Dear Anthem Blue Cross Blue Shield, This Hate-o-Gram is For You

Feb 14, 2010: Updated with new information at the end of the post. See you over the jump.

Anthem Blue Cross Blue Shield loves to send me letters. Unfortunately, each sweet valentine lets me know how much more I can pay them. In November, they raised our monthly insurance rate $100 from $297/month to $397/month. That's 33%.

Now they're raising rates up to 39% for individuals otherwise not insured through employers, or some 800,000 people in California. I guess all that wining and dining and lobbying stupid fucking senators and congressmen for all of 2009 so that they'd oppose health insurance reform was expensive. Not to mention profitable--eightfold growth in the last quarter of 2009 alone.

And this is in a state, California, where health insurers are permitted to spend ONLY 70% of the premium collected on patient health care. The rest of the 30%? OVERHEAD. As in, first class flights for insurance executives, expense account dinners, pricey corporate retreats at five star resorts. A $9 million salary for the CEO of Wellpoint, which is Anthem Blue Cross Blue Shield's parent corporation.

WHY AM I PAYING FOR MY INSURER TO LOBBY AGAINST MY INTERESTS? I'd love to grab every Medicare-supported Teabagging fool out there and shake them by the shoulders to get an answer to that question. Great for you if you're on Medicare, but what about your kids and grandkids? Why should they have to pay 30% off the top to an insurer who'll lobby against their interests and pad their bottom line by culling the sickest and most in need of care, and only insuring the healthiest?

The California State Insurance Commissioner has opened an inquiry into Wellpoint/Anthem Blue Cross Blue Shield's latest rate hike. Health and Human Services Secretary Kathleen Sebelius, and members of Congress, will be demanding that Wellpoint CEO Angela Braly justify the increase in premiums. Wellpoint's CEO will have to face a congressional committee and spin her justifications out loud, into tv cameras.

That's all very nice, and the least my state and national representatives can do.

BUT I DON'T WANT "I FEEL YOUR PAIN" KABUKI. I WANT TO SEE THE ROOT PROBLEM SOLVED.

PASS MEANINGFUL HEALTH INSURANCE REFORM NOW.

If you lack the resolve, I am happy to lend you 20 Harriet Tubman-fuls of mine.

See, I have resolve because I have a kid. We do not qualify for SCHIP. And I would no more let my child go uninsured than let him lick lead and slurp mercury.

I did not sit through marathon sessions of Congress, on Christmas eve or a Saturday, to watch a bunch of federally insured, "I've got mine" people who are supposed to FIGHT on my behalf suddenly decide health insurance reform is too hard. So they'll go back to dithering in their offices while the fundamental problems persist: denial of coverage for pre-existing conditions, rescission, gender rating, and rate increases that far outpace the cost of care.

So Conservadems and Republicant's in Congress, unless you've got more for me than a strongly worded letter, I've got nothing but hate-o-grams and NO votes for you too. Conservadems, I'm giving no dollars to your 2010 races, I'm saying no to re-election of anti-choice incumbents (**cough** Stupak-Pitts**cough**).

___________________________________

There are now three investigations opened into Wellpoint/Anthem Blue Cross Blue Shield's 25-39% premium increase:

• the California Assembly's health committee meeting on this is February 23, 2010
• the House Energy and Commerce Committee's Congressional investigatory hearing is February 24, 2010
• the California State Insurance Commission has asked Axene Health Partners to provide actuarial review of the process that went into determining the increases in premiums

And finally, President Obama's bipartisan panel on health insurance reform is scheduled for broadcast on CSPAN on February 25, 2010. I'm sure Wellpoint CEO Angela Braly's testimony will be a centerpiece of that discussion, and I'd like to see Republican senators and congressmen defend the hugely profitable insurer's premium increases. Really. Go ahead. Live and in color on CSPAN, that socialistic publicly-owned tv station that broadcast hundreds of hours of footage of floor debates (some of which I actually watched).

As I said before, I'm glad that Wellpoint's unsupportable rate hikes have attracted a lot of disinfecting sunlight. It's good that California State Insurance Commissioner Steve Poizner is going forward with an investigation and has publicly said, "If the independent actuary concludes that Anthem's rates are not actuarially justified and do not meet the 70 percent loss ratio requirement, I will take all legal action available to me to stop the rate increase."

But I'm also EXTREMELY skeptical that Poizner, a Republican gubernatorial candidate in California's 2010 election, has suddenly become the dear friend of California consumers. While it's true that the insurance commissioner lacks the ability to regulate insurance rates (shocking, I know, as you'd think that'd be the main point of the office's existence), nevertheless the California Department of Insurance was notified of Wellpoint/Anthem BCBS's planned rate increases in November, 2009. Perhaps 2009 was too early to make hay of the issue for the 2010 governor's race? 

