BCBSNC: Smoke & mirrors re: no screening colonoscopies in western NC (and across NC)

I talked to "Lynn Tennant (Rep. Fisher)" on May 22, 2008 regarding the persistent run-around that BCBSNC has created since the Fall of 2007.

It appears you can complain forever about this lack of a critical health service but nothing gets done and indeed, BCBSNC's 'Government Affairs' employees serve to throw the NC State Legislature representatives off the track by implying that something is being addressed----when it is not.

Interestingly, in one of the NC State Legislature's representatives' offices, a relative of an aide died a couple of years ago from a BCBSNC colonoscopy----done as an office based procedure wherein no anesthetic is given and the patient might be agitated related the pain of the procedure. The procedure was associated with a nicking of the colon wall, sepsis set in, and the person died.

VIEW MESSAGE

SUBJECT: Congressional Inquiry: Dr. Marsha Hammond
FROM: Nell.Boone@bcbsnc.com
TO: Fisherla@ncleg.net
SENT: Mon 19 May 2008 11:58:23 EDT
EXPIRES: Mon 23 Jun 2008 11:58:23 EDT
Reply
Reply to All

Dear Representative Fisher:

This is in response to your email of May 7, 2008 regarding Dr. MarshaHammond as it relates to concerns she has with there being no screeningcolonoscopies available in Western North Carolina per Blue Cross andBlue Shield of North Carolina (BCBSNC). I appreciate the opportunity toassist you.

I have spoken with Dr. Hammond on several occasions, most recentlyforwarding her concerns to BCBSNC's Provider Networks and CustomerSatisfaction Departments who have advised they would be following upwith her soon. BCBSNC is working to provide Dr. Hammond answers to herquestions and concerns brought to our attention by your inquiry on herbehalf.

I hope this information is helpful to you in your response to Dr.Hammond.Please let me know if I can assist you further.

Thank you.
Sincerely,Nell BooneGovernment Affairs CoordinatorBlue Cross Blue Shield of North Carolina(919) 765-2680

BCBSNC Round-Robin / Pass the Buck : Mismanagement by their 'Network' re: Screening Colonoscopies in NC

May 20, 2008

Dear Jonathan Givens (supervisor, Customer Service: 919 765 3951) :

I appreciated you calling me back today and spending time on the phone re: my query associated with non-availability of screening colonoscopies in western NC.

As was revealed by earlier conversations w/ supervisors at BCBCNS, the closest screening colonoscopies----of any sort--- be they office-based or clinic-based-----is in Boone, NC and Charlotte, NC.

Additionally, as you apparently scanned your provider information while we talked on the phone, you acknowledged that there seemed to be a general lack of this service across NC.

What perplexes me is that I have brought up this topic w/ over a dozen individuals within BCBSNC----and everyone appears to be surprised at the non-availability of screening colonoscopies in NC.

Does the left hand know what the right is doing at BCBSNC----or has the administration of BCBSNC created a set response for those wanting to choose health over possible disease, disease which is entirely addressable in its early form?

I appreciated, Mr. Givens, you stating that you believe that the problem is with the ‘BCBSNC Network’ as pertaining to lack of providers. I would like to suggest that BCBSNC has known about this problem for some time now-----at least the past 9 months that I have been following up on this matter.

I wrote the BCBSNC CEO in October, 2007 and all I received back was a letter indicating that the ‘problem’ was with the providers.

Sorry: its BCBSNC’s problem. And until they own up to this, it’s my problem.

And as I commented, I would be elated if you came up w/ a solution.

However, all I have gotten from BCBSNC for the past 9 months-----as associated with various chains of supervisors----and the ‘Government Affairs’ supervisor, Nell Boone, is a passing of the buck, with no one willing to tackle the problem for BCBSNC’s ‘state plan’ insured (you indicated to me that PPO---which I have----and ‘state plan’ is one and the same thing).

While Nell Boone appeared curious about my speculation that gastroenterologists have evolved to the place where they believe that ‘clinic-based’ screening colonoscopies are to be preferred over the office-based, non-medicated/ stick it up your arse, treatment, apparently BCBSNC does not believe that their insured should be accorded treatment which has been deemed medically appropriate.

There are literally thousands of BCBSNC insured who have no access to screening colonoscopies, medicated or non-medicated-----indicated by the American Cancer Society and gastroenterologists----as a critically important screen. With over 2 million PPO insured as per your website, I believe that this would translate into literally hundred of thousands of consumers w/o this important service.

I am looking forward to you finding a gastroenterologist----someone within a reasonable travel time----not 2-3 hours as is currently available----in western NC.

You owe it to your insured. Can we not move to a more reasonable manner of procuring health care which---in the long run----costs less, assures consumer satisfaction, and increases the quality of life of BCBSNC consumers?

