Medicare
Leaves Us Blue
By
JOSEPH WEISS, MD
Blue Cross gave those of us who are its subscribers a grand announcement
in a quiet and underhanded way. At the end of October, just in time
for the election, BCBS mailed out the 2009 edition of Medicare Plus
Blue coverage manual.
With no previous warning, subscribers learned that:
- BCBS had increased the monthly premium nearly 30 percent
- from $151/month to $190/month;
- that inpatient hospital care, previously requiring a $0 co-pay
would now carry a $300 co-pay for each hospital stay;
- skilled nursing home care that in the past required a $100/day
co-pay for a stay longer than 21 days, now will require
a $130/day co-pay for a stay longer than 21 days;
- co-pays for a visit to a specialist that in the past required
a $15 out-of-pocket payment now require a $20 co-pay.
The list goes on but, with few exceptions, increases in co-pays
averaged nearly 30 percent across all covered services.
Blue Cross gives no reasons for these increases. We know
Advantage plans like Medicare Plus Blue continue to receive
Bush administration subsidies, so why does BCBS need more
from us? We know that BCBS remains committed to expanding
its ownership of the health insurance market and needs
money to feed that ambition. We are free to imagine what
Wall Street perks and bonuses the Blues top administrators
will receive.
We can expect BCBS, if pressed, to make a statement asserting
that the cost of health care is increasing and the rise
in premiums and co-pays reflects that increase. But the
cost of health care is not rising at the 30 percent rate
BCBS forced on us. In the case of hospital stays,
co-pays changed from zero to $300 an infinite increase;
BCBS did not say a word about why it instituted such a
fee. Likely, the Blues couldn’t find a good reason.
What can we expect next year? Certainly no better than what
we received this year.
The BCBS plan is called Medicare Advantage, but who gains?
We subscribers are not paying premiums as much as we are
making ransom payments. For doctors, the lesson is beware
BCBS as in the name of reimbursments, BCBS soon will offer
us mere rations.
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