Thursday, June 11, 2015

BX in the Crosshairs

Surprised only that it took this long:

"Blue Cross and Blue Shield (BCBS), along with the Blue Cross Blue Shield Association, was sued across all states in a class action brought by two types of plaintiffs ... BCBS is able to buy services as a cartel and is not passing savings on to consumers."

This would be news, of course, only to those who haven't been following along, or who don't understand the true role of Blue Cross/Blue Shield (BX):

"In the insurance world, MFN (no, that's not an acronym for something dirty) means "Most Favored Nation," a term usually reserved for international trade agreements. In this case, it's an agreement between an insurer and a provider (or many providers) which grants the insurer exclusive and substantial discounts on medical services."

Back in Aught 10, we noted how BX had (seemingly) abused this status, but the sad truth is that they are the 800 pound gorilla in (virtually?) every market.

The challenge here is that as premiums increased, there was no concomitant rise in provider reimbursements. And in true vicious cycle fashion, these savings weren't then funneled back to the insureds.

Now, the lawsuit covers the period from 2000 to 2007, so it pre-dates the ObamaTax and thus MLR (Medical Loss Ratio) requirements. The fact that the case is still going forward is interesting, inasmuch as the underlying problem seems to have been resolved. Still, one supposes that those (allegedly) harmed by it deserve their day in court.

On the other hand, who do they think is going to actually pay should plaintiffs prevail?
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