Steep Health Insurance Increases for Individual Policyholders

The article on the latest rate increase by Blue Cross caught my attention because of its understatement. While reporter Kenneth Reich repeats the apparent Blue Cross party line that “health insurance rates (will rise) . . . an average of 25% for individual California policyholders under the age of 65,” I find that my rates have been increased 48.8%!

As usual, it is the individual members, and not the group members, who are forced to shoulder the burden of keeping Blue Cross solvent.

But that is only half of the story. I have not yet read an article in the newspaper which tells what happens to the Blue Cross member after he has paid these outrageous fees, foolishly confident that he is now protected from financial disaster, should illness strike.

What happens is that Blue Cross may not pay his bill if it is too large by its standards. And non-payment, or very low payment, is much more likely to occur if the member happens to consult a physician who is not a participant in the Blue Cross Prudent Buyer Plan, with a contract with Blue Cross to accept its ceiling on charges for certain procedures. By withholding or delaying payment, Blue Cross exerts pressure on doctors to join the plan, as well as on patients to patronize only Prudent Buyer participants. The member’s freedom of choice of physician is thus being eroded, with control passing to the medical insurer.

SHIRLEY LEVENSON

Northridge