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Home / Articles / General / Jim Longworth /  Greetings from Blue Cross/Blue Shield
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Wednesday, November 2,2011

Greetings from Blue Cross/Blue Shield

By Jim Longworth
Those of us old enough to remember the Vietnam War are all too familiar with a somewhat duplicitous letter sent by the draft board. “Greetings,” it began (as if we were old friends). “You are hereby ordered for induction into the Armed Forces of the United States.” Earlier this month I received a similarly disingenuous letter which began, “Dear Valued Subscriber.” I didn’t have to read any further to know it was bad news. Yes, it was time for my annual Blue Cross/Blue Shield proctoscopic, only this one wasn’t ordered by my doctor. Instead, it was notification from BCBS that I was to bend over and take yet another premium increase up the backside.

Every year it’s the same old story: Our insurance premiums increase by 20 to 30 percent, and every year Big Blue blames it on “medical cost trends.”

Pardon me if I am skeptical, but not once has Blue Cross ever told the whole truth in one of their annual letters.

For instance, they always fail to mention that they operate as a monopoly, controlling more than 60 percent of the health-insurance market in North Carolina and, according to the NC Department of Insurance, taking in more than 71 percent of all dollars spent on health-insurance premiums.

Additionally, the Blue Cross letters never divulge the exorbitant salaries and bonuses received by its top executives. In 2008, for ex ample,

Big Blue’s Top 9 executives took home a total of $13 million ($4 million of that went to their CEO), with raises each year that almost directly paralleled the percentage increases in subscriber premiums. Meanwhile members of the board of directors allegedly receive about $38,000 per year to attend five meetings. That means the BCBS board makes in five days what most North Carolinians make in one year.

BCBS also never mentions that their net profits continue to rise (now over $180 million) while imposing rate hikes on those of us who are struggling to make ends meet.

And then there’s the elephant in the room (I mean in the letter). Blue Cross/Blue Shield never mentions how much they spend on lobbying each year. According to CNN/Money.com, BCBS spent about $21 million on lobbyists in 2009 and 2010 in an effort to keep Congress from enacting any legislation that would negatively impact on Big Blue’s profits. If pressed for information, a BCBS spokesperson might brag that they actually cut back on money spent lobbying Congress in 2010 compared to the previous year. But what they don’t say is that according to Consumer Watchdog, BCBS has simply shifted some of the lobby monies away from Congress so they can focus on swaying state legislators to hold the line against healthcare reform.

It’s not surprising then, that BCBS of NC doesn’t include such information in their annual “stick it to me” letter. After all, this is the same company that, just one week after pledging to help President Obama constrain rising health insurance costs, released a series of expensive videos and mass mailings designed to frighten subscribers about the horrors of reform. That was in 2009, but BCBS’s shenanigans continue to this day. For instance, federal law requires states to have health insurance exchanges up and running by 2014. According to the National Academy of Social insurance, these exchanges will “promote effective competition for health insurance, and offer a wide selection of coverage options to individuals and businesses.” But according to iwatchnews.org, BCBS of NC is now busy helping to draft a bill that would allow the company to control the exchange’s governing body, which would undermine the very purpose of the mandated reform.

The good news is that there are steps which can be taken to curb rising health-insurance premiums and reduce Big Blue’s influence in shaping and controlling laws. First the FEC must change the way political donations are made, and outlaw PACs entirely. Next, the president should sign two executive orders, the first of which would ban all lobbyists from having any contact with federally elected or appointed officials. The other order would place a cap on health-insurance premiums at or below 2008 levels. Finally, and most importantly, Congress must vote against its own worst instincts and repeal McCarran-Ferguson, an act passed back in 1945 that protected the business of insurance from the federal government.

Both the Vietnam War and the draft eventually ended, and with them, so did the government’s “Greetings” letters. Now, I’m looking forward to the day when we won’t have to keep receiving annual letters telling us how “valued” we are by a company who only values their profits.

Jim Longworth is the host of “Triad Today,” airing on Fridays at 6:30 a.m. on ABC 45 (cable channel 7) and Sundays at 10 p.m. on WMYV (cable channel 15).

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I understand your frustration, but you've got nearly all your facts wrong.  First of all while 60% is a big market share, it's hardly a monopoly.  Especially compared to NC hospitals that have 99% market share in some localities.  BCBSNC does disclose salaries of top execs in a publicly available report released annually.  BCBSNC's net profits do rise as they take on more members, but their profit margin has been pretty flat at around 3% or so for years.  The lobbying numbers you quote must be for the national association -- the group that owns the BCBS brand.  Whatever portion of that cost this is borne locally is split among many states, and even what's passed down is spread many ways. You may not like them spending money on lobbying, but it's unlikely to impact your bill much. For example, their past CEO got a lot flack for making $3M a year.  Philosophically, you may not like that, but at less than a buck a head per year, no one can claim that this is "the problem" with insurance premiums.  What, at $1999 a year premiums are affordable, but at $2,000 a year, they're not? I don't think so.
It makes for a far less enjoyable rant, but the fact is that people want insurance to  cover everything and the health care system is expensive and woefully uncoordinated and wasteful.   Until we begin to pay for value (that is, good results) instead of just volume (numbers of procedures), prices will continue to rise.  Even a single payer, .01% profit system won't fix the delivery system -- We have to do that.

 

 
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