More On Blue Cross

Last Wednesday I posted on the dust-up caused when Blue Cross sent a letter to its doctors asking them to rat out patients who might not have included pre-existing medical conditions on their insurance applications. The Los Angeles Times article on the practice resulted in such a furor that health care's Big Blue had to back down.

Today, the Sacramento Bee has an editorial which reminds me of something I actually knew, but forgot.

Blue Cross of California, the state's largest health insurer, was also one of the strongest opponents of Gov. Arnold Schwarzenegger's proposal to overhaul California's health insurance industry last year. The motivation for the company's opposition was clear: The governor's plan would have required insurers to sell policies to anyone who applied, regardless of any pre-existing conditions. Blue Cross' business model, in contrast, is built on the practice of denying insurance to those who are most likely to need it.

While we find that practice distasteful and some people see it as evil, Blue Cross defends it as the best way to offer low-cost policies in the individual market, where the firm does most of its business. By refusing to sell coverage to people who have been sick or are likely to be sick in the near future, the company keeps costs down for the generally healthy population it does serve. [Emphasis added]

Here's the important part: Blue Cross gets away with denying insurance policies to those with conditions that might actually lead to the insurance being used because it is legal to do so in California. The governor's plan would have done away with that, which was certainly one of the better parts of a medium-good bill. It was a decent start. Blue Cross was having none of that, however, and they did everything they could to make sure the bill never got out of the legislature.

...the real solution is a comprehensive program that creates a way for all Californians to share risk, so none of us has to face unmanageable medical bills without insurance. That's what the governor was trying to accomplish with his plan.

The concept of "shared risk" is not recognized by Blue Cross. They are in the business of making money. Sooner or later, folks in this country are going to have to face the fact that the only way we will all have access to decent health care is if we remove the profit motive from the equation, which means removing the health "insurance" companies from the equation.