Health Insurance News

Blue Cross Blue Shield of Florida has come forward with their vision of health reform, and no you crazy kids it doesn’t involve corporate malfeasance or shooting everyone that doesn’t buy a Blue Cross policy, but it does involve of course increasing profits while maintaining a certain level of health coverage in Florida.  In other words, they picture it as you would if you owned Blue Cross.

The following post is from an email we received outlining the Blue Cross Blue Shield vision of health reform in Florida and nationwide.  If you have the attention span to sit through it, I applaud you.

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Reform

Introduction The number of uninsured is growing at epidemic proportions. Nearly 50 million Americans — one in six individuals — lack appropriate health coverage and access to care. In Florida, nearly four million people are without health insurance.

Unfortunately, these numbers continue to increase, a fact that should come as no surprise since health care costs have risen more than 70 percent over the past seven years. The increase in the cost of health care and, consequently, the cost of coverage, has far outpaced wage increases for the average American. Absent an employer or government subsidy, health care coverage is simply unaffordable for many Americans.

Vision of Reform
Blue Cross and Blue Shield of Florida’s Vision of Reform Blue Cross and Blue Shield of Florida (BCBSF) believes that the severity of the affordability and uninsured issues require a case for transformational change in today’s health care environment. Our vision for reform includes five critical elements: wellness and prevention; evolution in health care delivery; universal coverage; consistent and equitable funding for safety net programs; and personal responsibility.

BCBSF’s Mission is to advance the health and well-being of Florida’s citizens and to work toward a system where appropriate health care is available to all. But we certainly can’t do it alone. Any change for which we advocate can only be accomplished when all of those involved in health care delivery, financing, utilization and supply coalesce to agree on a realistic platform for reform. Until all parties recognize that the current model is unsustainable, it is unlikely change will occur proactively. And if the health care industry doesn’t come together quickly, a declining economy will drive a political agenda that diminishes the positive impact brought by the private sector in terms of innovation and meaningful competition.

Wellness and Prevention BCBSF envisions a medical delivery system that evolves from an illness model to a wellness model. Today, doctors and other providers are paid to treat the sick with very little financial reward for keeping people healthy. This paradigm must be changed. Incentives for preventive medicine and wellness should be offered to both patients and providers. Steady doses of wellness education should be offered beginning at a very young age and continued through one’s entire educational career.

Overall, our health care financing needs to be realigned to reward both the practitioners and consumers who achieve the best health outcomes. Evolution in Health Care Delivery BCBSF and other payers need to work with our provider partners to implement critical changes in medical delivery.

A system that embraces objective, proven clinical standards as the foundation for reimbursement is the goal. Physicians should be rewarded for adherence to these standards and for the enhanced value that efficient, integrated and clinically appropriate care brings to patients.

Protections from legal liability can be legislated to shield clinicians and eliminate the costs caused by defensive medicine and other consequences of malpractice lawsuits. With the total impact on medical expenditures costing $124 billion each year, removing this cost would pay for virtually any version of comprehensive health care reform. Universal Coverage For the insurance industry and medical community to successfully implement system changes that would bring coverage to all Americans, BCBSF envisions the federal government playing a significant role. For those individuals and businesses that do not obtain coverage voluntarily, an enforceable mandate must be created.

Policy studies consistently find that a voluntary system cannot produce universal participation. Our country’s compassion has created a safe haven of emergency room treatment for all. The cost of this care is being borne by a diminishing number of insured. The fundamental principle of spreading risk can only be achieved when all of those capable of paying for their own or their employees’ coverage are mandated to do so with appropriate incentives. Those who do not have the financial ability should receive a meaningful public subsidy. Consistent and Equitable Funding for Safety Net Programs We believe the best approach for funding these programs will spread the risk nationwide.

Additionally, public subsidies and safety net programs should be equitably funded across the states. Inconsistency in federal and state funding adds to the problem of a disjointed health care system and does not encourage integrated care. Florida has a disproportionate responsibility of caring for seniors in long-term care settings. While an increase in taxes would be necessary, long-term care costs should be part of the Medicare program. Personal Responsibility Finally, BCBSF believes private and public entities, along with the federal government, can create an environment that encourages personal responsibility for each individual. It took only one generation to reduce the number of smokers by half.

We can work together to address and improve conditions that deplete most of our health care dollars; like asthma, diabetes, heart disease and depression. Obesity and diabetes can be significantly addressed through good nutrition and exercise. Can we expect people to take personal responsibility when their neighborhood is unsafe, where there are no sidewalks on which to walk or playgrounds on which to play, and only fast food is available?

When a large percentage of Florida’s adult population is functionally illiterate, how realistic is the expectation that food labels will be read and understood? Clearly, education and resources are the keys to promoting personal responsibility and good health. Let’s work together to put exercise back into our schools, to build and create neighborhoods where children can play in a protected environment and spaces can exist for community markets. How can we eliminate economic and environmental chemical burdens that foster depression and physical illnesses?

We need the commitment to create incentives that promote and pay for early disease intervention and preventive care. BCBSF is not promoting a vision of utopia but rather asking everyone to take a role in building and supporting a long-term view of a healthy Florida and the United States for future generations. As we move forward, BCBSF pledges to continue the dialogue, develop solutions that align with this vision and work with various stakeholders to develop integrated approaches to health care affordability and access.