Frankenstein vs. BC CA
E-newsletter FierceHealthcare reported on Blue Cross of CA's attempt to enlist doctors to help expose patient’s healthcare discrepancies in order to cancel policies (read below). This is of course troubling, though not surprising (do health plans have ulterior motives like this in pushing PHRs?)
Even more troubling is the existence of Dr. Frankenstein, who is head of the California Medical Association. This Dr. Richard Frankenstein was “outraged” by Blue Cross’ action. I would be careful Blue Cross. Dr. Frankenstein doubtless has powerful progeny who you do not want to meet on a dark and stormy night, unless you have a lot of torches.
“Blue Cross of California has raised eyebrows around the state, and sparked protests from some physician groups, by sending medical groups applications filled out by beneficiaries and asking the doctors, in effect, if the patients lied about their health. With the applications, which went out to large medical groups who have capitation contracts with the health plan, Blue Cross advised doctors to narc on patients who had any conditions not listed on the applications. This is just the latest in the plan's attempts to aggressively weed out sick patients. Blue Cross has already faced the ire of regulators for issuing policies then canceling them when the patients incur big medical bills.
The Good Doctor, Before His Outrage
The letter and accompanying application "outraged" the California Medical Association, according to president Dr. Richard Frankenstein. He argues that with doctors in the role of police, patients may be afraid to share their whole medical history with doctors, putting their health at risk. The association has sent a letter to state regulators asking them to order Blue Cross to stop asking doctors for patient information. A spokesperson for the state insurance commissioner said that while their office hadn't gotten any complaints about the letter, they consider it "extremely troubling," in that it effectively places doctors in the role of underwriters.”
The Villain of our Tale
Post Script. A few weeks later, BlueCross of California relented before the outrage of Dr. Frankenstein and his physician minions. Policy changed. Happy ending.
Posted by Shawn Whalen on April 1, 2008 at 6:06 AM
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