Blue Shield CEO Op Ed on Health Care Reform | Arthritis Information
What I found interesting about this article, is that the CEO of Blue Shield recognizes that any reform should include a ban on denying coverage to those with pre existing conditions, for those of us with a chronic condition like RA this should be an important issue.
As the health care reform debate moves to Washington ...
Bruce Bodaken
Wednesday, June 4, 2008
Are Harry and Louise lurking in the pantry again, ready to derail federal health reform like they did in 1994? Not necessarily. Recent state health reform efforts indicate a changing dynamic in which health plans can be a valuable ally of coverage expansion advocates.
With the demise of the Schwarzenegger/Núñez health reform proposal in California, the health coverage expansion action is likely to move to Washington. Sens. Barack Obama and John McCain, and key congressional leaders have indicated they will pursue significant health reforms in 2009. Our experience suggests that federal policymakers would be making a big mistake if they wrote off the health insurance industry in those deliberations.
A variety of states have pursued universal coverage in recent years. Most significantly, Massachusetts passed universal coverage in 2006, and we came close to doing so here in California one year later. In both of those instances, health plans - rather than blocking coverage expansion - were among the leading advocates.
The Massachusetts Blue Cross and Blue Shield Foundation was widely credited with providing the conceptual framework for the bipartisan plan that was eventually adopted by the state. In California, six of the state's seven largest health plans worked together on the Schwarzenegger/Núñez proposal. In both states, plans made it clear that we were willing to consider restrictions - such as a ban on denying coverage to those with pre-existing conditions, and limits on profits and administrative expenses - that the industry had previously fought.
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Even more scary is that they want to have the option of charging extra or not insuring if a person does not conform to what they consider a healthy lifestyle. Scarey stuff.
LEV
Lev, I think that's reasonable. If you're doing something intentionally that you don't HAVE to do, that is known to put you at higher risk for health problems, why should insurance companies take the hit for your lifestyle choices?Sin taxes in health care???
Pip
[QUOTE=Linncn]Lev, I think that's reasonable. If you're doing something intentionally that you don't HAVE to do, that is known to put you at higher risk for health problems, why should insurance companies take the hit for your lifestyle choices?[/QUOTE]
But who gets to decide? Is it fair to penalize someone who drinks a couple beers here and there (or god forbid has an occasional cigarette) but issue no sanctions against someone who chronically overindulges in unhealthy food (whether or not they are overweight)? And who gets to decide what is an unhealthy diet? Are we going to have the vegans vs. the Atkins vs. the Ornish vs. whatever?
They do it with auto insurance and life insurance. Your speedy little Porsche costs more to insure than my little (very cute) Mazda. My 16 year old son cost more to insure than my 16 year old daughter. Bet an accountant pays less for life insurance than a coal miner.
It's not like a reasonably healthy lifestyle is hard to pin down. Don't smoke, lose the extra pounds, put down the fifth of vodka you consume everyday... That's another reason insurance prices are so high for all, because everyone has to pick up the slack for bad choices other people make. Why should one guy be penalized when he takes care of himself?
Linncn2008-06-04 10:51:41Everyone raises interesting points, but I just wanna refocus the discussion for a moment. I found Blue Shield's CEOs statements hopeful:
" In both states (Mass and CA), plans made it clear that we were willing to consider restrictions - such as a ban on denying coverage to those with pre-existing conditions, and limits on profits and administrative expenses - that the industry had previously fought."
He's speaking of restrictions on the insurance industry -- reform that would not deny coverage to those with pre-existing conditions. This issue is one concern I have w/McCain's proposal, people with pre existing conditions would have to find coverage in high risk pools, that could cost more, cover less.
Fixing our health care system is a complex matter, but its possible if stakeholders, like the insurance companies and others, make some concessions, and work toward an affordable, fair system.
Okay, back to beer and cigarettes -- oh, not me -- in the discussion.
LOL Joy - that was so like "and now from a word from our sponsor"
Hugs,
Pip who would be in the high risk pool with smoking...