Marsha V. Hammond, PhD: ‘insured’ by BCBSNC

5 weeks to hammer on BCBSNC via 'short session' NC State Legislature re: no screening colonoscopies in western NC

Marsha V. Hammond, PhD, Clinical Licensed Psychologist
e mail: hammondmv@netzero.com cell: 404 964 5338

Public Health blogspots associated w/ Dr. Hammond

NC mental health reform blogspot: http://madame-defarge.blogspot.com/

Scrutinizing Blue Cross/ Blue Shield North Carolina (BCBSNC) blogspot: http://madamedefarge2scutinizingbcbsnc.blogspot.com/

May 17,2008

Dear Nell Boone (nell.boone@bcbsnc.com) , Government Affairs, BCBSNC, Supervisor:

Thank you, Ms. Boone, for calling me this past Thursday, May 15, 2008, as associated with my persistent querying regarding the lack of screening colonoscopies in western NC.

As you know, I have been investigating this and getting nothing but run around by BCBSNC, since September, 2007.

In that you came up with no solution, but apparently have passed the buck to someone else, I am speculating that BCBSNC is going to continue to try and avoid their lack of coverage for colon cancer screening, the 3rd leading cause of cancer deaths in the US.

You stated, as per the phone message you left me, that 'someone' from Customer Satisfaction and BCBSNC Network, would be in touch w/ me 'soon.' You stated that you would be calling my NC House Representative, Susan Fisher, whom I notified about the lack of screening colonoscopies for BCBSNC consumers.

I am letting Susan Fisher know by this e mail that yes, indeed, BCBSNC is continuing to avoid addressing this critical public health issue.

In that the NC State Legislature will meet for only 5 more weeks, I am asking that someone from BCBSNC contact me by May 20, 2008. If I do not hear something positive about the creation of screening colonoscopies for citizens of western NC who have BCBSNC family plans----for which they pay premium $$----I will then escalate my activism.

BCBSNC continues to be under scrutiny by NC citizens who care about public health matters.
Moreover, BCBSNC's so far actions indicate a distinct attempt to avoid providing screening for colon cancer.

This cannot possibly be good public relations for a company that continues to attempt to get out from under the thumb of the state legislature.

However, I guess that BCBSNC simply cannot manage its company in a way that would suggest that this would be a good idea. Thus, I'm stuck to this issue like glue.

I'll be the first to herald your forward thinking when you create screening colonoscopies for western NC citizens paying over $600/ month for BCBSNC PPO health insurance.

My husband and I cannot afford $2500 for the two screening colonoscopies.

This does not even take into account if there were biopsies or other procedures which are not uncommon as associated with this important preventive care.

Thank you for passing this on to pertinent parties.

Sincerely,
Marsha V. Hammond, PhD

Is NC losing its critical coverage of BCBSNC by its NPR stations supported by BCBSNC Foundation? : Mr. Nesbitt don't make me spill my machiato

Marsha V. Hammond, PhD : Clinical Licensed Psychologist, Asheville, NC
cell phone: 404 964 5338 e mail: hammondmv@netzero.com
NC Mental Health Reform blogspot:
BCBSNC blogspot:

May 16, 2008
RE: lack of screening colonoscopies in NC

Dear WUNC radio, Laura Leslie of WUNC (hunters.tavern@gmail.com <hunters.tavern@gmail.com>), and its affiliates; other NPR stations in NC; and WCQS, NPR station in Asheville, NC (info@wcqs.org):

Thank you for covering news about BCBSNC over the years.

Adam Searing of NCJustice (adam@ncjustice.org) tipped me off to Laura Leslie and WUNC coverage, over the years, of BCBSNC.

Dear WUNC radio, Laura Leslie of WUNC, and its affiliates, covering news about BCBSNC:
Adam Searing of NCJustice tipped me off to Laura Leslie and WUNC coverage, over the years, of BCBSNC.

I would like to alert you to a very problematic matter associated with BCBSNC at this time. This has been going on for some time. For me personally, I have been seeking a gastroenterologist in western NC to simply do a screening colonoscopy, something that is recommended by American Cancer Society and experts throughout the US.

Colon cancer is the 3rd leading cause of cancer deaths in the US.

I have BCBSNC PPO plan as associated w/ myself, my husband, and our 13 yr old son. We pay over $600/ month for what I thought was a good plan.

I have been trying to obtain this procedure for almost 8 months now. Please see the details in Item 3 below as associated with my post at my BCBSNC blogspot.

Over 7 months ago, upon recognizing the problem of no available screening colonoscopies in western NC, I contacted the CEO, Mr. Bob Greczyn, who sent me back a letter which indicated, essentially, that BCBSNC was not in control of having extremely limited numbers of gastroenterologists to do screening colonoscopies.

