http://www.bcbs.com/issues/uninsured/pathway-to-covering-america/ The "5 Point Plan" that BC/BS lays out for consumers warns of things to come in our health services industry.
http://www.bcbs.com/innovations/healthcare/
First the summary: BC/BS wants to encourage "what works" explained as supporting research on what works by comparing effectiveness of treatment, then BC/BS wants to "change incentives" to reduce payments for services that may be "ineffective, redundant or even harmful," then BC/BS wants to "empower consumers and providers" by getting consumers to create "personal health records," fourth BC/BS will "promote health and wellness to "aggressively...help patients with chronic illnesses manage their own health," and finally BC/BS wants to "expand coverage" to cover more of the uninsured.
If you are not concerned about this window into the thinking of health insurance companies, you are not reading the famed handwriting on the wall.
A RESPONSE TO THE BC/BS 5 POINT PLAN FOR THE HEALTH SERVICES INDUSTRY: A CONSUMER 5 POINT PLAN
1) Reduce Redundant and Excessive Expenses to Lobbyists: I have some inquiries for BC/BS: As a "major political contributor," BC/BS has spent approximately 10 Million Dollars a Year on Lobbying (see: http://www.opensecrets.org/lobbyists/clientsum.asp?txtname=Blue+Cross%2FBlue+Shield&year=2007) why doesn't BC/BS follow the age old wisdom of looking at itself to streamline waste of money? As a consumer, I'd like to see BC/BS EMPOWER itself to save money.
2) Health Savings Accounts are Employer/Consumer or Consumer only versions of the old vacation fund, putting aside money for health care. There is no benefit for consumers to give BC/BS the banking business of saving for a rainy day. Why is BC/BS in the banking business and selling it as if they bring something to the table for consumers? Finally we have gotten down to the seeming truth. BC/BS is in the banking business, stripping health services down to its basic motivation, making money off the sick.
http://www.bcbs.com/innovations/healthcare/
With banks facing all sorts of challenges, BC/BS is in the banking business: pushing high deductible policies, health savings policies, and all sorts of products for consumers to pay their own medical bills. While many employers will probably decide to love this banking because it offers help with paperwork, taking administration out of company hands and pawning it off to Blue Cross/Blue Shield, my question is the following: Is BC/BS shifting its original idea of health services reimbursement to the business of money manager for those who are ill? Can we expect to see more fully owned subsidiaries of BC/BS that are for profit banks that will "EMPOWER" consumers by managing their money as well as insurance companies have looked out for consumer money up until now?
3) Why do consumers pay for BC/BS lawsuits and irresponsibility? Termination of policies, denying claims, and lawsuits that BC/BS must defend against for its fraudulent and unethical business practices...how much are they costing per year? As these lawsuits proliferate in various states, why is it that the BC/BS website does not include expenses for legal fees, settlements and fines that it has to pay out of its "revenue"? My question, while you're "EMPOWERING" those who pay your salary, why are we paying for your fraud, bad faith and the costs of defending or rectifying the same? While you try to squeeze out more money to pay for your own practices by judging those you feel should not receive medical care because they make bad health choices such as smoking or not working out, or because they work out in a dangerous way like riding motorcycles, why are you not AGGRESSIVELY managing the fraudulent business model that is leading to increased lawsuits and expenses from those lawsuits?
4) BC/BS spends large portions of their money on non-insurance services. Why should consumers pay money for third-party nanny calls that don't work? Third-party nanny calls to check up on insureds not only is misleading in terms of patient privacy because these callers often identify themselves as being with the insurance company rather than with a subcontractor, but have proven ineffective in terms of cost management. Recently this was reported here regarding the attempted use of such non-physician management services and their expense in the medicare progragram.
http://conoutconsumer.blogspot.com/2008/04/medicare-costs-for-calling-to-make-sure.html
Why can't consumers find out the amount of money you spent on hiring third party nanny callers and how much money you saved by paying for such a program? As advocates of research that "shows what works," why aren't those numbers available to consumers?
5) BC/BS is clearly getting out of the insurance business as it covers less and less risk. Consumers only need health insurance to help pay for the cost of medical services...in other words, the risk of illness. Why does BC/BS continue to advocate less coverage when less than half of each premium dollar paid currently goes to this insurance function? As reported and cited (http://conoutconsumer.blogspot.com/2008/02/why-support-health-insurance-companies.html) a recent study paid for by American Insurance Companies notes that less than half of consumer premium dollars paid to health insurance companies is actually used for utilization by consumers in paying for health services. While BC/BS continues to try to weed out the sick, how low does BC/BS want the percentage of actual payments for consumer utilization to go, 1%? 0%? As BC/BS tries to preserve and EXPAND its profits from premiums, what streamlining techniques are being implemented to INCREASE the amount of premium money actually spent on helping consumers pay for medical care which is the only reason consumers have any interest in health insurance to begin with?
