Article

2008-02-13 -Signs, Portents, and the Weather-

CA Blue Cross Tries To Rid Itself Of Sickly Newcomers

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Posted by Anonymoose 2008-02-13 15:19|| || Front Page|| [11 views ] Top

#1 We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information..

Wait a second. Wasn't Roe vs Wade predicated upon the sacredness of the private communication between a patient and their doctor?

Posted by Procopius2k 2008-02-13 15:56|| 2008-02-13 15:56|| Front Page Top

#2 Sent by Blues last night

"Blue Cross of California highly values the trust of its members and understands the personal relationship members have with their physicians and medical groups. It is our responsibility to assure all member records are accurate and up to date, both for the benefit of our members and the providers in our HMO network. One of the ways we do this is to send the member's application for medical coverage to the physicians to ensure that it mirrors what is reflected in the physician's notes for that member. We believe the sending of the application satisfies this obligation.

This notification process has been in place for several years, and to date we have not received any calls or letters of concern. However, we are now aware that the CMA has some concerns regarding a cover letter that accompanies the applications. We greatly value our relationship with the CMA and look forward to working with them to address any questions or concerns they may have regarding this letter.

It is important to note that of the approximately 300,000 new individual Blue Cross members each year, this letter pertains to less than 1,000 HMO members per month."

Posted by Beavis 2008-02-13 16:03|| 2008-02-13 16:03|| Front Page Top

#3 Well, yeah p2k, if you want to get rid of the pregnancy. If you want to bring it to term, apparently, that's another matter.

Posted by Swamp Blondie 2008-02-13 16:15|| 2008-02-13 16:15|| Front Page Top

#4 I don't see the issue here. Insurers try to get information to access their risk. Not revealing that info is fraud.

Try getting life insurance after you have disclosed you have a terminal illness.

Fraud is a huge problem for insurers. No one knows how big it really is, fraud raises insurance costs for everyone.

Posted by phil_b 2008-02-13 17:38|| 2008-02-13 17:38|| Front Page Top

#5 phil_b: unfortunately, there are hundreds of genetic diseases that, even if they only increase your chances of getting a disease by 10%, mean that nobody wants to insure you. One of the big ones is breast cancer, where genetics may be the fourth or fifth most determining factor of whether you get cancer.

In truth, probably 80% of people have some known, underlying *excuse* that could be used to deny them insurance, if the insurer *or* their underwriter knew. Why gamble on people with a chance to become sick, if you can do so only with people less likely to become sick?

Optimally, a health insurer would want only to insure people who would be very healthy to the age of 65, then die of an acute heart attack before they hit the ground. That way, they would get paid a fortune, with minimal expense.

However, a whole life insurer would prefer somebody who is sickly but long-lived, so they don't have to pay a dime until they've had the premiums for years.

Posted by Anonymoose 2008-02-13 19:36|| 2008-02-13 19:36|| Front Page Top

#6 It's fair to cancel coverage if the patient concealed a pre-existing condition - I suspect a lot of cases Blue Cross is trying to dump are patients with previously undiagnosed but pre-existing conditions. "Gee, sir, that's a pretty advanced case of colon cancer you've got there, and you've only been insured a couple of months, so I'm afraid we're going to have to cancel you." I KNOW this happens.

Posted by Glenmore">Glenmore 2008-02-13 19:38|| 2008-02-13 19:38|| Front Page Top

#7 The problem is legislative. Insurance companies assess their risks and price accordingly.

If they are required by law to price insurance without reference to pre-existing conditions, then they will do so. Of course, the cost to everyone will be substantially higher.

Take your pick?

Disclaimer: I know fraud is so rampant in Insurance that buyng lottery tickets gives you better odds than buying insurance.

Posted by phil_b 2008-02-13 23:07|| 2008-02-13 23:07|| Front Page Top

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