In any case, spare me the dramatics. No laurels for people doing what the job requires, Poizner.

Just get the health insurance reform bill passed.

Cynematic still has no time to be writing this rant. She ignores her personal blog P i l l o w b o o k.

Comments

[magpie]

It is so screwed up. So very very screwed up.

[Huma]

Bam! Love it. Great post.

[DIANNA]

DAAAamn..! You GOOO grl!

[Sean Ackley]

I hear you on almost every point here. The only problem, is that the "health care bill" currently being proposed in Congress doesn't solve any of this. In fact, it guarantees rates will be raised and insurance companies getting more fat.

This is an insurance "reform" bill, NOT health care bill. When I say reform, I mean it reforms the way insurance companies are protected and can make money. It ensures that government will steal money from more people, more effectively and give it to the insurnace companies.

Small companies will start going out of business, or simply not offering health insurance to their employees.

The "teabaggers" as you call them, if you are referring to the TEA party movement has been fighting against the insurance companies this whole time. Personally, I am not fighting against a health plan, I am fighting against the fact we are not getting any health bill to be passed, its an insurance bill in Congress.

The "health reform bill" in Congress was written by the insurance lobby groups, so who do you think it will benefit?

[Cynematic]

Sean, I'd like to see evidence the Teabaggers have been fighting against insurance companies all this time. I've only seen evidence that they oppose the president and much of Congress.

Got links?

[Joe Hutchinson]

I hate Anthem Blue Cross. My wife is trying to change to an agent that will actually help us for their 10% of our monthly premium. The jerk off agent who we've had for over 10 years refuses to contact us by phone and the contract states he will be paid for life-even when he retires or dies. WTF? How is this fair? Screw you ABC-you have no morals or shame and your lame excuses of cost increasing; You're in the health insurance biz-you're still making billions while you loose customers.

[alan bennett]

I' am a cab driver in the desert area and I thought someone should be aware of what this company is doing with peoples hard earned money. I 'am going to try to get any info and schedules on dinners and golfing for there group.

Breaking News; Blue Cross, Blue Shield, Well-point are having a very expensive week retreat in Palm Desert Ca. @ the J.W. Marriott Resort. They have taken over the whole hotel and golf resort and are trying to keep everything very hush hush. The employee's have even been told not to pay for things like taxis with there credit cards so that no one will know they are here. I' am a cab driver that has been driving some of then to dinner tonight. Thought someone should know about this is where all of the increases in insurance is going

[Jojo dancer]

Yeah obama really stuck it to us middle class. My premiums went up more than 40% in last 18 months.

Can't wait to vote these bums out!!! :D

[Hanna k.]

Anybody to complain to regarding the constant increases in premiums? I kept holding on. I think that this last increase is going to cause us to lose our medical insurance. what to do?? My husband and myself are in our fifties and we have a teenage son. I hate anthem blue cross. We have been paying our insurance for 30 years and now that we need them the most, we can't pay anymore.

[Cynematic]

Hanna K, I hear you. According to this article in the LA Times, a bunch of insurers were allowed to raise premiums from 14% (Anthem) to 29% (Aetna). http://articles.latimes.com/2010/sep/17/business/la-fi-aetna-20100918 In CA insurers only have to put 70c out of every dollar to actual health care costs. The remaining 30c is pure profit. Because Anthem BCBS complies with this CA law, the CA Insurance Commission probably wasn't able to deny the 14% increase.

Relief could be as soon as this winter, however. CA has had two single payer laws make it through the CA Assembly and CA Senate, and twice been vetoed by Governor Schwarzenegger. Single payer, much like the VA health plan or Medicare, uses the bargaining power of a huge group of people (in this case, Californians) to get the same services for lower prices. If we elect Jerry Brown, there's a strong likelihood we can get him to sign a state single-payer law, which would drop everyone's rates immediately. Here's more on CA state single payer, strategically blocked right now in the hopes we get a good governor post-November: http://pnhp.org/blog/2010/09/01/democrats-block-california-single-payer-bill/

I'd call your local congressperson to complain about Anthem's rate hikes. The prospects aren't good that they could help you, but it wouldn't hurt. I'd also call the CA State Insurance Commission, Steve Poizner, http://www.insurance.ca.gov/contact-us/, and ask for help.

I hate Anthem BCBS too. Good luck.

[Cynematic]

PS @Hanna K., hope you're still reading.

