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Wednesday, August 19, 2009

North Carolina's Health Care Insurers Sending State's Citizens To The Poor House...Charging Unusually High Premiums


































Newsobserver, Charlotte Observer, MSNBC, Huffington Post, WRAL, Washington Post, Think Progress, Talking Points Memo----

(Congressional Blue Dogs' secret agenda is to bring Pres. Obama down, especially in the area of Health Care Reform. MSNBC's Rachel Maddow reports.)




(RNC Chairman Michael Steele has a lot to say about Pres. Obama's Health Care Reform agenda but isn't sure which Health Care Insurer he's covered by.)

CNN: What type of health insurance do you have? Do you get that through the RNC?

STEELE: Yup, through my employer.

CNN: What company is it?

STEELE: Uhh. BlueCross BlueShield, I believe. Or maybe not.

Watch it:




North Carolinians have seen their health insurance costs rise five times faster than their salaries over the past decade, according a new report released this morning that will likely add more fuel to the health-care debate.

The report found that health care premiums in the state rose 96.8 percent from 2000 through 2009, while median individual earnings rose by 18.4 percent, according to the study by Families USA and by Action for Children North Carolina.

“Rising health care costs threaten the financial well-being of families in North Carolina and across the nation,” said Ron Pollack, executive director of Families USA. “If health care reform does not happen soon, more and more families will be priced out of the health coverage they used to take for granted.”

The study comes at at time when there is intense national debate in Congress over President Barack Obama’s proposals to overhaul the health care system.

In recent days, supporters and opponents of health care changes have jammed town hall meetings on health care in Rocky Mount, Lillington and Durham. Last Friday, 250 opponents picketed the the Raleigh offices of Democratic Sen. Kay Hagan.

On Monday, two national groups, began running a TV ad criticizing Republican Sen. Richard Burr for not backing the president’s health care proposals.

“Why is Senator Burr taking the side of the insurance companies in the health care debate?” says the five-day $95,000 ad campaign sponsored by Health Care for America Now and the American Federation of State County and Municipal Employees.

Meanwhile, the John Locke Foundation, a conservative Raleigh-based think tank, announced that it will hold a health care discussion Tuesday August 25 at 11:30 at Embassy Suites in Cary.

The new study charted how health care costs are rising in North Carolina between the years 2000 and 2009:

* The average annual health insurance premium (for employer and worker) rose from $6,649 to $13,083 between 2000-2009 or 98.6 percent. During the same period, the median earnings of North Carolina workers rose from $23,080 to $27,330 or 18.4 percent.

* The employer’s portion of the annual premium for a family’s health coverage in North Carolina for that period rose from $4,867 to $8,714 or a 79 percent increase.The employer’s porton for an individual’s coverage rose from $2,195 to $3,864 or a 76.1 percent.

* The worker’s portion of annual premium for a family’s health coverage rose form $1,782 to $4,370 or a 145.2 percent increase. A worker’s portion for an individual health coverage rose from $475 to $877 or a 84.5 percent increase.

“For North Carolina, any absence of health care reform reform will mean that businesses have a harder time staying competitive, and more and more families will have to cope with stagnant wages and the loss of affordable health coverage,” said Barbara Bradley, president and CEO of Action for Children.

Action for Children, started in 1983, is a non-profit organization that has advocated for early childhood programs such as Smart Start. Families USA is a 25-year old health-care advocacy organization.



NC State Workers Urge NC Blue Cross Blue Shield To Support Health Care Reform Efforts


NC State employees rallied Wednesday morning outside the headquarters of Blue Cross Blue Shield of North Carolina, urging the state's largest insurer to back nationwide health-care reform instead of fighting it.

Members of the State Employees Association of North Carolina lined U.S. Highway 15/501, chanting and waving signs supporting the so-called "public option" that President Barack Obama has proposed as a guaranteed backstop to ensure all Americans have health insurance.

The employees said insurance premiums are so expensive that they can't afford health coverage for their spouses or children. They said the public option would lower costs.

