninsured then add to the skyrocketing expense when they do get sick or injured. Just ask any hospital administrator what the write off for the uninsured is -- then ask what percentage of your bill goes to pay for that.
On top of all that, there is admin. Now, when I wrote that I cost the system nothing, I was not being entirely accurate. I have not drawn a dime in benefits from this policy, and I'm okay with that. It's the bargain I freely made. But I cost the system for admin, and in America that's huge. If you care to compare the admin costs of U.S. health insurers with those in other advanced countries, you will find a jaw-dropping disparity. We spend triple what Canada -- yes, "socialist" Canada -- does on healthcare administration. It's not all featherbedding. Some of it is just dumb. BC/BS sends me an endless parade of letters through the U.S. mails with messages like "Your claim for your $4 generic prescription is still being processed. We will notify you when the review is completed." Why? You're not going to pay me for it! If you have to notify me, send me an email. Lord knows you've got that and every other bit of personal info about me from my phone calls, which you record!
If only we weren't so easily fooled by scare ads, if only we could see the difference between Stalinism and Medicare, and not label both of them "socialism," maybe we Americans would get the healthcare we deserve at rates we can afford -- the way Canada, France, Germany, Japan, and Taiwan do.
But unless Nebraskans stop listening to bad jokes like the one Steve Martin cracked, it looks like that's not going to happen. Instead, we'll continue to bankrupt ourselves to pay for a wasteful, greedy, hypocritical health system. But at least there won't be federally sponsored death panels. We can thank our stars for that!
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Thomas Rogers
aliquot
Kerry Lauerman
Joan Walsh
Salon.com
Comments
if you lived in a democracy, citizen initiative would have provided a health care system as good as any long ago. that is why you don't live in a democracy. it was the intent of the constitution writers that the rich and well-connected would stay that way. they have been brilliantly successful. the best part of their success is the creation of national myths, the most important of which is that democracy wouldn't work, bur 'representative democracy' will, and it's even better.
not one american in a thousand penetrates this myth, and so you will continue to be serfs, with no hope for anything but a kind master. those whom the gods wish to destroy, they make dumb.
Clay - I feel for you Americans. We in Canada don't have to worry about insurance companies sucking every available penny out of health care. They get NADA. (Except for offering extras to those who want them by side arrangements.) And the government bureaucracy processing claims don't decide whether or not any specific procedure is needed - they have caps for payments to doctors or for hospitals, but up to that cap they simply reimburse the doctors and hospitals for bills presented to them. Lot of time and expense saved right there (and decisions about medical procedures are left to medical professionals and patients). I can only wish that Americans could have our system - or that of any of the other industrialized nations.
I recently got the yearly report from my medical insurance company telling of changes for the year 2010. Here's what it says:
The maximum out-of-pocket expense will be up 36%. Copayment for inpatient hospital care : up 25%. Copayment for a primary physician: up 50%. Copayments for specialists, eye exams, hearing exams, podiatry, chiropractic, or rehabilitation services: all up 40%. Copayment for generic and many name-brand drugs: up 20%.
All of the above comes after a year in which the cost-of-living did not go up. And I haven't heard about any health-insurance companies losing money in 2009.
Ed Pearlstein
For those of you who aren't familiar with Nebraska politics, Senator Ben will have to win over Republican votes to get re-elected in 2012, and to make that happen, he had to establish his independent bona fides in this crucial debate. What's left of reform looks like pretty thin gruel. Maybe some new provisions to prevent insurers from dropping their customers when they actually need the insurance, and maybe something to help young people stay on their parents insurance a little longer. But the heart of the monster that is American medicine remains untouched.
All the incentives point the wrong way. The more we pay, the more we want to get something for our money. The more tests, procedures, and prescriptions doctors perform, the more they make. And the more that Big Pharma, Big Med, and Big Insurance invests in lobbying, the more they get rewarded by Congress.
The shame of it lies not with Nelson and his colleagues, but with a supine public that is willing to be bamboozled over and over again to vote against its own interests. There was only one big potential loser in the debate over whether to import drugs -- the big pharmaceutical companies. There was only one really big potential loser in the debate over a public option -- the uncompetitive health insurers. Looks like they turned those threats around by scaring the socks off the voting public. So, along with the rest of you suckers, I'll be handing over more and more of my paycheck to the insurers. P.T. Barnum must be chuckling in his grave.
-- Clay