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Wendy Block Headshot

My Blue Shield Experience Embodies Our Stupid and Wasteful Health Insurance System

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Dah DEE dah
DAH dee dah
Dah dah dah dee DAY

Dah DEE dah
DAH dee dah
Dah dee DEE dah day...

Recognize this melody? If you're a Blue Shield of California member, you hear it pretty much every time you call and end up holding till an actual person answers. A few days ago I heard it for half an hour, interrupted only by a man's recorded voice telling me how Blue Shield is giving me better, more affordable access to healthcare.

Everybody has had a version of this experience, so why am I asking you to read about mine? Because it embodies our stupid, wasteful health insurance system, and underscores the need for single payer health care.

After my divorce two years ago I was COBRA-ed. COBRA, I'm pretty sure, is the administrator of my Blue Shield policy. I lucked into meeting Janet -- a smart, efficient, nice insurance broker from an independent brokerage -- who helped me survive the jurisdictional mess that accompanied -- at no extra charge -- the COBRA conversion. She's kept in touch, most recently to confirm I'd received an important packet she'd emailed me just before Thanksgiving.

I'd been so focused on the holidays I had ignored Office Outlook. Janet told me that the non-profit through which I'm insured was switching dental plans, and that I had to enroll soon if I wanted to keep coverage. She urged me to sign and send her the forms asap and offered to expedite my enrollment to beat the deadline. I did, and she did. Thanks again, Janet!

To guarantee that my overall insurance would continue, I needed to choose specific levels of coverage and mail the paperwork by December 15. On the 14th (hey, 24 hours ahead) I studied the choices and called the recommended 800- number with a few questions. That number turned out to be COBRA's, but the rep couldn't answer my questions. Asking her what questions she could answer didn't yield much, so I tried a few subjects until it became clear that COBRA knew only about administering insurance plans, not about the plans themselves.

She did know Blue Shield's number which she gave me, and I called. After the de rigeur two minute holding period to reach a human, during which my relationship with Dah DEE dah, DAH dee dah... began, a chirpy young woman named Sophie asked if she could help me. But first she needed my ID number etc.

Once she heard I was on COBRA, she asked whether it was state or national COBRA, and whatever I replied triggered her bureaucratic reflex. Zombie-like, she kept repeating, "Call COBRA," "Call COBRA."

I asked for her supervisor, which gave me more time with Dah DEE dah ... When Sophie returned she said her supervisor was on another call. Did I want COBRA's number?

I'd been polite, but no more. "You're saying you work for Blue Shield, but you can't tell me the difference among Blue Shield plans?" I asked, incredulous and pissed. "No," she said, "COBRA..." I don't remember exactly how I responded -- though I used no curse words; my response inspired her to ask if I wanted to wait for her supervisor. "Yes," I replied, mercifully releasing us from this exchange.

It was during the next wait that I started humming along with and scatting the Blue Shield on-hold tune. A few minutes later I began singing harmony. I considered writing lyrics, but time was a-wasting and now I'd have to scramble to arrive at a scheduled appointment.

Just when I was about to hang up -- 30 minutes after this hold-fest began -- Sophie's supervisor Tom picked up. He started yapping about COBRA when I interrupted, saying that after waiting half an hour I had to run; just please distinguish between HMO 250 and HMO 400 and POS plus and so on. He did! And I got it!

I wanted to stick around for the post-call survey another robotic Blue Shield voice sometimes asks me to take -- I had definitive responses. But, tickety tock.

Altogether, I'd called six people from five companies. (I've spared you two other unhelpful conversations.) Janet the broker was the lone hero.

With a single payer system, one entity would coordinate everything. Eliminating the majority of paper-pushing companies and employees with their cubicle-bred mindsets (forget expertise!) could lead the way for Janet and other competent people to run things.

Plus, single payer health care would save California nearly $350 billion in health costs over 10 years, according to-- ready?--the Lewin Group! (p 42) There'd be more funds for doctors and for healthcare itself, from which everyone -- finally -- could benefit.

Yeah, reality is messy. But a simple, lean structure makes it easier for anyone to work efficiently. Customer reps would likely know their straightforward universe; they wouldn't need to put callers on hold for half an hour. And I could spend the rest of my day without whistling that damn Dah DEE dah, DAH dee dah...