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  #1  
Old 09-30-2008, 04:57 PM
Liz Liz is offline
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Default Let's Shield California - 6.7 Million Californians Uncovered

please see http://www.letsshieldcalifornia.com/

6.7 million of California's 38 million residents are uninsured. The US government estimates that 47 million people have no health coverage in a country of over 300 million. Seriously.

Blue Shield of California states they are for reforms in health care (which we all know is badly needed) and for universal coverage, yet i find it a bit ironic that many insured patients on this forum with BCBS are unable to get coverage for FDA approved ADR procedures. Still, Blue Shield is bringing attention to the issue of the staggering number of the uninsured and to possible reform.

You can send a form to Speaker Pelosi at the end, or I'd recommend a personal letter. You don't have to be a resident of California.

The site states that Blue Shield will be coming to Los Angeles and San Francisco with a video booth to record the ideas, stories and feelings of Californians on this issue.

I haven't seen anything about this in the papers... anyone know more about this?
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  #2  
Old 10-01-2008, 04:54 AM
kimmers kimmers is offline
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I think Blue Shield just wants more business, so they can make more money. Blue Shield and Blue Cross are some of the worse offenders when it comes to coverage. Universal coverage in their language means they get a lot of money and we get the shaft. I hope they are scared that real change is coming.
I am sick of their commercials because they do not tell the truth. The truth is that Blue Shield and Blue Cross have rescinded policies and in particular denied ADR surgery among other procedures.
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  #3  
Old 10-07-2008, 09:33 PM
ans ans is offline
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Off-topic but I don't know why BC and BC/BS are the worst in paying for ADR surgeries. Also, lotsa doctors are trying to drop BC in LA at least.
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  #4  
Old 12-13-2008, 02:39 PM
ZorroSF ZorroSF is offline
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Quote:
Originally Posted by Liz View Post
Blue Shield of California states they are for reforms in health care (which we all know is badly needed) and for universal coverage, yet i find it a bit ironic that many insured patients on this forum with BCBS are unable to get coverage for FDA approved ADR procedures. Still, Blue Shield is bringing attention to the issue of the staggering number of the uninsured and to possible reform.

somehow I really doubt BC-BS really gives a damn about universal healthcare. On the otherhand I think they are just trying to game the situation. If you notice blue cross/blue shield helps manage Med-Cal in california. Medi-cal being the state sponsored HMO plan for kids, elderly and the disabled.

I just qualified for this plan, but I don't see anybody accepting Medi-Cal in Los Angeles except for the county hospitals in the ghettos.

I really think Blue Cross/Blue Shield is positioning themselves to help takeover or at least to be the company that manages a universal healthcare system. This company, which has probably caused the deaths of thousands of people over the last 20 years, should be the last on the list to manage a universal healthcare system.

Judging all the recent appointments to political positions, I can pretty much guarantee Obamas administration will be against a universal healthcare system.
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  #5  
Old 12-13-2008, 08:09 PM
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Terry Terry is offline
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I agree that BC/BS is attempting to be the main controller of insurance in America. They pretty much have a monopoly in Michigan and are trying some legal maneuvering currently to get the rest of the self-insured market. Ours, in Michigan, is a non-profit Blue Cross.

I am opposed to universal health care. I would hope that people are mandated to have insurance based on a sliding fee scale. If everyone had insurance the price should drop significantly. A sliding fee scale and subsidizing for low-income folks means that government could get rid of the Medicaid system if this is worked right. Right now employers who pay for insurance for their employees are paying massive premiums to cover the under-insured and uninsured. This is forcing many employers to drop coverage all together forcing many more Americans in to the ranks of the uninsured. This is a huge crisis that is waiting to explode. I pay for a full coverage plan of medical/dental for my employees, their spouse, and all children living at home. I pay $14,644 per year for a married couple with no kids for their medical, dental, life, disability premiums. It runs about $18,644 for a married couple with children. This is one of our largest expenses in the company I am the director of. I always advocate for keeping the coverage as this is such an incredible benefit. I can only imagine if everyone paid something for their health care coverage how our premiums will go down. This is what needs to be promoted rather than universal health care.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
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  #6  
Old 12-14-2008, 12:21 AM
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Harrison Harrison is offline
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Default BCBS Needs Your Tax Dollars?! Please....

