June 22, 2009
Breaking down the Blue Cross talking points, part I
Despite a new poll showing that 72 percent of Americans want a public health plan competing with private insurance companies for business, Blue Cross and Blue Shield opposes the idea.
Most talk of health reform includes the idea of an individual mandate, which health insurance companies heartily endorse, as it will drive a huge number of people to their companies. Currently, Blue Cross has little competition in the state. That means that when individuals are required to buy insurance many will purchase plans through Blue Cross. If a public plan is available it will introduce some competition into the mix, and Blue Cross has been spent millions over the years to buy political influence so that it can squash competition not by offering superior service but by rigging the system.
Naturally, Blue Cross does not mention any of this on its anti-reform website. Under “Government-run Health Insurance” Blue Cross has a mishmash of misleading claims meant to scare people. Let’s take a closer look.
The first claim on the website is that a public plan will make it more difficult for people to find a doctor because government plans reimburse at a lower rate than commercial insurers.
But the problem with primary care shortages has more to do with the fact that primary care docs get paid less than specialists. Primary care physicians also have to spend a great deal of time and money on administration instead of sitting with patients. This has nothing to do with commercial versus government insurance. Instead, it relates to prioritizing primary care in health reform proposals.
The federal government should lead the way in reimbursing doctors for spending time with patients and taking phone calls and answering email. There should also be money included for training new physicians.
Under the title “less innovation” the Blue Cross website claims that private insurers are “leading efforts” to curb costs and create new models of care delivery. Private companies, Blue Cross says, are developing new payment methods that “reward quality and value” over “the number of procedures.”
The site then links to two programs, Bridges to Excellence and NC Center for Hospital Quality and Patient Safety, that don’t really do what Blue Cross claims. Both are admirable programs. But Bridges to Excellence pays doctors for quality care on top of the normal fee-for-service payments. Apparently Blue Cross doesn’t think that doctors try all that hard to provide quality care unless you pay them more. And the NC Center for Hospital Quality and Patient Safety tracks quality data but is hardly a new payment scheme.
Private insurers, we are also told, are implementing chronic care management programs and health information technology. Welcome to the party private insurance companies! North Carolina’s Medicaid program has operated a chronic care management program for years, known as Community Care of North Carolina, which is a national model. And the Veteran’s Health Administration began implementing comprehensive health information technology in 2001.
But you really have to read the entire page until the last sentence, when you finally get at what’s bugging Blue Cross CEO Bob Greczyn. It reads:
“Ultimately private insurers simply could not compete with a heavily advantaged government plan and would go out of business, further eliminating the options for those seeking a plan that fits their needs.”
Blue Cross, which got a no-bid $100 million contract to administer the State Health Plan, apparently does not want anyone else getting special advantages.
There is another revealing sentence on the Blue Cross website:
“To begin with, more than 100 million people could be shifted into such a [public] program immediately.”
I like that passive construction, as if people will “be shifted” into a public health insurance plan. In reality, people will not “be shifted,” they will choose to shift if they don’t like their current insurance coverage. Then Blue Cross will have to offer competitive prices or better service to woo them back. Blue Cross just doesn’t want that kind of competition.
So the Blue Cross talking points, not surprisingly, are bunk. But it’s always helpful to show how the company is standing in the way of reform. Remember, Bob Greczyn has 4 million reasons to oppose any changes to our current health care system.
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5 Comments Add yours »
[...] Most talk of health reform includes the idea of an individual mandate, which health insurance companies heartily endorse, as it will drive a huge number of people to their companies. Currently, Blue Cross has little competition in the state. That means that when individuals are required to buy insurance many will purchase plans through Blue CrossRead more at http://pulse.ncpolicywatch.org/2009/06/22/breaking-down-the-blue-cross-talking-points-part-i/ [...]
The point of an individual mandate is that it allows relaxation of underwriting guidelines because more healthy folks will enter the system, helping to subsidize the costs of the sick.
If you guarantee acceptance to anyone without that individual mandate, then people have no reason to buy coverage until they get sick. That’s like buying homeowners insurance only when a hurricane gets to the end of your driveway. Obviously, that’s not a sustainable model.
Adam, what would YOU do — offer community rating without a mandate? Explain to me how that would not inevitably lead to adverse selection and a cost spiral for the sickest individuals.
We’d obviously like people to be required to purchase coverage – at an affordable price tied to their income – but to have a choice of health plans. Right now, there is little choice in North Carolina except for Blue Cross and a public health plan option would go a long way to solving that problem.
A individual mandate without competition means a profit mandate for NC Blue Cross. Besides, CEO Bob Greczyn doesn’t think reform will happen for another 5-10 years and is “having a lot of fun” with the debate right now apparently. Guess it’s easy to “have fun” when you don’t have any real competition for your business and you make so many millions of dollars a year that no one in your family will ever have to worry about not being able to afford health care.
[...] Most talk of health reform includes the idea of an individual mandate, which health insurance companies heartily endorse, as it will drive a huge number of people to their companies. Currently, Blue Cross has little competition in the state. That means that when individuals are required to buy insurance many will purchase plans through Blue CrossRead more at http://pulse.ncpolicywatch.org/2009/06/22/breaking-down-the-blue-cross-talking-points-part-i/ [...]
Middle Road, everyone understands why an individual mandate is necessary. Of course it’s needed. The point is that insurance companies support it b/c it will mean a flood of new customers. The problem is that they strongly reject any of the other parts of health reform that must accompany an individual mandate like community rating, public option, increased regulation etc.