Your Semi-Regular Blue Cross of California Outrage of the Day

Today we find them asking doctors to break doctor/patient confidentiality and report back to them on their customers so the insurer can knock them off their plans.

The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage.

Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."

"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.

Fortunately, doctors are recoiling at this effort to enlist them as de facto employees for Blue Cross. This is why eliminating pre-existing condition has to be the very first priority of any major health reform. If the insurers weren't spending so much money trying to get sick people kicked off their roads, maybe they could afford to actually help people get well.

Meanwhile, it turns out that one interest group is really interested in single payer healthcare: employers:

Many large employers are struggling with the obligation to cover the rising medical costs of retirees, but last year officials in Michigan found a way to save at least $40 million on care for retired teachers and other public-school workers: Send the bills to Washington.

Almost overnight, by taking advantage of a little-understood feature of Medicare, the school retirement system shifted a big chunk of the healthcare costs of more than 100,000 retirees off its budget and onto the federal government. This year, the state is shifting its civil service retirees too.

Michigan is not alone. Across the country, state and local government agencies, big nonprofit organizations and major corporations are rushing to do the same. One result is that the Medicare trust fund is evaporating even faster than expected.

At the heart of what critics say is a major cost-shifting maneuver is a program called Medicare Advantage, which pays private insurers a bonus to take over Medicare coverage for seniors.

The payments to the private insurers average more per senior than the cost of care with regular Medicare. The bonus payments enable insurers to offer features that seniors in regular Medicare don't get.

That has made the private plans attractive to individual seniors, with nearly 9 million -- about 1 in 5 -- now enrolled in them.

Medicare Advantage payments were floated as one way to pay for SCHIP, by the way. If you want a public program, that's one thing. But a public program that actually uses the private insurers, allows for all the same pitfalls as the private system, and has no funding source whatsoever, that's not the way to go and will crumble the only safety net left for the poor and the elderly.