I meant to post this last week....thx for the reminder...I think. This article is so needed, though it may add fuel to the fire.
_______________________________________________

DECEMBER 4, 2008
Michigan Blue Cross Makes Bid for Aid


By VANESSA FUHRMANS and BARBARA MARTINEZ

(See Corrections & Amplifications item below.)
As Detroit's auto makers seek aid in Washington, Michigan's biggest health insurer is arguing that it needs a rescue of sorts too.

Blue Cross Blue Shield of Michigan has asked state lawmakers to give it more flexibility over the premiums it charges, reduce regulators' power to intervene and toughen regulations for its rivals. If the not-for-profit insurer's controversial plan succeeds, the Michigan insurance market for individuals -- one of the most affordable in the country -- will be revamped.




Blue Cross says the changes, which could be voted on as early as this week, are necessary to curb the mounting losses that result from its status as the state's insurer of last resort.

But the company's push has sparked a political showdown with the state attorney general, for-profit insurers and consumer groups. They argue that Blue Cross is exaggerating its financial problems and that the proposals would lead to higher premiums for sicker customers and permit Blue Cross to skirt its social mission.

In exchange for being exempt from $80 million to $110 million in state and local taxes every year, Blue Cross is expected to provide affordable health insurance and take all applicants, including those rejected by for-profit insurers.

As the economy worsens, other not-for-profit Blue Cross and Blue Shield plans across the country are also making moves to improve their financial situations and fend off for-profit competition.
In Pennsylvania, the two biggest not-for-profit Blues, Highmark Inc. and Independence Blue Cross, argue that the merger they proposed last year is necessary to better compete against multistate, for-profit insurers. Last summer, Horizon Blue Cross Blue Shield of New Jersey applied to switch to for-profit status. Others are raising premiums more than in the recent past.

Such moves could affect the health coverage of millions of Americans. Though no single Blue plan provides health coverage for nearly as many people as the major publicly traded insurers, such as UnitedHealth Group Inc. or Aetna Inc., not-for-profit Blues dominate insurance markets in more than 30 states. Altogether, they cover one in three people with private health insurance in the U.S.

The debate in Michigan is particularly heated because of Blue Cross's history in the state. Like other Blues, Michigan's was set up 70 years ago by doctors and hospitals that wanted to be sure they would be paid for their services. But the state is one of a handful that hasn't revoked or pared Blue Cross's special tax breaks and freed it from its insurer-of-last-resort mission.

Now, though, as more people in Michigan lose their jobs or company health benefits, Blue Cross argues that it is headed for financial difficulties as well. The number of individual Blue Cross policy holders, many of them former auto workers, has doubled in the past two years. But because it takes all comers, the insurer says its per-member costs are four times as high as those of commercial carriers, which can reject applicants they deem to be potentially costly.

Though it continued to make a profit through the first nine months of 2008, Blue Cross says it is likely to have a $166.5 million loss on individual products for the full year. It also projects its loss on individuals will swell to $264 million in 2009.

One version of Blue Cross's proposal was passed last year by the Michigan House of Representatives, and a bill stripping out some of the more dramatic proposals was passed this spring in the Senate. Lawmakers, many of whom are ending their terms this year, are working to hammer out a final version, which could be voted on this week.

In addition to giving Blue Cross more flexibility, the draft legislation would require for-profit insurers to pay a "cherry-picking" penalty for rejecting high-cost consumers who end up with Blue Cross, helping finance their premiums.

Other insurers operating in Michigan have lobbied intensively against the plan, though they have been outspent by Blue Cross. "This does nothing for Michigan's uninsured population, and it only raised the possibility of the worst-case scenario of higher premiums," says Richard Murdock, executive director of the Michigan Association of Health Plans.

Blue Cross's spokesman, Andrew Hetzel, responds: "They don't want to see Michigan change because they know it's the last free ride."

But other critics say the increased latitude Blue Cross would have to set and adjust premiums would also diminish regulatory oversight. "It would take away the ability of individual policy holders and the attorney general to challenge proposed rate increases," says Charles Bell, program director at Consumers Union, the Yonkers, N.Y., nonprofit publisher of Consumer Reports. Blue Cross says the proposals would make rates more dependent on actuarial data and less on "politics."

