Blue Cross’s taste of what’s to come if health reform fails

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Those of us who have health insurance–or think we have health
insurance–can get complacent about whether the nation needs that big,
complicated health reform legislation. But just try getting sick. Is
your insurance even real? If it is, can you afford it after the latest
round of price hikes? Is your deductible so big that paying it will
mean financial ruin? Check out these stories and think about what the
White House and Congress, by wimping out again on health reform, will
condemn all of us to:

Start with the price hikes. The LA Times’ David Lazarus wrote today about huge rate increases,
mostly by Anthem Blue Cross, and interviewed a couple just over 60
whose premium, with a combined $10,000 deductible (!) just got hiked to
nearly $1,000 a month. 

From Lazarus:

The L’Esperances are your typical American family. They work hard. They try to get ahead. They don’t ask anyone for help.

And they pray they don’t get sick.

Mom and Dad — a.k.a. Laguna Beach residents Jan and Paul L’Esperance
— sell kitchenware on behalf of various manufacturers. They’ve just
been informed by Anthem Blue Cross that premiums for their health
insurance will rise 18% to $985 a month.

That might sound almost reasonable until you understand that Paul, 63,
and Jan, 61, each have a $5,000 deductible, meaning that they’re on the
hook for all healthcare expenses except under the most catastrophic

It’s even more startling when you find out that they had to change
from a better policy with a $1,000 deductible and $1,200 a month
payment just last year, because the premium went up to $1,400.

All across California, Blue Cross is raising rates on individual policies up to 39%,
for the second year in a row. There’s no sign that dysfunctional,
corporate-funded California lawmakers plan to haul Blue Cross execs
into a hearing room about it. But the Obama administration today asked the company to justify the increases, which are 1,500% above the rate of inflation.

In a letter to Blue Cross, HHS head Kathleen Sebelius said that Anthem’s "strong financial position" made the
increases "even more difficult to understand." She cited recent profit
reported by its Indianapolis-based parent company, WellPoint Inc. Last
month the company announced an eightfold increase in profit for the
last three months of 2009, a surge attributed largely to the sale of

"I believe Anthem Blue Cross has a responsibility to provide a detailed
justification for these rate increases to the public," Sebelius wrote.
"Additionally, you should make public information on the percent of
your individual market premiums that is used for medical care versus
the percent that is used for administrative costs."

What’s amazing is that the White House has to beg for the information,
which would be made public under the major health reform bills.

Another LA Times story is on medical "discount cards,"
for dental, vision and more recently for doctor care.  It’s no mistake
that their advertising makes the cards appear to be insurance, and they
cost a fair bit, often $100 a month. The state of California is
cracking down on the worst of them–the sellers who outright lie about
their doctor networks and don’t give the promised "discounts." But the
truth is that even the discounts are a higher price than insurance
companies pay to doctors–it’s only a discount in the sense of being
less than the ludicrous "full price" charged by doctors and hospitals.

As one commenter to the story noted, individuals willing to bargain
with doctors and hospitals can often do as well or better than the
discount cards. (Think of it as flea-market medical care–just what you
need with that cancer diagnosis). There’s a useful free discount in Los
Angeles that deserved a mention: the city’s LARx program will give a
free prescripton drug card to any resident to cut the price of
prescriptions from 5% to 40%. Get it here.

So if the insured aren’t covered, and the uninsured aren’t covered, what next? 

Obvious answer: the sniveling wimps in Congress need to pass health reform now and defend it afterward. Here’s the best analogy I’ve heard, from E.J. Dionne’s Washington Post column: It’s just like getting through a kitchen remodeling. You want to kill the contractor while it’s going on, but you love the kitchen later.

Consumer Watchdog
Consumer Watchdog
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