Wednesday, March 18, 2009

BCBSNC: they donated $643,000 to state legislators who are then supposed to OVERSEE BCBSNC

"Democracy NC releases report on Blue Cross campaign donations
Posted at 10:08 AM by Adam Searing
See contact information for Democracy NC and the chart detailing donations here. Excerpts from the statement by Democracy NC Director Bob Hall today:
An analysis by Democracy North Carolina reveals that no other company the size of Blue Cross has donated more to state politics through its political action committee –- a total of $643,000 from the 2000 election cycle through 2008. Seven company-backed PACs have given more, like those of the big banks and utilities, but all seven of those corporations operate in multiple states and are much larger than Blue Cross. As a not-for-profit corporation, Blue Cross is in a class of its own…"


YEESS! Now, we're getting somewhere. Let's have the details of which state legislators received the money and I would assume that it is the state legislators who are supposed to do the monitoring as re: the BCBSNC state legislative committee.

Turn on the heat:

I would hope that Martin Nesbitt would lead the way to get BCBSNC overview OUT of the NC State Legislature----given how he used to be associated w/ BCBSNC, via his racing son, 'advantaged' a BCBSNC Advanta car: see the pic here: (from Defarge blog): 'NC losing its critical coverage of BCBSNC by its NPR stations supported by BCBSNC Foundation? : Mr. Nesbitt don't make me spill my machiato':

Here is the list of some of the purportedly 'government affairs' employees associated w/ BCBSNC (ya know: those people who are supposed to 'tell' the state legislators what they want them to know): (Ken Wright, best I understand it, is the lead person, and you sometimes can catch Nell Boone at her desk on a Saturday: I bet she doesn't pick up her phone anymore, though):


Notice that they all have bcbsnc e mail suffixes.

Let's have the list of the state legislators who were 'advantaged' the 643,000 from the 2000 election cycle through 2008.

WE NEED A ONE PAYOR SYSTEM in order to cut down the administrative costs of health insurance. We all suffer because of this.

Marsha V. Hammond, PhD

Wednesday, March 11, 2009

$16 Million paid to BCBSNC Board Members: the Ponzi scheme that the insured have paid into

Look at this pdf:

You will see that the 13 members of the BCBSNC board 2008 reimbursement is approximatly $16 million.

Gee, I wonder why our premiums keep going up?

Gotta keep up with the Greczyn's.

Friday, March 6, 2009

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Change the law to increase NC Department of Insurance ability to monitor health insurance companies like BCBSNC

Marsha V. Hammond, PhD: Clinical Licensed Psychologist, Asheville, NC
NC Mental Health Reform blogspot:
Scrutinizing BCBSNC blogspot:
March 6, 2009
Dear Susan Fisher, NC Rep for Asheville, NC:
I have spoken w/ you and your assistant, Lynn Tennant, in the past, Ms. Fisher, about problems I have had---personally----as associated w/ BCBSNC as pertaining to the BCBSNC Advanta Plan that my healthy, 3 member family has. Specific to my own personal concerns,I cannot be reimbursed for mammograms or screening colonoscoopies.
Specific to NC Mental Health Reform and mental health issues, there is no adherence of BCBSNC to mental health parity.
And every state legislator seems terrified of BCBSNC. Its very concerning. Citizens feel impotent to get anything done.
Colon cancer screening is required by law. But if you do not have $1200 to pay out of pocket, and there is only one gastroenterologist 2 hours away in western NC in Boone, NC, it does not matter what the law states. You try driving two hours after taking the fluid in order to keep your colon cleaned out.
I am writing to you to encourage you to support any and all efforts associated w/ strengthening the NC Department of Insurance to oversee & monitor health insurance companies such as BCBSNC. I enclose a scanned version of a letter I received in December, 2008, from obert C. Lisson, Ph.D.Deputy Commissioner, Consumer Services Division. This was also placed on my blog scrutinizing BCBSNC back in December, 2008..

December 15, 2008Dr. Marsha Hammond--------------------------Asheville, NC 28806 RE: Blue Cross & Blue Shield of North Carolina------------------- -.­Dear Dr. Hammond:Thank you for your recent correspondence to the Consumer Services Division. I am writing in response to your December 13, 2008 em ail message to Becky Thornton, regarding your BCBSNC policy's coverage for colonoscopies in your immediate area.First, "coverage" and "reimbursement" are two different things. North Carolina health plans subject to North Carolina General Statute 58-3-179 must indeed cover colorectal cancer screening. As you are aware, though, a claim for "covered" services does not always result in reimbursement from the health plan. . For example this could occur when (even after the cost of the covered service) the member has not yet met the applicable policy deductible. In such situations, the cost of the covered service is credited to the member's deductible. If the service were not covered, the cost would not be credited to the deductible.Second, North Carolina law does not give the Department of Insurance the regulatory authority to dictate place-of-service for this mandated benefit. More specifically, we do not have the authority to require BCBSNC to make the procedure in question available in office-based settings. My understanding is that the procedure can be obtained from in-network BCBSNC providers in your immediate area. Whether the service is available only in contracted clinic settings or also from contracted office-based providers does not affect BCBSNC's compliance with applicable provider availability/accessibility requirements.We certainly understand your disappointment, and regret that we do not have the authority to further assist you. However, please do not hesitate to contact me at (800) 546-5664 if you wish to discuss the matter.Robert C. Lisson, Ph.D.Deputy Commissioner, Consumer Services Division

Thank you, Susan Fisher. Pass this e mail to any pertinent person or entity.

Wednesday, March 4, 2009

"Health Information Highway" will create efficiency (as will a one payer system reduce massive administrative costs)

It's More Than an Electronic Health Record - Call It a "Health Information Highway"
by RJ Eskow March 3, 2009 - 11:02am

".....Paradoxically, computerizing the health system in this country could make it much more humane than it is today. But that calls for a broad vision of health IT as an "information highway" that stores information, looks for problems, and eases the many routine interactions that make up the health system. A well-designed "health highway" would have features like these:

A common set of programming specifications for coding, storing, sharing, and manipulating health information. Just as XML (eXtensible Markup Language) allowed web designers to create sites that interact with one another, a health markup language or "HML" could allow systems used by doctors, hospitals, patients, and others to easily "talk" with one another.

The ability for systems to "look for" adverse medical reactions together. Certain harmless drugs become deadly in combination with other drugs, or when a person has other medical conditions. One way this technology could be used is to automatically look for these interactions every time a prescription is electronically "written."

Personal convenience. A doctor recommended minor surgery for me last week. What if her office had been able to schedule an appointment for me on the spot, send me a before-and-after personal care plan (tailored to my medical history), pre-authorized the treatment -- and checked my health plan to tell me how much it was going to cost me?

More privacy than we have today. I began tracking health privacy breaches a couple of years ago, but had to stop -- because they're too frequent. Laptops get stolen with medical information on them, storage disks get misplaced, or computers get hacked. (I wrote a paper about potential criminal uses of stolen medical data, but decided not to publish it ...) A comprehensive health IT system would include better protections for health data.

Tools for primary care doctors to manage your health. US and Canadian primary care doctors - the ones who should be managing your overall health -- have historically lagged behind their European counterparts in some vital IT capabilities. Health reform depends on stronger primary care - and health IT can help.

Automatic claim submission. Why shouldn't the health IT network automatically submit my claim after I've received medical treatment? Why shouldn't it tell me how far I've gone in meeting my deductible, and share any other financial information I might need? Our current system is too clerical, too bureaucratic, and too difficult to navigate....."