Thursday, July 23, 2009
Rationing is what US health insurance companies do best!
This morning on a local news show I heard yet another health insurance apologist sledge-hammering home the single talking point that the anti-public option vampires (and not the cute kind either) have chosen: the government will be blocking our access whenever we need medical care.
Could such scary unknown governmental 'rationing' possibly be any worse than what happens today? On July 22 a New Jersey hospital, Bayonne, filed suit in federal court detailing the antics of Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ).
What have BCBSNJ been doing? A few tidbits:
--Selling customers higher priced "out-of-network" coverage, and then disallowing out of network claims.
--Making absurd determinations that procedures are not medically necessary and refusing to cover them. In one case (found on page 40 of the complaint) a patient with out-of-network coverage was initially denied emergency coverage at the nearest out-of-network hospital. After they admitted that the patient had purchased such care, they decided that because the patient had once been a nurse, she should have been able to administer IV antibiotics to herself. Care Denied!
--Sending emergency room patients letters (by courier delivered directly to the patient's bedside) telling them that BCBSNJ won't pay for their emergency room coverage, and they must transfer immediately to a BCBSNJ facility on the grounds (determined by mysterious, faceless bureaurocrats) that the care isn't medically necessary, no matter what the attending physician says. The entire complaint can be found here.
Rationing? Methinks so.
Not surprisingly BCBSNJ makes quite a bit of money. This is such a great business plan! Make people pay through the nose for health coverage and then don't give them any. The market value of BCBSNJ is between 7.5 and 8 Billion dollars; they paid their CEO just a hair under 5 Million dollars last year, and they currently have 1.6 Billion dollars in reserves.
BCBSNJ has paid 5 Million dollars to Wall Street to take the company private. Shocking. Not. As a non-profit, they have to at least attempt to pretend they are working for the public good.
Moreover, 21 hospitals have been driven out of business in New Jersey in the last few years, and it appears that BCBSNJ is attempting to kill Bayonne as well. This would be a serious problem for the people of Bayonne, as the next-nearest facility is between 30 minutes (when traffic is light) to over an hour away.
BCBN's 2007 annual financial report can be found here. If you're curious, the company has 20% overhead--contrast with the 3% overhead for Medicare/Medicaid.