"We have families who are spending $500 and $600 a month for health care insurance, and they are only bringing home maybe $1,500, $1,600 a month," state employee Doris Daye said.

Cheryl Moon said her boyfriend's medical bills are so high they are looking at filing for bankruptcy protection.

"If we had an option, we might be able to choose a plan that's more adequate for what he needs," said Moon, a retired state worker.

Blue Cross officials have said they support health care reform, but they believe a public option would price them out of business by underpaying providers and passing that cost along to the private insurers.

"They should not stand in the way of meaningful, affordable health care reform in the country," said Dana Cope, SEANC executive director. "North Carolina's Blue Cross Blue Shield is leading the national effort against President Obama's health-reform plan, and that's a shame."

Barbara Morales Burke, Blue Cross vice president for health policy, said Cope and the state workers are misinterpreting the company's position.

"We're not saying 'not the Obama plan,'" Burke said. "We are not in favor of a government option – a government insurance option – but we are in favor of many things that I understand to be part of the Obama plan, which (are) covering everyone, promoting quality and containing costs."

She said more than two dozen insurers already provide health coverage in North Carolina, so the state doesn't need a public option.

"I'm not sure what one more choice would do," she said.

Dr. Gustavo Montana, a radiation oncologist, said he thinks the nation should move away from a health insurance system largely funded by employers. Many patients who are unemployed or work part time can't get coverage, he said.

"Employment used to be a more secure, if you will, thing for people," Montana said.

Burke said the solution is not for the government to provide health care, but to subsidize it in some instances to make it more affordable.

"That's where we think the role of government comes in – to assist people who can't afford today to buy coverage," she said. "If we get everyone covered and do nothing else, then we will have a system that will blow up."



BlueCross BlueShield of North Carolina's Desperate Attempt To Deceive

BlueCross BlueShield of North Carolina Has A History Of Denying Coverage Due To Preexisting Conditions:

BCBS Of North Carolina Implied Public Option May Not Cover Preexisting Conditions.

The Washington Post obtained storyboards of BlueCross BlueShield of North Carolina advertisements opposed to health care reform. In a crowded gathering, the advertisement viewer will hear, "...pre-existing conditions? Nobody knows yet..." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

It is BlueCross Blue Shield of North Carolina that has a history of denying coverage due to preexisting conditions.

BCBS of NC: "Maternity Benefits And Preexisting Conditions Are Excluded." A BlueCross BlueShield of North Carolina press release announcing new coverage options stated, "maternity benefits and preexisting conditions are excluded, among other benefit limitations. To apply for Short Term Health Care, a consumer must be a resident of North Carolina, under age 65 and not eligible for Medicare or Medicaid." [BCBS of NC Release via PR Newswire, 3/31/94]

BCBS Of North Carolina Denied Coverage To Applicants Due To PREEXISTING CONDITIONS. As reported by the News & Observer:

"In the world of individual health insurance, it doesn't take much to become undesirable. For Denis O'Connor, 61, of Chapel Hill, all it took was too many years without sunscreen and a few small skin cancers. For his wife Alice, 54, it was migraine headaches. Those health conditions got the retired couple a health insurance quote of $3,000 a month -- $36,000 a year -- when they applied for a Blue Cross and Blue Shield of North Carolina plan in October 2003. They declined it." [News & Observer, 2/27/05]

After Wrongly Denying Coverage To Customers, BCBS Of North Carolina Was Forced To Pay For Medical Services.

According to the Durham Herald-Sun: "A state insurance department program launched in 2002 has forced North Carolina health plans to pay almost $1 million for medical services they had refused to cover.... Blue Cross and Blue Shield of North Carolina, the state's largest health insurer, had the second most cases reviewed at 28, of which 32 percent were overturned." [Herald-Sun, 5/22/05]

"Blue Cross And Blue Shield Of North Carolina... Said Denial-Of-Coverage Cases Really Are About Contract Interpretation."