I believe that the problem may in fact be endemic and even epidemic, across NC.

I maintain that the problem is that few gastroenterologists want to do office based screening colonoscopies because they do not want to traumatize their patients. Clinic based colonoscopies avail patients of the use of IV anesthetics e.g., Versed, which eases pain and facilitates the procedure.

The cost, out of pocket, is over $1200.00 for a screening colonoscopies. If biopsies have to be taken or polyps have to be removed, there are additional costs.

I hope you can use this information to follow-up on this matter.

I have contacted everyone I know to contact re: this matter, including the Government Affairs supervisor, Nell Boone, at BCBSNC, as well as all the members of the Health Committee of the NC State Legislature. I have heard nothing from any state legislator. I know this is the short session of the state legislature and so I am feeling some pressure to get this resolved----and in the direction of BCBSNC creating relationships w/ gastroenterologists to do this procedure in western NC.

I contacted a string of supervisors at BCBSNC a couple of months ago and got nowhere. I am now 'on hold' vis a vis Nell Boone as 'someone is investigating the matter.'

Someone investigated the matter months ago and the only answer that came back is that there were screening colonoscopies in Charlotte and Boone, NC, several hours from my family in Asheville, NC----not exactly an unpopulated city.

Moreover, from what I see online re: the Insurance Committee of the NC State Legislature, there is no point in me contacting them as they appear to be in the pocket of BCBSNC.
Thank you for your coverage of this public health issue.

Marsha V. Hammond, PhD
*******************************
materials utilized for this post:
Item 1: http://wunc.org/programs/news/Isaac-Hunters-Tavern/thursday-round-up/?searchterm=%22blue%20cross%22
Bob Greczyn proved he still has a lot of friends on the House Insurance Committee, which today turned down a proposal to prevent Blue Cross execs from receiving "excessive compensation." BCBSNC CEO Greczyn hauled in almost 3 million dollars last year in compensation and bonuses. Not bad for a non-profit gig - and evidence, perhaps, that it pays to have friends in Raleigh. According to the National Institute on Money in State Politics, BCBS sank more than $70,000 into state campaign funds in the 2006 election cycle.
****************************
Item 2: http://pulse.ncpolicywatch.org/?p=1102
May 15, 2008
NC Public Radio – Getting too Cozy with NC Blue Cross?
Posted at 3:22 PM by Adam Searing
Driving home yesterday I tuned in to WUNC to hear some of the NPR China coverage and was struck by something else. Referring to health news coverage at WUNC, the station thanked the "Blue Cross and Blue Shield of North Carolina Foundation for their support of WUNC's health coverage."

I was quite taken aback. Isn't it a huge conflict of interest to have the largest health insurance company in the state sponsoring health coverage on a public news outlet that routinely reaches 250,000 people in North Carolina? Can WUNC faithfully report on the campaign to guarantee 100% of kids in NC access to an affordable health plan if one of their major sponsors on health news coverage has a huge financial interest in the outcome of the debate – and has quietly deep-sixed legislative efforts to expand health coverage to all kids?

What about the excellent coverage WUNC engaged in over the past decade the two times nonprofit NC Blue Cross made extraordinarily controversial moves to become a for-profit company? If NC Blue decides to engage in similar behavior again, will WUNC be too fatally compromised to report on this critical issue?

Finally, I have no doubt Capitol Reporter Laura Leslie will not shy away from telling it like it is about Blue in the General Assembly – as she does here in her blog – or the continued great reporting of Rose Hoban on all issues health, but what about the editors and other powers that be back at the station? Will there be pressure to change what stories are reported on in the future if they involve Blue?

I just don't see how the answer to the above questions can now be anything other than a disappointing "yes."

And, before I get jumped all over, here are two points to keep in mind. First, while businesses and some nonprofits often generally sponsor the work of the station and get taglines that help their name recognition, they are rarely – if ever – identified as sponsoring news coverage of their own business area. Imagine the outcry if WUNC was thanking "NC's poultry industry for sponsoring our coverage of working conditions at NC chicken plants."

Second, don't give me any guff that the NC Blue Cross Foundation isn't wholly controlled as an unofficial PR subsidiary of NC Blue Cross itself, despite any pretensions of independence. Blue CEO Bob Greczyn is also Chair of the foundation board and the board is unabashedly Blue:
Our Board of Directors is comprised of executive-level employees within Blue Cross and Blue Shield of North Carolina, in addition to one medical community representative who also serves on the BCBSNC corporate Board of Trustees. Bob Greczyn, President and Chief Executive Officer of BCBSNC, serves as our Chairman.

