By Paul Beebe

The Salt Lake Tribune

November 14, 2009

As the battle over health care reform rages in Congress, Regence BlueCross BlueShield is using a slick Internet site, social media and billboards to say that consumers bear much of the blame for high premiums.

The message isn’t that bald, but it’s there.

“It really is about motivating people about the real cost of health care and how the choices they make each day impact those costs. To motivate consumers to take action is really what it’s all about,” Regence spokeswoman Georganne Benjamin said Wednesday.

“Cost is a big factor in this debate, and we need to address the high rate of medical spending, or we will not have meaningful health care transformation. This campaign does play a role in that,” she said.

The heart of Regence’s campaign is an interactive Web site (What’s the Real Cost?). But if a visitor overlooks or doesn’t click on a link next to a navigation button, he won’t easily discern that the site was put up by (Regence BlueCross BlueShield).

Regence is also using traditional tactics.

It has erected billboards along Interstate 15 that display two messages: “Health care hums like a machine with no off button because we don’t question it” and “Should ‘Because it’s covered’ be guiding health care?”

http://www.sltrib.com/business/ci_13562042

What’s the Real Cost? (a game):

http://www.whatstherealcost.org

Comment:

By Don McCanne, MD

How many people do you know that request health care that they know they don’t need but they want to have “because it’s covered”? In over thirty years of my very busy family practice, I cannot recall one single patient with such a request. Yet the thrust of this Regence BlueCross BlueShield campaign is to blame the patient for requesting too much health care.

We know the primary sources of the very high costs for health care in the United States. First, the administrative excesses of our fragmented financing system waste hundreds of billions of dollars each year (about four trillion in the next ten years, reformers please note). Also our prices are much higher than in other nations. Although technological advances have increased costs, they do not account for our excess spending since the level of use is comparable to that of most other nations.

So what about the excess of unnecessary care? Health care decisions are predominantly supply-side, provider-driven decisions. In spite of the plethora of anecdotes of patients demanding too much care, very few health care decisions are demand-side, patient-driven decisions. Regence couldn’t be further off target with this campaign.

Regence BlueCross BlueShield is a not-for-profit insurer, theoretically a traditional Blues plan. But it, like the other not-for-profits, has adopted the market innovations of the other Blues such as WellPoint that have converted to for-profit for the primary purpose of making money, with patient service being only a secondary necessity.

Regence BlueCross BlueShield is part of the reason for our outrageous health care costs, both for the administrative waste from its own activities and the administrative burden placed on providers, plus its ineffectiveness in improving value by improving the allocation of our health care dollars. For Regence to place the blame with the patients for demanding too much care is the ultimate of chutzpah.