According to the Charlotte Observer, "Blue Cross and Blue Shield of North Carolina general counsel Brad Wilson said denial-of-coverage cases really are about contract interpretation -- whether an insurance policy covers a service or not. Consumer advocates argue that insurers use vague contract language as grounds to deny payment and save themselves money." [Charlotte Observer, 4/27/99]
Yes, Al Can Still See Dr. Ferguson

BlueCross BlueShield Of North Carolina Implied Public May Be Unable To Keep Their Current Doctors.

According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post: "As the camera searches the room, or continues to narrow the frame after beginning at a wide focus, an older Hispanic woman comes into view. She's standing quietly in the middle of the action, as if she found herself at the wrong party, and doesn't know a soul. The background noise is dialed down significantly, enough to hear her say to no one in particular: 'Will somebody just tell me whether my Al will still be able to see Dr. Ferguson if we go through with this government plan?'" [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09;emphasis added]

President Obama: "Americans Must Have The Freedom To Keep Whatever Doctor And Health Care Plan They Have." While announcing a partnership to lower health care costs, President Obama laid out his vision for health care reform. He said, "I'm also committed to ensuring that whatever plan we design upholds three basic principles: First, the rising cost of health care must be brought down; second, Americans must have the freedom to keep whatever doctor and health care plan they have, or to choose a new doctor or health care plan if they want it; and third, all Americans must have quality, affordable health care." [Obama Remarks via RealClearPolitics, 5/11/09]

BlueCross BlueShield Of North Carolina Says One Thing, Does Another

Says One Thing...

BlueCross BlueShield Of NC: "We Believe An Unchecked Government-Run Plan Would Lower Payment To Doctors." Discussing an upcoming ad campaign against health care reform with the Washington Post, BlueCross BlueShield of North Carolina spokesman Lew Borman said: "We believe an unchecked government-run plan would lower payment to doctors and hospitals, forcing them to attempt to charge private insurers more and thus further eliminate private insurers' ability to compete against the government." [Washington Post, 5/18/09]

Does Another...

BlueCross BlueShield Of North Carolina Lost $128 Million Lawsuit For Fraudulently UNDERPAYING DOCTORS.

As reported by the Durham Herald-Sun, "Blue Cross and Blue Shield of North Carolina was among 23 Blues plans across the country that Friday announced a $128 million settlement of a class action lawsuit brought by 900,000 physicians regarding the insurers' business practices. Numerous state medical societies, including the N.C. Medical Society, were involved in the lawsuit, which charged that North Carolina Blue Cross and other Blues plans harmed doctors with unfair business practices that denied and delayed payments for medical care... The complaint identified numerous Blue Cross and Blue Shield plans as defendants in an alleged scheme to defraud doctors in violation of the federal Racketeer Influenced and Corrupt Organizations Act (RICO)." [Herald-Sun, 4/28/07]
BlueCross BlueShield: Not One To Talk

BlueCross BlueShield Ad Falsely Implies Premiums Would Rise Under Public Plan:

According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post, the viewer can overhear partygoers discuss "rising premiums." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

In Reality:

Private Health Insurance Premiums Are Up 119% Since 1999, Compared To A 34% Increase In Wages. According to the Kaiser Family Foundation, health insurance premiums have increased 119% since 1999, while workers' earnings have increased by just 34%. [Kaiser Family Foundation, accessed 5/19/09]
Any Public Option Would Provide The Private Sector With Healthy Competition

BlueCross BlueShield Ad Falsely States The Health Care System Would Be Government-Run:

According to storyboards of a BlueCross BlueShield of North Carolina advertisement obtained by the Washington Post, the narrator says: "We need a plan for reform that will achieve the right results the first time around. We can do a lot better than a government-run health care system." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

House Democrats Are Committed To A Public Health Care Option Which Will "Spur Competition Within The Insurance Industry:

" The Hill reported: "[Majority Leader] Hoyer indicated that House Democrats are committed to including a public plan option in their bill. 'We believe that a public option clearly is going to be necessary' to provide consumers with an alternative to private insurance and to spur competition within the insurance industry, Hoyer said." [The Hill, 3/26/09]

Senate Democrats Have Proposed That Public Health Care Should "Comply With All The Rules And Standards That Apply To Private Insurance" To Ensure That Private Insurance Can Compete:

