By Paul von Ebers, President and CEO
North Dakotans are ill served by inaccurate, overheated rhetoric that obscures the facts about health reform and its true impact on the citizens of our state.
False generalizations, unsubstantiated claims and inflammatory language blur the issues and get in the way of reasoned debate aimed at achieving real solutions. Some examples specific to Blue Cross Blue Shield of North Dakota that recently appeared in North Dakota newspapers:
Allegations BCBSND pockets 90 cents for every $1 paid in private insurance claims in North Dakota. In fact, more than 90 cents of every dollar collected by BCBSND is PAID OUT to hospitals and doctors for services provided to our members. In 2008, our administrative costs were 7.2 percent and we paid out 92.8 cents.
- Allegations BCBSND denies coverage based on pre-existing conditions and has incentivized the denial of care. In fact, we approve more than 90 percent of all individual applications and have NEVER incentivized the denial of care. We also pay more than 97 percent of all submitted claims.
- Allegations BCBSND was found to have doctored marketing materials with misleading statements exaggerating the portion of revenue paid out in health care claims. BCBSND was never charged with "doctoring" any documents. A disagreement over wording was resolved by changing 93 cents to 92.8 cents – and finalized with the Department of Insurance this past week.
Other rhetoric has been more general, painting all insurers as "profiteers" who "rake in record profits" and "deny care to ordinary Americans."
- In fact, as a not-for-profit organization, BCBSND focuses on serving members more than profitability, and targets just a 1 percent profit from operations each year. Any income achieved is added to our reserves to ensure our ability to cover the future needs of our members. Our current reserve level is one of the lowest in the entire system of Blue Cross Blue Shield plans.
In addition, recent stories in the national media have reported that health insurer profits nationwide are not so fat as the public has been led to believe, with profit margins typically running about 6 percent, give or take a point or two – a figure that was described in one AP article as "anemic compared with other forms of insurance and a broad array of industries, even some beleaguered ones."
No one is saying insurance companies, like every other business, shouldn't be held accountable. But vilifying all insurers – or any one entity, for that matter – ignores the complex realities of health reform and fails to address the fundamental issues driving the soaring cost of care.
We must do more than simply focus on increasing coverage. We must work together to make substantial changes in the way we use, deliver and pay for care.
I believe that we, in North Dakota, are uniquely positioned to do that. This is a state where all the stakeholders can be at the table – hospitals, doctors, employers, consumers, regulators, lawmakers and insurers – engaging in the discussion to find new and innovative approaches that will cut costs, increase access and improve quality. We must not let the tenor of the discussion distract us from the hard work at hand as we collaborate to achieve what is truly in the best interests of all North Dakotans – affordable and sustainable health care for all.