To All Of Our Blue Cross Blue Shield Patients: Fill & Download for Free

My husband began having cardiac problems in his late forties. Clot-busting drugs didn’t exist yet, so when he had a heart attack, he underwent an angioplasty to clear up three arterial blockages. Soon after, he lost his job. His employer gave a B.S. excuse for laying him off, but we knew it was because they didn’t want an employee on their group plan who might need very expensive health care in the future.Losing his job meant losing his—our—health insurance. I immediately signed up the entire family with my employer’s group health insurance, but ten months after the angioplasty, my husband needed triple bypass surgery. Today, I suppose the hospital and the doctors would verify that he was covered before they’d proceed with the surgery. Either they didn’t, or else Blue Cross/Blue Shield double-crossed them.My husband had the bypass, but when presented with the bills, BC/BS refused to pay on the grounds that it didn’t cover pre-existing conditions until the patient had been on the plan for a full year. (Ten months, remember?) We wound up filing for bankruptcy protection, and I’ve hated BC/BS ever since.When she was on the faculty of Harvard Law School, Senator Elizabeth Warren taught bankruptcy law. She became a consumer advocate when her research proved that most people didn’t file for bankruptcy because they used credit cards like drunken sailors to buy luxuries; they filed due to medical expenses for which they had no insurance. Before Obamacare there were millions of people like us. In states which refused to take the Medicaid expansion, there still are.I retired from a workers’ compensation law firm. Many times I heard my boss say that a certain claimant was trying to tie everything wrong with him to his accident so he could get workers’ comp to pay for treatment. Of course some accidents injure more than one body part, but other times the injuries were old and unrelated but had never been treated, for lack of health insurance. Most of my boss’s clients were insurance carriers, not claimants, and she could not ethically advise an insurance company to pay for treatment of a claimant’s old injuries. Still, she sympathized with the desperate claimants, and complained that it was all due to the United States’ not having universal health care.If my husband’s cardiologist, cardiac surgeon and hospital had known BC/BS wouldn’t cover his bills, I suppose they would have sent him back home with his blocked arteries and advised him to get his affairs in order. Most likely I would have been a widow these last 25 years, yet Grover Norquist and the CEO of Blue Cross/Blue Shield wouldn’t have lost a moment of sleep over his death.For that matter, I never lose any sleep over filing bankruptcy to discharge those bills; after all, my husband is still alive. It is simply outrageous that for lack of universal health care—blame greedy billionaires and “government is not the solution to the problem, government is the problem” Ronald Reagan wannabes—we were ever in that position to start with.

Since many of us can add anecdotal thoughts and beliefs around N/D usage, I thought I would simply provide what and how we use it here in my employer. I work for Palmetto GBA, a subsidiary of Blue Cross/Blue Shield of South Carolina. We are a contractor to the U.S. government, and we manage Medicare/Medicaid for the US Government in various regions throughout the country. We work with the providers (e.g. doctors, hospitals, etc.), not the end customers/patients. Anyway, our entire Web presence - both the public, anonymous web presence and the authenticated provider interface - are on Domino 8.5.x. Let me say that again:The entire site. All of it.It works extremely well for what we do, and we have no plans to move away from it in the foreseeable future (contrary to popular IT belief). Now the interesting twist is that we do not have any users, at all, on a Notes client. Not a single internal user is on the Notes client. The only Notes clients (and DDE, Admin) are used by our team, the developers and Domino Admins. We use the M$ "stack" for email and calendaring.Interesting, huh?The bulk of our site is still "old school" Domino web development techniques; however we are beginning to integrate xpages into our environment, and that's the direction we're heading. Of course we're only adding xpages for new development efforts, and existing changes where it makes sense. (Changing to a new technology, just for new technology's sake, is stupid.)So we're moving forward in Domino land. We're open to other technologies - in fact we're about to roll out a bitchin' search engine that integrates and indexes Domino data, natively - because it is the best tool for the job. So, we don't bleed yellow and blue; we just use what works for us.

It seems like a theme of the many thoughtful answers to this question is: It depends on where you live. States with robust Medicaid and public health systems seem to give more hopeful answers than those that do not. I can only speak about Hawaii.We have the second-highest rate of insurance coverage in the nation after Massachusetts which has universal coverage. The reason is that if you work 19 or more hours a week, your employer must pay nearly all of your insurance coverage. This is called the Prepaid Health Care Act and we’ve had it since the 70s. Minimum benefits are defined by the largest insurer, Hawaii Medical Services Association (HMSA or Blue Cross/Blue Shield). We’also expanded Medicaid services and have really good public health clinics like Waikiki Health and Waianae Comprehensive Health. We also have a teaching hospital (Queens Hospital and clinics) and a well-endowed women and childrens’ hospital (Kapiolani Women and Childrens’ Hospital). So your hopefully hypothetical patient would do just fine here.However, this comes at a price. Our taxes are some of the highest in the nation and small businesses get crushed by health insurance costs making us consistently ranked one of the worst places in the country for business. Physician reimbursements are some of the lowest in country meaning that it is often difficult to recruit and retain good doctors across specialties. However, we as a state decided some time ago that it was worth the trade off. God forbid that global warming inundates are main tourist attractions like Waikiki because if that ever goes away, we will be in dire straits.To paraphrase one of my favorite answers, health care is never free. Somebody, somewhere must pay for it, somehow.