Doctors balk at request for data (From Blue Cross CA)

[RamboLiberal]

Source: LA Times

The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage.

Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."

"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.

The letter wasn't going down well with physicians.

"We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Assn.

Read more: http://www.latimes.com/business/la-fi-bluecross12feb12,0,4319662.story

---

The letter http://www.calendarlive.com/media/acrobat/2008-02/35508226.pdf

Reason # xxxx we need Single-Payer Insurance!

[Lasher]

1. Sadly, we're not going to see single payer for a long time.

Individual mandate is the wrong direction. :-(

[dkf]

4. Yes, individual mandate will make it HARDER to get single

payer set up.

Indeed, it is the opposite of single payer in that it institutionalizes medical insurance instead of real health care!

And now we see that the insurance industry IS THE PROBLEM, not the solution.

[AndyTiedye]

5. How Does Individual Mandate Work if the Insurance Companies Won't Insure You?

There is a mandate on the individual that he MUST buy insurance, no matter what.
Is there any mandate on the insurers that they must sell you insurance?
If so, are they allowed to charge you double or triple because of a "pre-existing condition"?

Does "affordable" have any connection to what is affordable in blue states?

[dkf]

6. Beats me.

[TechBear_Seattle]

13. They'll insure you... if you have LOTS of money

That is what it comes down to: force as much money as possible out of the rubes and give them nothing in return. "We will insure you, but it will cost you lots of cash. Thank goodness you will be forced to give us that cash."

[BooScout]

18. They'll put you in a 'high risk' pool to insure you....

That way they spread the risk. I would imagine the government may have to underwrite that pool to a certain extent for it to be viable.

[EFerrari]

2. Mike was right.

These people know no "sacred trust". They know their bottom line.

[moggie]

3. Dr Frankenstein?

Does he pronounce it Fronkensteen?

[Lasher]

12. Could be worse.

Could be raining.

[DRoseDARs]

7. God, they sure are gunning for a second class-action lawsuit. Didn't learn their lesson the 1st time

eom

[grilled onions]

8. I Would Love To See The Day When Cherry Picking Is Stopped

The day when insurance discovers that their base is not bringing in enough bucks because they turned away more people(and their $$$) then they brought in.

[Vinca]

9. The health insurance industry is not for sick people, it's an investment. nt

[Hepburn]

14. Exact;ly....

...and isn't that just so fucking wrong!

[Proletariatprincess]

10. Scurrilous scumbags....

Insurance has always been a form of legalized extortion. For profit health care is immoral. No civilized nation should tolerate this despicable method of caring for the health of its citizens.

[sweetpotato]

11. Where is the RW on this?

Blue Cross is attacking the FETUS!!!

By denying care to a woman because of "pre-existing pregnancy" is a clear attack on the precious fetus.

These women, in order to be "personally responsible" and secure health care coverage for themselves and their *future* children, will have to sacrifice this baby in order to get it.

Its disgusting and the *pro-lifers* should be outraged as well.

[AndyTiedye]

15. Any Doctor Who Provides Such Data Might Be Liable for Damage$ for Breach of Confidentiality

If your doctor rats you out, sue him!

[BooScout]

16. I seriously doubt that.......

Most insurance applications have a medical release authorization signed by the proposed insured that authorizes physicians to release their medical records to the insurance companies.

[BooScout]

17. What this is ..is the insurance company having Dr's do their work for them...

When you apply for life insurance or health insurance your are asked health questions. You also sign a medical release that authorizes physicians to release your medical records to the insurance company if it asks for them. If it's a large policy (like maybe a $ 500,000 life insurance policy).....the insurance company will ask for the last two years of your medical records, pay a fee for copies to the Doctor's medical records provider and then the insurance company personnel will review the records themselves.

It sounds to me like BC is now wanting Doctors to do their clerical work for them in reviewing the applications for misrepresentations.

Also, most states allow an insurance company to contest the policy within the first two policy years if any material misrepresentation is found. That means if you lied on the application about a significant health issue and the company finds out they can consider the policy null and void and refund the premiums you have paid.

I'm no fan of health insurance companies, but I worked in life insurance for 23 years and a hell of a lot of people lie on the policy applications and when they do and don't get caught it raises everyone's rates. They will say they don't smoke, use drugs, don't have a heart condition or even a terminal illness to either save on the premiums (smokers pay about 40 % more in premiums on life insurance) or in some cases, people with terminal illnesses will lie in order to get a policy thinking they will be providing for their loved ones after they die.

As it stands now, insurance in America is a business. The insurers are betting you will stay healthy and live a long time. You're hedging your bets in case you don't.