[an error occurred while processing this directive]

In BayCare, BlueCross fight, we're the losers

By MARY JO MELONE, Times Columnist

© St. Petersburg Times, published October 6, 2002

Once, a whole city could be brought to its knees by a strike. Bus drivers would walk. Or teachers. This was particularly true up North.

Once, a whole city could be brought to its knees by a strike. Bus drivers would walk. Or teachers. This was particularly true up North.

Looking back, these various crises seem quaint. Sure, people were put out. But nobody's health was at stake.

There are thousands of hostages in the battle between BlueCross BlueShield of Florida and BayCare, a network of seven hospitals in Pinellas, Hillsborough and Pasco counties. There's no union, but there is a contract dispute between the insurance company and the hospital network, and there is a stalemate.

The people caught in the middle pay through the wazoo for their health insurance, and they ought to be able to rest easy knowing that having paid their premiums they'll get the treatment they need.

But that's way too reasonable an assumption. Just because you pay, why should you expect to get what you pay for?

BayCare and BlueCross have locked horns over BayCare's demand that BlueCross pay more to reimburse the hospitals for out-patient services. Nobody's predicting when this will end.

BlueCross calls itself a non-profit, because it turns back what it earns into the funds it needs to do business. The company is private. It has no stockholders to answer to.

Yet the company pays taxes and earns more than nicely. Once the bills were paid, BlueCross made $92-million in profits this year.

Please. Feel sorry for BlueCross.

What you have here is a big, rich company, complete with corporate jet, at odds with an assortment of non-profit hospitals that pay no taxes to anybody.

Who would you put your money on?

I've had my own experience with BlueCross. Last year, the company provided Times employees with health insurance.

It stank.

Although my bills were eventually paid, every time I turned around it seemed BlueCross was trying to reject some bill or other. Whenever this happened, I would contemplate how much money BlueCross was earning on my weekly premium payment while the company dragged its feet on carrying out its obligation.

It must not have just been me. After the year was up, the Times went elsewhere for health insurance.

Experts (don't you just love 'em?) say this dispute between BlueCross and BayCare is the result of market forces, in which the insurance companies wants to hold down premiums to stay competitive and hospitals demand higher payments to cover their rising, real costs.

You and me, we're just caught in the middle. Whatever rising costs there are, we pay, in the form of higher insurance costs.

These arguments may work when you're talking about the manufacture of car bumpers. But I am not a car bumper. My health insurance should be treated differently. I ought to be able to have confidence that what I've paid for, I'll get.

And I ought to be able to get it without having to carry demeaning permission slips -- those so-called referrals -- from doctor to doctor. I shouldn't have to worry that a long delay in paying a bill will hurt my credit rating. And I shouldn't have to factor in a contract dispute between an insurance company and a hospital into when I'll have my surgery.

Do you remember the first days of managed care, how the insurance companies were so chipper?

They tried to sell the new way of doing business on the idea that you, the consumer, would be in control. You could choose your doctor, your hospital. Everything would be grand.

What a joke that is now.

-- You can reach Mary Jo Melone at mjmelone@sptimes.com or (813) 226-3402.

© Copyright, St. Petersburg Times. All rights reserved.