WellPoint/Blue Cross looking for a few good spies

As if it isn't bad enough with Big Pharma and their cozy (and what many consider unethical) relationship with doctors. WellPoint/Blue Cross now want to be even creepier as they are asking medical doctors to spy on patients and report back to the corporate offices. (You may remember WellPoint from the seedy scandal involving the ex-CEO who was having affairs across the country allegedly promising marriage, passing on STDs and screaming "ABORT" to one women he impregnated. A fine GOP fund raiser and a good moral leader, they say.)

While medical doctors so often are game when it involves holidays to the Caribbean or commission/perks for prescribing drugs, this may be going too far. Blue Cross is asking doctors to report any pre-existing conditions so they can use this as grounds for termination or decline payment. When an individual is canceled, good luck finding another insurance company that will accept you.

More after the jump.

Who doesn't have some sort of pre-existing condition? While this can be difficult for working age people, just imagine the consequences for retired Americans. After my father died a few years ago, my mother received the usual series of nasty letters from the insurance company telling her that she needed to move on. (So much for the retirement benefits promised by my father's company.) Maybe person of 73 years exists that does not have any pre-existing conditions but they are rare. This is a period when most Americans will spend a lot of their hard earned money, paying for medical treatment. If my mother was in California and moving to Blue Cross, WellPoint/Blue Cross would be asking her doctor - her doctor! - to turn in a list of pre-existing conditions so they could cancel her. Then again, would it be her doctor or is Blue Cross forcing customers to use their own special list of doctors who will tow the line for corporate?

WellPoint Inc., the Indianapolis-based company that operates Blue Cross of California, said it was sending out the letters in an effort to keep costs at a minimum.

"Enrolling an applicant who did not disclose their true condition (and the condition is chronic or acute), will quickly drive increased utilization of services, which drives up costs for all members," WellPoint spokeswoman Shannon Troughton said in an e-mail to the newspaper.

"Blue Cross feels it is our responsibility to assure all records are accurate and up to date for HMO providers," she said. "We send these letters to identify members early on in the process who may not have been honest in their application."

And who makes this judgment call? Sounds like it's Blue Cross, an obviously biased player in this situation. A simple, honest mistake could send a customer onto the street without coverage. Worse still, as the article says, patients may hide more serious problems which will then be much more expensive to treat later, if even treated.

When the insurance industry wonders why they are consistently detested in America, this is a prime example. They only want the good customers but who the hell are the good customers? Americans spend more on health care per person than anywhere else in the world and yet the insurance industry is confident enough in their own power that they can pull stunts like this. Sadly, they're probably right. They can and do get away with just about any crazy program they want. Thanks to the GOP program of "let business govern itself" this is the end result.

If WellPoint and Blue Cross want out of the insurance business, fine. If they want to stay in the business, practices like this need to be examined and balanced. As I've said before, here in France (which has it's own problems, of course) I have never once heard someone panic that they were going to be thrown off of an insurance plan or lose their savings due to illness. Not once. As a country we have allowed business to go much too far and it's time we move back to finding a proper balance. Right now, it's a one-sided relationship and that's no longer acceptable.