Pat and Dave Parker know plenty about the unreasonable cost of prescription drugs. That hard-to-meet expense, along with other abuses of the health care system, has dogged them for years now. Their Blue Cross premiums and drug co-pays increased this year alone by 80 percent.
Over the past few years, the Parkers have struggled to survive rising costs and diminishing service. They have tried to hang on with several providers. Pat, attaining the age of 65, recently entered a new health care dimension, the wonderful world of Medicare, and is accustoming herself to a whole new set of hoops to jump through.
During this time, the Parkers have attained some notoriety by trying to get Gov. Arnold Schwarzenegger, "the people’s governor" to listen to them and use his considerable political muscle to fix California’s broken down health care delivery system.
Schwarzenegger, however, spent more quality time with The Predator than he ever has with these ailing California senior citizens. For months, he has been furtively sneaking away from them like a girlie-man trying to hide from Mike Tyson.
The Parkers continue to fight, though. Booking passage on the RX Express is part of that battle.
Pat and Dave have lived in Orange for 27 years. They are semi-retired. Dave was let go from his job at a small electronics sales firm in October 2001. Dave had open-heart surgery in November 2002, the first time either of them had incurred major medical expenses. Dave was covered by Blue Cross under COBRA.
A few months after the heart episode, in April, Blue Cross raised their premium by 38 percent – from $673 to $941. It was a devastating blow. The Parkers, like so many people nearing retirement, monitor the expenditure of every penny. Existence is a month-to-month struggle, and there is no margin for unexpected costs.
Pat thought at first that Blue Cross had made a mistake. She made inquiries and was led on the infamous bureaucratic shuffle that all health insurers put their customers through; as though the insurers thought its clients needed some emotional pain to go along with the physical and financial stress.
When she finally emerged from the bureaucrats’ maze, Pat discovered that she did indeed have to pay the higher premium, less a small refund because Blue Cross had not given the Parkers 30 days notice of the boost.
She learned something important, though: Health care premium increases are not based on the actual cost to the insurer.
Pat went on the Internet, in what has become a long and thorough process of self-education. She discovered that Wellpoint, Blue Cross‘s parent company, had reported a revenue increase of 39 percent in its most recent filing period, while medical costs had risen by only single digits.
There can be no explanation for this discrepancy that augurs well for the health care consumer. It is sheer profiteering, a bitter medicine that cannot be washed down with the bromides and generalities that Wellpoint provides to those who ask questions.
Energized, the Parkers have fought the acquisition of Wellpoint by Anthem Inc. Neither Parker, ironically, is now paying to Blue Cross. Pat is on Medicare, and Blue Cross dropped Dave after his former employee switched to Kaiser.
Nevertheless, both Parkers know that their money, tens of thousands of dollars of it, is sitting in the Blue Cross coffers as part of the company’s billion dollar reserves. If the merger goes through, that money will flee the state. The Parkers believe that they and others who paid it should get it back.
What angers them even more, they wrote in an unanswered letter to the governor, is "the incredibly small number of top executives who figure to split up to $607 million in stock and cash from the pending merger, with no logical benefit for policy holders or care providers. This stinks to high heaven!"
This unconscionable transfer of funds "not only harms us, but all current and former Blue Cross enrollees and society at large," they wrote.
Schwarzenegger, who receives money from the health care industry and pharmaceutical companies, has backed the merger. Only Insurance Commissioner John Garamendi, who derailed the merger express by refusing to rubber stamp it, stands in the way of it becoming a fait accompli.
The Parkers are not limiting their fight to the Wellpoint-Anthem merger, however. They see a need for top to bottom reform, beginning with the state regulating the industry.
"They’re sticking it to everybody," Pat says, but prey especially on the weak – people under COBRA, retirees, older people. "They are out of work and already struggling to maintain their medical insurance on limited incomes, trying not to go into retirement accounts or Social Security."
Blue Cross and its industry peers are "entitled to make a profit," Pat says, but not in a way that discards the people they are supposed to help.
"The whole system is completely out of control. I just don’t understand it."