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Blues join health care exaggeration game

By Staff | Nov 30, 2009

In a lengthy letter to Blue Cross-Blue Shield subscribers, CEO Paul von Ebers gave us an exaggerated “sky is falling” portrayal of the health care legislation now pending in Congress.

It was the kind of communication one would expect from the management of a “for-profit” insurance company.

The public insurance option in the present legislation seems to create the most fear in the Blues. Their “analysis” of the health plan assumes that the public option will be very competitive and offers projections that the Blues will lose one-third to one-half of their present subscribers to the public option plan. (This projection suggests to subscribers that many of them would get a better deal in the public option.)

Another chunk of sky falls due to surmised increases in insurance premiums because of the “richer benefits” being mandated in the legislation. Blues management claims that these benefits would be “contrary to current member product preferences.”

What they are talking about is an end to denying coverage for pre-existing conditions, non-cancellable policies, and other coverage mandates. The public dialogue and polling suggest that these are the features most favored by the insured and not contrary to member preferences.

There are plenty of problems with the health care legislation as it exists today. Blues management is right in stating that new mandated coverage requirements are going to cost somebody something somewhere. Not only that, the whole health care funding strategy is based on Jell-O. And there is a major political problem: the 180 million people with coverage are not willing to pay a dime to help the 45 million without coverage, making funding a major problem.

It is appropriate for Blue Cross-Blue Shield to inform us about the impact of the legislation. However, it isn’t necessary to scandalize the issue with unfounded assumptions and scare tactics. At present, the legislation has plenty of flaws. There is no need to exaggerate.

The health care letter may be symptomatic of an on-going problem at the Blues. When the scandal over lavish spending erupted a year ago, the board of directors rushed to dump top management and find a new CEO. With that done, the board seems to have retreated, leaving a leadership vacuum.

The board needs to be more assertive. When subscribers get letters about major initiatives or changes, they should be signed, not by the administrators, but by the board. Subscribers elect and pay the 13-member board to represent them in Blues policy development. Board involvement is important for credibility because subscribers trust the board to approach policy with a broader perspective than would management.

Would board members have put their names on a letter loaded with dubious suppositions? Having a personal acquaintance with several of the board members, I am sure that they would insist on a reasonable and factual discussion of the concerns involved. In the final analysis, it seems that subscribers would have greater confidence in an analysis from a representative board more directly involved in the deliberation process.

Omdahl is a UND professor emeritus in political science and a former lieutenant governor of North Dakota.

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