Oops! Sorry, didn't mean to change your subject :)[QUOTE=Linncn]It's not like a reasonably healthy lifestyle is hard to pin down. Don't smoke, lose the extra pounds, put down the fifth of vodka you consume everyday... That's another reason insurance prices are so high for all, because everyone has to pick up the slack for bad choices other people make. Why should one guy be penalized when he takes care of himself?[/QUOTE]
I respectfully disagree that it's not hard to pin down. For example, what about the study that was just posted here the other day showing a correlation between being "overweight" and having less joint erosion? And nutritionists have been arguing forever about which diets are bad and which are good (carbs vs fats vs processed, etc). And what if they decide that because I'm taking immunosuppressants, I should be penalized for encouraging infections? We know just enough to be dangerous IMHO.
[QUOTE=Linncn]Oops! Sorry, didn't mean to change your subject :)[/QUOTE]
That's okay, that often happens, its just that access to affordable health coverage for those w/pre-existing conditions is an important issue for me, having had RA for 31 years, and likely for the rest of my life, so just wanted to make sure folks noticed what this insurance CEO said. The comment that Blue Shield would be willing to "limit their profit and administrative costs" was also an eye opener, hard not to be skeptical, would like to believe they are genuinely concerned, and just not trying to head off growing interest and support for a single payer system that would do away with insurance companies.
Joie2008-06-04 11:24:23It's important to me too Joy. Right now I have good insurance and don't foresee any change in that. But you never know, and I would like to know that if my status should change in the future I won't be on an insurance "blacklist".
[QUOTE=Linncn]They do it with auto insurance and life insurance. Your speedy little Porsche costs more to insure than my little (very cute) Mazda. My 16 year old son cost more to insure than my 16 year old daughter. Bet an accountant pays less for life insurance than a coal miner.
Linnc,
Why start a bad thing because the beginning looks good? Soon children will be taken away from good parents because the children are overweight. It's like it's okay to steal the old womans purse but don't break her arm in the process. I like bar-b-que, big juicy burgers with all the fixins. Are we to become people that sacrifice an enjoyable life for a healthy life and still end up with some fatal or life long disease or die at 38? Why start a bad thing? Only for the purpose of making a small amount of people rich so they can eat their low in fat russian caviar. Does't it bother you every time someone tries to put puppet strings on you? Do you really want to roll over when "they" tell you to roll over? This life is so short and is so much fun, why ruin it, just for the sake of adding a few old years? As far as car insurance, as you know the insurance companies still use the credit report for classification. In other words, those with poor credit scores pay more for car insurance. A person in Oakland county pays less for car insurance than someone in Wayne county. Why start a bad thing? Why tell someone how to live this short life? Doesn't make sense. So many have died for our freedoms and on a constant sneaky snake basis the freedoms are being taken away, many in the name of health, but let's not kid ourselves, it's all in the name of the great god MONEY, all bow.
LEV
I like a fat red juicy burger sometimes too (with bleu cheese). But if all I ever eat are big fat juicy burgers, why should you have to help me pay the bill when it's time to get the ol' arteries scraped? It was my decision to eat that way. No one's telling you what you can and can't do, just that their's a cost to the choices you make. People have to make those kinds of choices everyday. If you really want a Coach purse, you will skimp on something else you don't care so much about. If you really want to drive an SUV, you accept that you'll have to pay more to drive it. If you really want to eat those fatty burgers every day, you accept that you'll pay higher insurance.But how do you police that? There are thin people with atrocious eating habits; there are people with other potentially dangerous lifestyle choices as well (unprotected sex, dangerous sports, etc).
Easy. The government can install cameras in our homes, cars, places of work. They'll be just like our very own big brother!! (ha ha ha)
Seriously Jas, it couldn't be done pefectly. Their's always someone scamming the system. Take a look at welfare, unemployment, workman's comp.....
That will be somewhere in the future Link. But even before that and even now, they can see if you have a genetic "flaw" that is going to cause plaq build-up even if you eat healthy. So bump all that healthy stuff, if you have a "bad" medical gene, guess what pay extra or no insurance. We know where it starts, we just can't even imagine where it ends. And yes, I will help pay fo have that beef grease scraped from your arteries, if I can get a copy of the movie.
LEV
You can have the movie AND the plaque :)
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