Blues play same games as for-profit insurers

By James Besante
Albuquerque Journal, Letters, June 10, 2014

Winthrop Quigley concisely summarizes the sale of Lovelace Health Plan’s Medicare Advantage and commercial businesses to Blue Cross Blue Shield of New Mexico in his article, “Blue Cross cleared to acquire Lovelace Health Plan on Sunday” (May 28).

The U.S. Department of Justice stalled approval of the purchase out of concern that it would significantly limit consumer choice for insurance products in the state.

BCBSNM now moves to take unprecedented market share of New Mexico’s insured population, even as news breaks of a class-action lawsuit against Health Care Service Corp., the parent company operating BCBSNM.

The suit claims the parent company breached its contract with members by accumulating excess profits of about $4.9 billion. And rather than disbursing that money to members through dividends, cheaper drugs or lower premiums, the company paid nearly $100 million in bonuses to its top 10 executives.

The nonprofit, mutually held insurer is neither acting like a nonprofit nor providing substantial mutual benefits to its members.

As a fourth-year medical student, every day I am confronted with the profit-maximizing schemes of private insurers. They avoid the sick, collect premiums, deny claims, and shift more and more costs onto my patients.

BCBSNM plays the same games as their for-profit counterparts and the endless pursuit of profits hurts all of us, but especially sick New Mexicans.

This picture is unjust and unacceptable. That’s why I and an increasing number of medical students are calling for replacing the private health insurance industry with a streamlined, publicly accountable health care system, such as “single payer,” also known as “improved Medicare for all.”

James Besante resides in Albuquerque.