According to the New York Times: "In an effort to defuse the most explosive issue in the debate over comprehensive health care legislation, a top Senate Democrat has proposed that any new government-run insurance program comply with all the rules and standards that apply to private insurance. The proposal was made Monday by Senator Charles E. Schumer of New York, the third-ranking member of the Senate Democratic leadership, in a bid to address fears that a public program would drive private insurers from the market." [New York Times, 5/5/09]

Speaker Pelosi Is Looking For A Public Option To Make Private Insurers More Competitive. According to Bloomberg:

"House Speaker Nancy Pelosi said the House this year will consider health-care legislation including an option for a government-run program that would compete with insurers. 'This is a big agenda, and I believe it should have a public option in it for it to be really substantial,' Pelosi told reporters at her weekly news conference in the U.S. Capitol. Pelosi said the Democratic-controlled House will be 'aggressive' in its approach to a health-care overhaul, which is a centerpiece of Obama's agenda. She said a government role in health care will help U.S. companies be more competitive." [Bloomberg, 3/26/09]

The Administration Advocates For Health Care Reform That Will "Reduce Long-Term Growth Of Health Care Costs For Businesses And Government." According to the White House: "The Administration believes that comprehensive health reform should:

* Reduce long-term growth of health care costs for businesses and government
* Protect families from bankruptcy or debt because of health care costs
* Guarantee choice of doctors and health plans
* Invest in prevention and wellness
* Improve patient safety and quality of care
* Assure affordable, quality health coverage for all Americans
* Maintain coverage when you change or lose your job
* End barriers to coverage for people with pre-existing medical conditions"

[WhiteHouse.gov, accessed 5/11/09]



North Carolina's Blue Cross Blue Shield Trying to Kill Key Plank of Obama Plan


One week after the nation's health insurance lobby pledged to President Obama to do what it can to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing touches on a public message campaign aimed at killing a key plank in Obama's reform platform.

As part of what it calls an "informational website," the company has hired an outside PR company to make a series of videos sounding the alarm about a government-sponsored health insurance option, known as the public plan. Obama has consistently maintained that a government-run plan, absent high-paid executives and the need for profits, could be a more affordable option for Americans who have trouble purchasing private insurance. The industry argues that creating a public insurance program will undermine the marketplace and eventually lead to a single-payer style system.

In three 30-second videos, the insurer paints a picture of a future system in which patients wait months for appointments and can't choose their own doctors, according to storyboards of the videos obtained by the Washington Post.

One video titled "Waiting" shows a receptionist fielding a request from a patient enrolled in the new program.

"The government plan. Okay hold on...let me see what's available," the woman says into the telephone. On the screen, with the caller on hold, the receptionist rearranges items on her desk, looks at a wide- open calendar and then fibs: "It looks like the first time we can fit you in is in two-and-a-half months."

Another spot in the series, being developed by Capstrat media in Raleigh, shows a woman and child wandering down a darkened hospital doorway "as if they're starting to realize that they've lost their way," according to sketches of the video. "We can do a lot better than a government-run health care system," the narrator concludes.

Blue Cross Blue Shield spokesman Lew Borman said the videos are still in the draft stage. On the question of creating a public option to compete with private insurers, he said: "We believe an unchecked government-run plan would lower payment to doctors and hospitals, forcing them to attempt to charge private insurers more and thus further eliminate private insurers' ability to compete against the government."

On its Web site, Capstrat touts its "agility in turning complex issues into simple, powerful and persuasive stories." Company president Karen Albritton declined to comment.

Blue Cross Blue Shield of North Carolina has 3.7 million members and processed more than $10.7 billion in medical claims last year. Get a first look at the video storyboards here.




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Sources: Newsobserver, Charlotte Observer, Huffington Post, Media Matters Action Network, Washington Post, MSNBC, Think Progress, Talking Points Memo, Whitehouse.gov, HealthReform.gov, Speaker.gov, CNN, North Carolina Blue Cross Blue Shield, North Carolina General Assembly, Google Maps

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