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Blue Cross Protest – Personal Story Makes it Real

Post on July 17, 2009 by Adam Searing 11 Comments »

On July 15, 2009, Cheryl Moon and Jerry Thompson joined nearly 100 people organized by the State Employees Association of NC outside NC Blue Cross’s state headquarters. Overwhelmed by medical bills because of Jerry’s recent serious chronic illness it looks like they may have to declare bankruptcy. Jerry is a 30 year state employee and Vietnam vet. This shouldn’t have to happen – we need a public health care plan option for everyone.

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Comments (Closed):11

Jeffrey Sykes
July 17, 2009 at 1:15 pm
I am sorry that Jerry had a recent chronic illness, but who do you suggest absorb the cost differential between what Jerry was charged for services rendered and the rate morally acceptable to the progressive mindset?

Where is the floor for the “morally acceptable” rate and do you believe the quality of our health care will remain the same once profitability has been removed from the equation?
Adam Searing
July 17, 2009 at 1:31 pm
The majority of personal bankruptcies in the US are caused by medical bills. The system doesn’t make any sense where, if you get seriously ill, there is a good chance you will go bankrupt – even if you have insurance.

Everyone – as Cheryl says – should pay what they can afford for health insurance. But, if you get seriously ill, that insurance should be a guarantee that all you have to worry about is getting better – not how you are going to find the money to pay for care.

That’s why we need reform. No one’s talking about removing “profit” from the system. After all, BCBS is now supposedly a “nonprofit” anyway.
Jeffrey Sykes
July 17, 2009 at 1:41 pm
The costs come from the service providers and facilities. How is government run insurance going to reduce those costs for Jerry?
Patti Ulirsch
July 17, 2009 at 1:56 pm
“Costs” are no longer representative of a real amounts when the charge for the same procedure or test can vary as much as 80%, depending on your particular plan, or being in or out of network, or far worse, having no insurance. The insurance companies have so muddled the water that you can’t clarify the “real” cost. That is why wee need a strong public option, although I personally would prefer single payer.
Jeffrey Sykes
July 17, 2009 at 4:10 pm
How will single payer or public option insurance plans reduce the costs of care for Jerry’s chronic illness?
Lou Meyers
July 17, 2009 at 5:19 pm
Echoing Patty—–How you pay sometimes seems to have more to do with costs than the actual service delivered. It’s getting so wacky that some clinics offer substantial discounts, if you prove you DON’T have insurance.

We are led to believe that insurance drives down costs when actually it tends to pump them up. Providers charge an inflated “list” price, but what they actually expect is considerably less. The uninsured that are not aware of these negotiable aspects are getting clobbered when all they are trying to do is the right thing——pay their bills! You know, even if they knew they could negotiate, maybe they are still recovering from their illness or injury and just don’t feel up to it! The madness continues!

There are a thousand questions but only one answer—single payer.
Jeffrey Sykes
July 17, 2009 at 6:35 pm
If a public financed insurance plan caps the fees they will pay a provider for a service, do you think the quality of the service will go up, down or stay the same?

Do you know any medical providers who are thinking of quitting their practice because of the unreasonably low reimbursements they receive for treating medicaid/medicare patients?

No? Single payer uber alles you say?

Viel Gluck.

You still haven’t answered how the costs of treating Jerry for a chronic illness will be reduced?

But by all means, lets continue to demonize the insurance companies.
Lou Meyers
July 17, 2009 at 9:17 pm
For starters, stop stressing Jerry out with high medical bills. With single payer, he’ll recover faster and that will lower cost of treatment. He’s paid into the system, now the system should take care of him. That is basic! How can anyone have a problem with that!

Single payer will slash administrative costs and eliminate insurance profiteering which is based on greed not sound healthcare.

Presently, “fees for service” tends to drive up costs, whereas reimbursement based on treatment and patient well being will drive them down. Clinics all over the country are dramatically lowering costs with this approach and the doctors and patients seemed to be thrilled.

Duke Hospital has 900 beds and 900 billing clerks-that’s because there are 1200 health insurance companies that Duke has to deal (fight)with. The public option makes 1201.——-Single payer–just one. That will save some money, don’t you think!

Simplicity that benefits everyone or complexity that benefits only a few. Single payer now!
Patti Ulirsch
July 18, 2009 at 9:58 am
I agree with Lou 100%. I have a friend who is an internist who has been practicing for more than 30 years. He says (1) the so-called annual negoriations are wearing him down, costing him too much time and staff money when you multiply it by each company; (2) his administrative costs have increased exponentially over the years, whereas the amount of time he gets to spend with a patient have decreased because the codes are all about “procedures” and not really about diagnostic and educational time; (3) he would rather have single payer because then practicing medicine could go back to the basics of what happens between doctor and patient. He could set his rates much lower if he didn’t have this mess to deal with. I don’t think our country is ready to go the single payer unfortunately, but at least a strong public option and potentially more simplified system could keep insurance companies such as BCBS in check.
Doremus Jessup
July 18, 2009 at 1:44 pm
we need state run single payer. Keep an eye out for Dennis Kucinich’s bill that would allow for that next week.
AdamL
July 18, 2009 at 5:53 pm
Deutsch! Wunderbar.

I’m not sure what you mean by a public insurance plan capping fees. All insurance plans cap fees, if you mean that reimbursement is set at a fixed amount (either administratively or through negotiation) for providers.

Medicare outcomes are great, and satisfaction rates are high. Every proposal in Washington calls for the public option to pay higher rates than Medicare — somewhere between Medicare +10 and Medicare +20. And since the AMA has endorsed the strong public option by embracing the House plan, I’m guessing they aren’t too worried about docs going out of business.

Now, the cost for treating Jerry would go down (for Jerry) b/c the insurance exchanges proposed, and the public option, all cap total payments at a percentage of income as nearly every policy analyst recommends. The cost for treating Jerry would go down because both the House and Senate plan begin to readjust payments to create Accountable Care Organizations and medical homes. And, by the way, reimbursements are increasing for primary care physicians under Medicare, not decreasing.

The general cost of insurance will also fall as everyone gets into the pool with individual and employer mandates, which is much how the German system works — but I’m sure you know that already, being a good German and all.

And, for the record, single-payer is not on the table in Washington.