Wealth Care

SO PREMERA BLUE CROSS wants to become a for-profit company. The state's biggest health insurer wants to raise money, and the state is salivating at the chance to collect taxes (back and future) from a new for-profit corporation. Public hearings were held in Seattle last week, and a second round will come next month. Gov. Gary Locke and lots of Oly legislators love the idea, just like they did when the state's second-largest insurer, Regence Blue Shield, proposed the same thing a few months back. Nobody will suffer but us customers—which is to say, everyone who needs health care at one time or another, which is to say most everyone.

That's not the official line, of course, which enthuses about improved service and rates and blah, blah, blah. Bullfeathers. This has been a trend sweeping the country, and it's been a disaster everywhere it's been tried. On this score, consider those flaming Bolshies, the Washington State Medical Association (WSMA). The association's CEO, Tom Curry, notes dryly of the idea, "We're not aware of anyplace in the country where these conversions have improved things for plan subscribers, patients, doctors, or hospitals. . . . The experience nationally is that plans that convert to investor-based operations use their capital to acquire other plans."

This can't be all that surprising. How much rocket physics do you need to know to understand that the more we insert profit-seeking middle people into our hemorrhaging health care system (insurers, drug companies, medical suppliers, hospitals, docs, etc., etc., etc.), the more blood they take and the more we patients lose? The fact that all that money will be available to pay those extra state taxes, and that companies still expect to come out way ahead, tells you what you need to know about how much of your health care costs would be reimbursed in the future.

Premera, of course, claims that when its stock price goes up, everyone will benefit. Two problems: First, the share price might not go up. Second, there are other companies swimming in these waters. In California, activists are fighting off a bid by Regence and a Chicago-based insurer, Health Care Service Corp., which operates in Illinois and Texas. Combined, they'd form the nation's largest nonprofit health insurer. But if they jointly switch to for-profit, activists charge, it may enable them to evade the extra taxes that budget-crunched states like Washington are dreaming of. The worst of both worlds. (OK, three problems. They're greedy bastards.)

I don't care about the suffering of legislators grappling with the state budget. I care about the suffering of people with health problems. I'm a bit sensitized on this issue. As regular readers might know, I'm a transplant patient, and that means prescription drugs—expensive ones. Last week, the same day this hit the news, I wrote a check to my local independent pharmacy (bless them for carrying me through this mess) for $11,986.05.

That staggering total is what we know so far of my health care costs for a five-month period starting when my previous insurance carrier terminated my policy without notifying me and ending with my entry into the state high-risk pool. (Thanks to those same state legislators, private carriers now deny coverage to people who are actually at risk of getting or staying sick.) Mine is a convoluted story, involving settlement of a previous class-action lawsuit for breach of contract. Thanks to the settlement, negotiated by that great consumer advocate, former state Insurance Commissioner Deborah Senn, I had no legal recourse when my insurer screwed me.

Pay up.

FORTUNATELY, I HAVE enough healthy days that I can work part-time from home. Many chronically or seriously ill people cannot, and they, like me, will die without their drugs or labs or treatment. And we're the minority; far more common are people being nickeled and dimed and dollared out of health care they thought they were covered for, thought they were insured for, thought they'd paid for, and discovered that the fine print ruled otherwise. Those big marine critters like blood. Ours.

How telling is it that state legislators seem to care more about quick budget fixes than peoples' lives—now and for the indefinite future, on this and any number of other issues. Anyone who works in health care can vouch that this is a bad idea. The WSMA used to be the most radically conservative of health care advocacy groups. A decade's worth of doctors no longer being allowed to practice medicine changed all that.

Too bad politicians can still be bribed. Guess we'll just go away and die now.

gparrish@seattleweekly.com

 
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