WUNC should reject NC Blue's donations for health coverage as fatally compromising their ability to fairly and accurately report on an increasingly critical issue for most North Carolinians – the quality and affordability of healthcare.
***************************************
Item 3: Photo of Martin Nesbitt (D-Buncombe; co-chair of the NC mental health reform legislative oversite committee) http://www.martnesbitt.com/photo%20truck.jpg

Monday, May 14, 2007
http://madame-defarge.blogspot.com/2007_05_01_archive.html

H973: save our Senator Nesbitt:the ballad of Nesbitt Jr.'s BCBS ADVANTA race car :PLEASE DON'T MAKE ME SPILL MY MACHIATO w/the clock runnning out

BCBSNC 'Government Affairs' employees work to deny authorization for citizens of western NC, a company SUPPOSEDLY overviewed by NC State Legislature

Marsha V. Hammond, PhD: Licensed Psychologist, Asheville, NC
cell: 404 964 5338 e mail: hammondmv@netzero.com

May 9, 2008

RE: No screening colonoscopies in western NC & no response from BCBSNC

Dear 'Government Affairs' employees of BCBSNC:
Katie.Cook@bcbsnc.com
ken.wright@bcbsnc.com
Kathryn.Millican@bcbsnc.com
Nell.Boone@bcbsnc.com

Katie, you stated in an e mail today: "I spoke with you yesterday and put you in touch with Nell Boone. She and I work in the same department. She is very good at handling customer inquires and will assist you as much as she can. "

I talked w/ Nell Boone yesterday and she stated she would be back in touch w/ me re: when I could expect an answer to 'where are the screening colonoscopies in western NC.'

What do leading experts in the US state re: the screening of CRC (colorectal cancer):

Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008

A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology*, the American Cancer Society

1. In the United States, colorectal cancer (CRC) is the third most common cancer diagnosed among men and women and the second leading cause of death from cancer.

2. Five-year survival is 90% if the disease is diagnosed while still localized (ie, confined to the wall of the bowel), but only 68% for regional disease (ie, disease with lymph node involvement), and only 10% if distant metastases are present

"It is the strong opinion of this expert panel that colon cancer prevention should
be the primary goal of CRC (colorectal cancer) screening."


This passing me from one person to the next----which has been occurring since September, 2007, when I first began to investigate why there were no screening colonoscopies in western NC------will not work.

My family, like many other families, pays a great deal of money in order to have a BCBSNC health insurance policy----over $600/ mo / 3 family members. It is a PPO. It is a high end policy.

And it is not possible to obtain a screening colonoscopies ANYWHERE in western NC except for one gastroenterologist in Boone and one in Charlotte.

The agenda of BCBSNC is to CONFUSE the issue with mumbo-jumbo about 'office based colonoscopies' vs 'clinic based colonoscopies'

BCBSNC will not pay for 'clinic-based' colonoscopies

BCBSNC will pay for 'office-based' colonoscopies

However, no gastroenterologist does any office based screening

colonoscopies in western NC.

Why would that be? Because to do office based screening colonoscopies is not appropriate medical procedure.

No, you didn't speak w/ me yesterday. I got an e mail from you and Kathryn Millican that does not open.

You are utilizing a program entitled 'Tumbleweed' which is not interfacing w/ my Windows system----or most anyone else's system.

Yesterday at 11:21 a.m., Angela Walker called me to give some info re: 'why there are so few office based screening colonoscopies in western NC.'

She can save her breath: I have already spoken to BCBSNC supervisors a couple of months ago and they tried to paint a picture of poor pitiful company that couldn't get any gastroenterology providers to sign on.

On my cell phone she called from 919 489 7431. That number, when you speak her name into the system, does not recognize her. So I got some nurse who had no idea what I was talking about.

Then I called the number she left me (I listed to it x2 and this is the number): 919 765 0634.

That number is not functional.

You, Katie and Kathryn, both sent me identical e mails which went nowhere when I opened the message. This is what I got when I opened up your message:

FROM: Kathryn Millican SUBJECT: Re: Fw: BCBSNC: no screening colonoscopies in western NC

VIEW MESSAGE Note: This message will be available online until 06/13/2008.

Internet Explorer cannot display the webpage Most likely causes:
You are not connected to the Internet.
The website is encountering problems.
There might be a typing error in the address.
What you can try: Diagnose Connection Problems

This is a public health issue, this lack of screening of colonoscopies in western NC.

I am waiting for an answer to this and that answer will include screening colonoscopies in western NC. If the NC State Legislature is supposed to be overseeing BCBSNC in some manner, on the basis of all of the non-action about this public health issue which endangers the lives of thousands of NC citizens-----I'd have to suggest that they beef up what they are doing.

Please feel free to forward this e mail to any salient party.

Marsha V. Hammond, PhDcc: health committee, NC state legislature, western nc health reporters