Last month, Blue Cross of Northeastern Pennsylvania, asked permission to raise its rates by up to 49%.
The "non-profit" health insurance company, headquartered in Wilkes Barre, recently attracted a policyholder suit for accruing a "surplus" of over $400,000,000.00 -- while increasing premiums. That lawsuit was thrown out (because the judge said that policyholders didn't have the right to contest the "nonprofit's" accumulation of profits). In apparent response to the fallout over the "but it is not a profit" disclosures, the NEPA insurer has been spending down the surplus, by doubling its "administrative expenses" over the last five years.
Among those increased administrative expenses are the efforts to defeat health insurance reform, including strong arming employees to play "citizen" and help defend those tremendous profits, err, "surpluses" (which, we are certain, will start to rebuild once all this silliness over reform has passed). Thus, this "confidential" memo by the Big Blue's CEO to the employees, teaching them how and what to say to targeted legislators (don't be alarmed -- I've disabled the 'take action' buttons). The woman that received this missive happens not to live in the Districts of the Congressmen mentioned, but clearly understood that her boss wanted her to use the "right" zip code so that she would appear to be in their District:
To: Enterprise Employees
From: Denise S. Cesare, President & CEO
Subject: Health Care Reform: An Invitation To Stay Involved
Date: September 1, 2009
As you will recall, earlier this summer I asked you to consider contacting Pennsylvania’s U.S. Senators on health care reform – an issue certain to have a dramatic effect on our Enterprise and our customers. I am pleased to note that an overwhelming 65 percent of our employees responded to this message and told our Senators that, while we agree that the time is right to reform our health care system, control costs and provide coverage to all Americans, the creation of a new government-run health plan should not be part of the solution.
I am again asking for your help, this time with our service area members of the U.S. House, Congressmen Chris Carney (D) and Paul Kanjorski (D). If your home zip code falls outside the districts of these Congressmen, we are asking you to send the same type of message to your members of Congress as dictated by your home zip code – our message still applies. Contrary to reports earlier in the summer, the U.S. House and Senate were unable to pass health care reform bills prior to the August recess. The fact that the path to reform has slowed and become a more deliberative debate is a direct result of citizens across the country – including us - getting actively engaged in this issue and speaking out.
Health care reform remains at the top of the legislative agenda and there is certain to be specific legislation under consideration this fall. Since Congress returns to session just after Labor Day, now is an ideal time to take action and contact members of Congress.
We will continue to advocate that all Americans have health insurance and for market reforms including a level playing field with no pre-existing condition exclusions or medical underwriting. At the same time, we continue to believe that a government-run health plan would be problematic for numerous reasons, some of them outlined below:o Millions of Americans are likely to lose the private coverage they enjoy today. Millions are likely to move to the government plan that will have many price advantages such as lower provider reimbursement rates based on the Medicare model and exemption from federal and state taxes. These factors will lead to lower premiums in comparison to the private market, making it nearly impossible for private plans to “compete.”
o The government plan would underpay providers, leading to severe access problems. Provider underpayments will lead to access issues within the health care system such as long wait for services, or trouble finding a physician to provide such services. As provider’s revenues decline from lower payment structures under the government plan, facilities may be forced to suspend hiring of physicians and staff, and even close facilities.
o The government plan would undermine much needed delivery system reforms critical to controlling costs. History has proven the government can be slow to innovate and implement changes due to restrictive legislative and regulatory processes. Conversely, the private sector is free to innovate within a highly competitive marketplace. As one example, our Blue Health Solutions program has produced dramatic results in reducing healthcare expenditures and in improving employee health by engaging members in an active approach to managing their health and well-being. A government-run plan would not have the same cost control flexibility.
I am asking you to consider taking immediate action. If you are an Enterprise employee based in Pennsylvania, please click here to voice your concerns to your member of Congress. Once on the site, go to the updated “Featured Alert” and click on the “Take Action” button. Enter your home zip code and press “Go!” You will be taken directly to a custom letter that will be sent directly to your local member of Congress. Simply sign your name and fill in pertinent information, and hit “Send.” Your letter will arrive immediately via e-mail to the appropriate Congressional office. Please note: If your home zip code falls outside the districts of Congressmen Carney or Kanjorski, please continue to send the letter to your local member of Congress as dictated by your zip code – our message still applies.
If you are a BCNEPA employee who is NOT based in Pennsylvania, click here to send a message to the members of Congress in your state. Simply enter your zip code in the box on the left-hand column, and then fill in the required information to send the pre-populated letter. If you have trouble accessing the above information, please contact Arielle Phillips of our Government Affairs Department at .
Sigh. Among the misrepresentations being fostered by the insurance companies to protect their profits, sorry, "surpluses":
Millions of Americans are likely to lose the private coverage they enjoy today. -- Under the House bill, the public option is initially limited to small employers and people without any coverage whatsoever -- a number growing by over 10,000 a day. This is one of the compromises already placed into the program in the spirit of bi-partisanship. It is designed to give hte profit/surplus-makers time to adjust their offerings. Like good capitalists, they will. After all, I haven't seen FedEx having a problem competing with the Postal Service.
The government plan would underpay providers. -- Where to start. First, nothing in the plan sets rates. Second, provider participation in the government health insurance option would be voluntary. Third, I don't see Medicare or the Veteran's Administration running short of providers.
The government plan would undermine much needed delivery system reforms critical to controlling costs.-- this is just argument by iteration, and I am not even sure what it means. But I do know that Medicare has administrative expenses of 3-7%, while the private insurers had admin costs of up to 30% and are paying executives millions in annual compensation.
Big Blue, spoon feeding its employees and teaching them that if they input a zip code from a target Congressional District, they will look for all the world like a "citizen" from that District, "alarmed" about a series of reforms that will cut into their profits and multi-million dollar salaries.
Time to mow the astroturf.