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NAVIGATION PNHP RESOURCES
Posted on December 15, 2004

Paying for health care that could be free

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The Philadelphia Inquirer
Dec. 10, 2004
Paying for health care that could be free
By Marian Uhlman

About 3,100 children from low-income families in Southeastern Pennsylvania who are entitled to free government health insurance aren’t getting it.

Instead, these children are enrolled in an Independence Blue Cross plan that has fewer benefits and costs their families $45 a month.

“This has come as a shock,” said Alisa Simon, health director for Philadelphia Citizens for Children and Youth. “This is taking income from a family who really needs it for other things - for rent, for food - and it’s buying them a product that is nowhere as good.”

Independence Blue Cross has offered both the government Children’s Health
Insurance Program and its own private Special Care plan to low-income people
since the early 1990s.

Health advocates said they became aware of the situation this fall while examining how Independence Blue Cross markets products to low-income
people, including the ones available to children.

Independence Blue Cross “did a very inadequate job of informing people of choices and providing accurate information,” said Jonathan Stein, general counsel for Community Legal Services Inc.

People would not deliberately choose “a costly, less satisfactory insurance product over a free and much more comprehensive package,” he said.

CHIP covers mental health services, prescription drugs, hearing aids, eyeglasses, and routine dental care. Independence Blue Cross’ Special Care does not.

CHIP also covers unlimited office visits. And there are no out-of-pocket costs. Blue Cross’ Special Care has a cap of four doctor office visits a year and a $10 copay per visit.

http://www.philly.com/mld/inquirer/news/local/10381195.htm

Comment: Many agree that we need national policies that would ensure coverage for the uninsured, but they are concerned about allowing the government to administer the program. They suggest that we should continue
to use private health plans to administer insurance programs.

Independence Blue Cross has provided us with yet one more example proving
that this industry lacks the ethics and integrity to properly manage health
care funding.

A publicly owned and publicly managed system would certainly require continual oversight. But at least the taxpayers, as owners, would have some semblance of control.