by CJ Janovy
Blue Cross and Blue Shield of Kansas City has been running full-page ads all week in The Kansas City Star, explaining its positions in the debate about health-care reform.
"At Blue Cross and Blue Shield of Kansas City, we're listening intently to your thoughts and concerns about health care and the proposed reforms now before Congress," the ads begin. "We'd like to take the opportunity to address some of the key issues surrounding this complex and rapidly evolving issue."
Mostly, the ads -- like the survey of local doctors Blue Cross also released this week -- reveal how much Blue Cross is invested in maintaining the status quo and looking like a good corporate citizen in the midst of heightened attacks on the insurance industry.
On Monday, the ads proclaimed that Blue Cross supports coverage for all Americans, along with "most insurance reform measures under consideration by Congress." Most but not all reforms. On Tuesday, in discussing reforms in somewhat more detail, Blue Cross said "We oppose the Public Option as unnecessary." This morning, it devoted a full page to arguing against the Public Option -- but only raised questions instead of offering reasons for that opposition.
On Wednesday, the ads talked about how Blue Cross treats its customers. In response to the question of whether Blue Cross denies coverage for the sick, it claimed: "Our company accepts 85 percent of all individual applicants for coverage and 99 percent of all applicants when group and individuals are combined."
That may be true, but it only took one phone call to find someone who fell outside the 85 percent of applicants that Blue Cross says it accepts.
That phone call was to Corrie Edwards, executive director of the Kansas Health Consumer Coalition. I was curious whether Edwards, whose agency advocates for affordable, accessible, high-quality health care in Kansas, knew of anyone who'd had problems getting insurance from Blue Cross and Blue Shield -- or, conversely, whether her organization considered Blue Cross an exemplary provider of affordable and accessible insurance.
Edwards didn't have to poll her members to answer my question. She had first-hand experience.
I changed jobs in 2006, I was on a Blue Cross plan at my old job and
had been since 2002. This [new] organization didn't have established health
insurance. I went to Blue Cross to try to get insurance from them. They
denied me and suggested that I go into a high risk pool. Get a load of
why they denied me: because I took a very common monthly maintenance
Edwards figured she might be denied, but not for that reason.
"I had breast cancer in 2000 when I was on
United Healthcare. I had been on medication for breast cancer since
2002, then I had a cervical cancer scare in 2005. I thought they were
going to deny me because of that, but that wasn't the reason. It took
me three meetings in person with Blue Cross, and I had to copy off all
of my health records from 2002, when I had breast cancer, all the way
to 2006, and take them to Blue Cross."
Three meetings and a
lot of stress later, Edwards says, Blue Cross put her in "a group plan
of one person." And gave her some unsolicited advice.
"They told me that I needed to hire a staff person so that I could have more than just one person on the 'group' plan," she says. "And they actually told me what type of staff person to hire: preferably a man, because women who were younger were of child-bearing age, and that would heighten my premium. Then they told me anyone older would also be an issue."
Edwards says she took none of that advice. Eventually she staffed up her non-profit's office and got legitimate group insurance from Blue Cross.
Even though Blue Cross eventually agreed to cover her, she still has to fight with the insurer. Once, she was scheduled for testing to see whether her breast cancer had been genetic. She called Blue Cross from her doctor's office, she says, "and they said the test would be covered absolutely. But after I got the test, they refused to cover it. I've had to fight them to get them to do what they said they were going to do in the first place."
In today's ad in the Star, Blue Cross reiterated its argument against a government-provided public health-insurance option:
A Public Option is not necessary to implement health insurance reforms like:Blue Cross says it supports those reforms, and doesn't need a government-run competitor to make sure they really happen. This apparent change of heart comes a bit too late for Corrie Edwards.
--The guaranteed issuance of coverage;
--The ban on pre-existing conditions; and
--The ban on using health status to set rates.