By Christopher Stack
Indianapolis Star
Posted: July 15, 2009
Serendipity is a wonderful thing. On June 29, The Star published the “Our View” article by executives and physicians employed by Anthem Blue Cross and Blue Shield titled “Beware pitfalls on road to health-care reform.” The same day, The New York Times printed an editorial titled “Insurance company schemes.” Those interested in the health-care debate now consuming Congress should read both. The contrast could not be more stunning.
On the one hand, three company physicians and an executive of WellPoint (it owns all the major shareholder-owned BC/BS plans in the country) make a plea for caution as Congress considers reform measures, particularly the public option. “Don’t throw out the baby with the bath water,” they seem to be saying. The “baby” is presumably our current system, which leaves 50 million uninsured, another 50 million underinsured, spends twice per capita of any other industrialized nation with poorer overall results, wastes 25 percent of the premium dollar on overhead, and is driven by profit-seeking behavior.
The WellPoint execs paint a frightening picture should any sort of strong public option exist: a government monopoly crushing a helpless industry, stifling innovation and efficiency, and threatening one-size-fits-all medicine as the prelude to dreaded “socialized medicine.” At the heart of the system they defend is the employer-based private insurance industry.
On the other hand, the Times editorial cites the recent testimony of Wendell Potter, former head of corporate communications for health insurance giant Cigna, before the Senate Committee on Commerce, Science and Transportation.
His testimony, supported by the committee’s own research, is particularly damning. It details industry practices such as rescission, the practice of retroactively finding fault in policy applications and then canceling policies. According to the Senate committee’s research, three large insurers canceled coverage for 20,000 people over a five-year period, saving the companies more than $300 million. WellPoint has paid substantial fines in the past year for such a practice. The industry also “purges” its base of unprofitable accounts.
Potter elaborates on industry practices such as cherry-picking, deceptive marketing and the deliberate design of confusing plans. He cites harsh underwriting terms that dictate maximum work-force age, number of female employees, and require an annual employee turnover rate such that many employees cannot qualify for benefits.
The final paragraph of the WellPoint piece is very ironic. It pleads for reforms that “focus on appropriate uses of resources currently available, improving the health and wellness of our society, and a reduction in the amount of unnecessary and inappropriate regulation placed upon the health-care system.” Such a reform already is operating — in the form of Medicare, which delivers care to the 45 million elderly and disabled with quality, efficiency, speed, and the backing of the federal government. The simplest, most cost-effective reform plan is “Medicare for All,” with more than 80 co-sponsors in the House, the single-payer option.
Stack is a physician in Indianapolis.