Mike Cox, Michigan's attorney general, and other critics say Blue Cross is exaggerating its problems and has been reaping handsome profits from its business and tax status. From 2001 to 2007, Blue Cross's reserves more than doubled to $2.96 billion.

In recent years, Blue Cross's capital ratio -- a key indicator of an insurer's capital adequacy and financial health -- has been higher or in line with the large surpluses of other not-for-profit Blues. Though the ratio of total capital to risk-based capital has fallen to 627% this year from 891% in 2005, part of the decline comes from the $493 million Blue Cross has spent to purchase for-profit companies.

But Blue Cross argues that its growing individual-business losses will drive its ratio to below 450% by 2011, and it says that doesn't take into account the possibility of continued investment losses. That ratio is perilously close to the 375% minimum required by the national Blue Cross Blue Shield Association, it says.

If that is the case, Mr. Cox argues, Blue Cross can avail itself of the state's premium-setting process to make the case for increases. Meanwhile, he says, Blue Cross has still been able to cover its individual losses with other income and still made a $110 million profit in the first nine months.

"You think about that in the Michigan economy," he adds. "Most for-profit businesses would kill for that."

Write to Vanessa Fuhrmans at vanessa.fuhrmans@wsj.com and Barbara Martinez at Barbara.Martinez@wsj.com
Corrections & Amplifications:

Andrew Hetzel is vice president of corporate communications for Blue Cross Blue Shield of Michigan. This article omitted his full name and title.

Courtesy of Wall Street Journal, see URL:

http://online.wsj.com/article/SB1228...html#printMode

Subscription required. New user print edition is $100 annually and includes online access. Not bad!
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  #7  
Old 12-14-2008, 11:36 AM
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Terry Terry is offline
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This Michigan Bill is making a lot of people cringe in Michigan. It has all of the makings of being anti competitive. The Attorney general has been a staunch fighter against this ploy by Blue Cross. If it passes there will not be any other insurance provider in Michigan. Our State has been in a full force recession long before the rest of the country crawled in to the same hole. We are bleeding dry in this State and the last one out needs to shut off the lights.

The snake oil sales people are out in full force on this one.

What business around would not like to have a three billion dollar reserve?

Terry Newton
__________________
1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5

Last edited by Terry; 12-14-2008 at 08:52 PM.
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  #8  
Old 12-14-2008, 05:34 PM
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KBear KBear is offline
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Quote:
Originally Posted by Terry View Post
I agree that BC/BS is attempting to be the main controller of insurance in America. They pretty much have a monopoly in Michigan and are trying some legal maneuvering currently to get the rest of the self-insured market. Ours, in Michigan, is a non-profit Blue Cross.

I am opposed to universal health care. I would hope that people are mandated to have insurance based on a sliding fee scale. If everyone had insurance the price should drop significantly. A sliding fee scale and subsidizing for low-income folks means that government could get rid of the Medicaid system if this is worked right. Right now employers who pay for insurance for their employees are paying massive premiums to cover the under-insured and uninsured. This is forcing many employers to drop coverage all together forcing many more Americans in to the ranks of the uninsured. This is a huge crisis that is waiting to explode. I pay for a full coverage plan of medical/dental for my employees, their spouse, and all children living at home. I pay $14,644 per year for a married couple with no kids for their medical, dental, life, disability premiums. It runs about $18,644 for a married couple with children. This is one of our largest expenses in the company I am the director of. I always advocate for keeping the coverage as this is such an incredible benefit. I can only imagine if everyone paid something for their health care coverage how our premiums will go down. This is what needs to be promoted rather than universal health care.

Terry Newton
I agree on everybody needing health insurance, some program that would make it affordable and mandatory. It is not right that we have to pay for everybody who does not have insurance to go and be treated (and treated better in many cases, than we the policy payers are). Something has to give. I am glad I am not the one in charge, because I have no idea how those numbers would work; but the Obama plan (in theory at least) seems to be the best bet to me. The extremely high price of insurance is one of the top reasons the Big 3 are failing to make a profit (I won't go into the unions, as they definitely play a part). I read in interesting article in Time Magazine about this the other day.
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