It looks like John Garamendi is one elected representative who is holding insurers' feet to the fire with regard to coverage for kids. I'd reach out to him asap.

See: Major Insurance Companies Prefer Making a Killing over Protecting Kids http://bit.ly/puregreed h/t Stevekimura for the tweet.

[Jan in So Calif.]

I may be on the wrong place to vent, but after my conversation with Blue Cross today, I then googled "i hate blue cross" and found this thread... Seeing above posts that says BC spend 30cents of every dollar for overhead, I want you to know what a waste of money THAT is...

I'm an insurance biller for 3 doctors here in CA. I've been in the same office for 23 years. I know my job and how to get a claim properly coded and billed out. Sometimes they reject, so I call the insurance. Today, I called BC to ask why they'd denied a claim when I clearly had put the proper modifier code on the office visit code that basically tells any insurance "the flu shot she got was not the primary reason she came in today. It was her toe nail fungus, but while she was here, she asked "can I get a flu shot, too" and so that's why I'm putting Modifier 25 on the office visit code of 99214 to tell you that". Well, ALL the charges were denied as "not covered". So I call BC. The pt's insurance is an out of state plan, but the ID card says "contact your local Anthem BC plan for any questions". It gives no #, so, I called 800-677-6669 for our local plan. The 1st rep. I talked to clearly was not in our hemisphere -- none of them are when I've call on other claims-- and after 7 mins of ID'ing myself, giving my ph#, giving the DR's tax ID#, giving the pt's ID # which she couldn't find in the system-- "please, ma'am, give me policy holder's SS#"-- having to look that up, spelling the pt's name to her, giving the pt's date of birth, and the date of service plus the total dollar amount bille, she finally says "I see Dr. is an in-network provider but I can not access any patient info regarding claim because this is handled by National Accounts... I will transfer you..."

Then I have to go through ALL the ID info all over again for the guy to answered "National Accounts. How may I help you?" -- and I'm about 99.9% sure he wasn't in THIS nation either -- and his first question is "Is this the first time you call us about this particular claim? Do you have a BC call reference #?" "NO..." Then after he reads to me exactly what I'm already looking at on the Explanation of Benefits in my hand that's denying the claims, I go into my "Modifier 25" schpiel re: proper coding so why's it denied, to which he says... ( let me take a deep breath here to calm down again)... "I can't access that information re: patient benefit. It has to go to Home Plan for review and I will email them". I asked who the Home Plan was; "Empire Blue, but you're not allowed to call them directly. I have to send your concern to them; they will respond in 7-10 business days." I asked "and how will I know what their response is?" "Oh, you call us back, if possible, and give reference # and we'll see if they've said anything to us". Then he politely asks "is there anything else I can help you with today?" And I said "Yes, you can tell BC that I'm very fed up with the way they handle their claims calls. It's always a hassle and very inefficient".

Now, I knew all the answers he was going to give my questions before he could talk, but I ask them anyway for what I call "ammo", so when I have to call back when the claim's still not resolved and I get another rep., they can't BS me. Also, I figure they're working for much lower pay than what a U.S. employee would have been making, so I make them earn it by asking them questions... But I know that his email is going to go to someone in New York for Empire Blue, someone I'm not allowed to talk to one on one per this dude (guess he's making sure he earns his low wage, too)

So, there... now I've vented, I don't feel much better, but that's ok, because I've shared frustration from a bit different perspective.

signed: Jan,
a short name for a short person who sometimes has a short temper...

[BIMKUBWA THANDIWE]

ANY SUGGESTIONS RE HOW TO ENSURE MY APPEAL CULMINATES IN A POSITIVE OUTCOME?

I HAVE HMO, WHICH DOES NOT OFFER INTERGRATIVE CHEMO OPTIONS, WITH (LOW DOSE METRONOMIC) CHEMO, SO I'M PAYING OUT OF POCKET.

[chris m.]

just got the April 2011 letter informing me of another 23.1% increase in my premium. such a racket - i'm considering dropping anthem blue cross and going for something like Kaiser. i've spoke with Kaiser members who've said nothing but good things about their experiences. my friend's mother works as a medical coder for a hospital and has said that if she had to pick her own insurance, she'd choose Kaiser. any thoughts?

[hate anthem.com]

I tried for two m8 hour days to make contact with a person with anthem to find out what coverages I had. I give them the information they requested and every one of them give me a second number to call. The second number was either a sex line or sex talk line or a line to purchase sex items. I told five different people the problems I was having and they talked like they had shit in their mouths where they could not be understood. ANTHEM SUCKS.