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Blue Cross and Blue Shield of Illinois Support Access to Care for All

July 21, 2009

Blue Cross and Blue Shield of Illinois (BCBSIL) wants all Americans to have access to quality, affordable health care. Shifting who pays for care won’t solve the access problem; controlling spiraling health care costs will. However, this is a challenge given how quickly health care costs and their underlying lifestyle and environmental drivers are increasing. From 2004 through 2008 alone:

  • The diagnosis of type 2 diabetes among our members increased by about 14% and charges for services increased by 34%, from about $22,000 to $29,000. And if the CDC’s estimates are correct — that one in three children born in 2000 will develop diabetes in their lifetimes — then these costs will increase substantially;
  • The diagnosis of atherosclerosis among our members increased by about 17% and charges for services increased by 29% from about $51,000 to $65,000. And that doesn’t include all of the other increasingly prevalent cardiac conditions, such as high blood pressure and high cholesterol; and
  • The diagnosis of asthma among our members increased by 12% and charges for services increased by 53% from about $11,000 to $17,000.

What’s more is that in Illinois, we have 47 mandates that require health plans to cover services, ranging from chiropractic to in vitro fertilization. These mandates alone increase the cost of health insurance policies by as much as 25% to 50%. While we would never judge the societal value of a particular mandate, everyone needs to understand that the more that's covered, the greater the costs.

To increase access, BCBSIL supports proposals that would require us and other health insurance companies to offer coverage to all applicants, meaning that no one would be denied for pre-existing conditions. However, this would work only if each and every American were required to carry health insurance. Otherwise, what’s likely to happen is a revolving door of individuals purchasing coverage only when they become ill, driving up costs for everyone and ultimately discouraging healthy individuals who may want to purchase or maintain their coverage from doing so.

On the other hand, BCBSIL is concerned about the establishment of a new government-run insurance plan. First, let’s be clear — It would not be free. A new government program would charge premiums and it would face the same underlying health care cost pressures as existing health insurance programs. It’s important to note that Medicare and Medicaid reimbursement doesn’t even cover the cost of care, while BCBSIL pays providers on average between 20 and 30 percent more than Medicare and Medicaid. Imagine if the new government plan covered less than the cost of care, too. Faced with less reimbursement for services for a much larger number of patients, hospitals already at risk could be driven out of business, and lower pay would mean fewer doctors would be available to treat a growing and aging population. And at the end of the day, we may be facing longer waits for medical services at a time when more and more Americans would be entering the health system and demanding care.

All Americans should have access to health care, and we need to start by taking steps to control costs and enhance quality. If we don’t do this correctly, we could actually lessen access and cause other unintended consequences that would take generations to fix.

Paul S. Boulis
President
Blue Cross and Blue Shield of Illinois



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