Tuesday, October 13, 2009

The Bush Doctrine of Health Care Reform and One Anecdote About What's Right About Regional Not For Profit Health Insurers

Oh my. Reading the news and bloggery about the AHIP-sponsored study by PricewaterhouseCoopers, it’d be easy to conclude that the Forces of Dark have finally been confronted by The Angelic Host. Using terms like ‘dishonest,’ threatening,’ ‘ self-serving and ingenuous’ as well as the mother of all invectives (‘tobacco industry!’), it’s become clear to reform supporters that anyone opposed to the health bills before Congress is Satan’s Spawn. It’s almost like an ironic version of the Bush Doctrine that rationalizes preemptive overwhelming attack on any entity that could give aid to evil-doers.

The Disease Management Care Blog has a different take and thinks the PWC report provides is useful. It thinks there are too many unknowns in reform to confidently predict the future and appreciates the insights from this worst case scenario analysis.

It’s too bad that the entire health insurance industry is being painted with such a broad brush of loathing. While shrillness makes for good website traffic, it can make the rest of us lose sight of the more subtle issues that are a far better gauge of what’s good about health care in the United States.

Take this local story about the unlucky employees at a company called Turbine Airfoil Designs (TAD), whose company went completely bankrupt months after failing to pay their workers’ health insurance premiums to Capital Blue Cross Blue Shield (CapBSBS). No one outside the leadership of the company apparently knew about the lapse and a number of the workers and their family members, assuming they had insurance, generated some significant health care bills. It was after they got the bad news about being unemployed that they also found that their health insurance hadn’t been in place and they were personally liable. What’s more, some tone deaf hospitals billed their full rate for services (instead of the discounted Cap BCBS rate they had agreed to accept in the first place) and. to add insult to injury, some patients were referred to collection agencies.

What developed what a circle of mutual non-culpability. Thanks to the bankruptcy, the outstanding health care debts got in line with the rest of the company’s creditors. CapBCBS couldn’t have been expected to notify these patients that they didn’t have insurance and arguably shouldn’t use their paying customers’ premium dollars to pay for nonpaying customers. The hospitals argued that they can’t afford to give services away for free. And some proud working class Americans unsurprisingly refused to turn to charity.

So what happened? The Chief Executive Officer of CapBCBS announced that it was going to fix the problem. The rationale that used was:

'Capital BlueCross is a business -- but we also are a nonprofit organization with a 70-year community mission. And this is one of those instances where mission should prevail.'

First of all, The DMCB says bravo to CapBCBS. But don’t be too surprised, because countless regional not-for-profit insurance companies with a local sense of mission and community mindedness would have done the same thing.

Secondly, it doubts very much that the close-minded Forces of Light described above will pay this anecdote any heed.

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