06/19/2009 05:12 am ET | Updated May 25, 2011

BlueCross BlueShield of North Carolina's Desperate Attempt To Deceive

BlueCross BlueShield of North Carolina Has A
History Of Denying Coverage Due To Preexisting Conditions

BCBS Of North Carolina Implied
Public Option May Not Cover Preexisting Conditions. 
The Washington
obtained storyboards of BlueCross BlueShield of North Carolina advertisements opposed to
health care reform.  In a crowded
gathering, the advertisement viewer will hear, "...pre-existing conditions?
Nobody knows yet..." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

It is
BlueCross Blue Shield of North
Carolina that has a history of denying coverage due
to preexisting conditions.

BCBS of NC: "Maternity Benefits And
Preexisting Conditions Are Excluded."
A BlueCross BlueShield of North Carolina press
release announcing new coverage options stated, "maternity benefits and
preexisting conditions are excluded, among other benefit limitations.  To apply for Short Term Health Care, a
consumer must be a resident of North
Carolina, under age 65 and not eligible for Medicare
or Medicaid." [BCBS of NC Release via PR Newswire, 3/31/94]

BCBS Of North Carolina Denied Coverage To Applicants
.  As
reported by the News & Observer:
"In the world of individual health insurance, it doesn't take much to become
undesirable. For Denis O'Connor, 61, of Chapel Hill,
all it took was too many years without sunscreen and a few small skin cancers.
For his wife Alice, 54, it was migraine headaches.  Those health conditions got the retired
couple a health insurance quote of $3,000 a month -- $36,000 a year -- when
they applied for a Blue Cross and Blue Shield of North Carolina plan in October
2003. They declined it." [News &
, 2/27/05]

After Wrongly Denying Coverage To
Customers, BCBS Of North Carolina
Was Forced To Pay For Medical Services.
According to the Durham Herald-Sun: "A state insurance
department program launched in 2002 has forced North Carolina health plans to pay almost $1
million for medical services they had refused to cover.... Blue Cross and Blue
Shield of North Carolina, the state's largest health insurer, had the second
most cases reviewed at 28, of which 32 percent were overturned." [Herald-Sun, 5/22/05]

"Blue Cross And Blue Shield Of North Carolina... Said
Denial-Of-Coverage Cases Really Are About Contract Interpretation."

According to the Charlotte Observer,
"Blue Cross and Blue Shield of North Carolina general counsel Brad Wilson said
denial-of-coverage cases really are about contract interpretation -- whether an
insurance policy covers a service or not. Consumer advocates argue that
insurers use vague contract language as grounds to deny payment and save
themselves money." [Charlotte Observer,

Yes, Al Can Still See Dr. Ferguson

BlueCross BlueShield Of North Carolina Implied
Public May Be Unable To Keep Their Current Doctors. 
According to storyboards of a BlueCross
BlueShield of North Carolina
advertisement obtained by the Washington
: "As the camera searches the
room, or continues to narrow the frame after beginning at a wide focus, an
older Hispanic woman comes into view. She's standing quietly in the middle of
the action, as if she found herself at the wrong party, and doesn't know a
soul. The background noise is dialed down significantly, enough to hear her say
to no one in particular: 'Will somebody just tell me whether my Al
will still be able to see Dr. Ferguson if we go through with this government
'" [BlueCross BlueShield of North
Carolina ad via Washington
, 5/18/09;emphasis

President Obama: "Americans
Must Have The Freedom To Keep Whatever Doctor And Health Care Plan They Have."
announcing a partnership to lower health care costs, President Obama laid out
his vision for health care reform.  He
said, "I'm also committed to ensuring that whatever plan we design upholds
three basic principles: First, the rising cost of health care must be brought
down; second, Americans must have the freedom to keep whatever doctor and
health care plan they have, or to choose a new doctor or health care plan if
they want it; and third, all Americans must have quality, affordable health
care." [Obama Remarks via RealClearPolitics, 5/11/09]

BlueCross BlueShield Of North Carolina Says One
Thing, Does Another

Says One Thing...

BlueCross BlueShield Of NC: "We Believe An Unchecked Government-Run Plan Would Lower
Payment To Doctors."
Discussing an upcoming ad campaign against health care
reform with the Washington Post,
BlueCross BlueShield of North
Carolina spokesman Lew Borman said: "We believe an
unchecked government-run plan would lower payment to doctors and hospitals,
forcing them to attempt to charge private insurers more and thus further
eliminate private insurers' ability to compete against the government." [Washington Post, 5/18/09]

Does Another...

BlueCross BlueShield Of North Carolina Lost $128 Million Lawsuit For Fraudulently UNDERPAYING
As reported by the Durham Herald-Sun, "Blue Cross and Blue Shield
of North Carolina was among 23 Blues plans
across the country that Friday announced a $128 million settlement of a class
action lawsuit brought by 900,000 physicians regarding the insurers' business
practices. Numerous state medical societies, including the N.C. Medical
Society, were involved in the lawsuit, which charged that North Carolina Blue Cross and other Blues plans harmed doctors
with unfair business practices that denied and delayed payments for medical
care... The complaint identified numerous Blue Cross and Blue
Shield plans as defendants in an alleged scheme to defraud doctors in violation
of the federal Racketeer Influenced and Corrupt Organizations Act (RICO)." [Herald-Sun, 4/28/07]

BlueCross BlueShield: Not One To Talk

BlueShield Ad Implies Premiums Would Rise Under Public Plan. 
According to storyboards of a BlueCross
BlueShield of North Carolina
advertisement obtained by the Washington
, the viewer can overhear partygoers discuss "rising premiums."
[BlueCross BlueShield of North
Carolina ad via Washington
, 5/18/09]

In Reality:

 Private Health Insurance Premiums Are Up 119% Since 1999, Compared To A
34% Increase In Wages. 
According to
the Kaiser Family Foundation, health insurance premiums have increased 119%
since 1999, while workers' earnings have increased by just 34%.  [Kaiser Family Foundation, accessed 5/19/09]

Any Public Option Would Provide The
Private Sector With Healthy Competition

BlueShield Ad States The Health Care System Would Be Government-Run. 
According to storyboards of a BlueCross
BlueShield of North Carolina
advertisement obtained by the Washington
, the narrator says: "We need a plan for reform that will achieve the
right results the first time around. We can do a lot better than a
government-run health care system." [BlueCross BlueShield of North Carolina ad via Washington Post, 5/18/09]

House Democrats Are
Committed To A Public Health Care Option Which Will "Spur Competition Within
The Insurance Industry."
The Hill
reported: "[Majority Leader] Hoyer indicated that House Democrats are committed
to including a public plan option in their bill. 'We believe that a public
option clearly is going to be necessary' to provide consumers with an
alternative to private insurance and to spur competition within the insurance
industry, Hoyer said." [The Hill, 3/26/09]

 Senate Democrats Have
Proposed That Public Health Care Should "Comply With All The Rules And
Standards That Apply To Private Insurance" To Ensure That Private Insurance Can
According to the New York Times: "In an effort to defuse
the most explosive issue in the debate over comprehensive health care
legislation, a top Senate Democrat has proposed that any new government-run
insurance program comply with all the rules and standards that apply to private
insurance. The proposal was made Monday by Senator
Charles E. Schumer of New York,
the third-ranking member of the Senate Democratic leadership, in a bid to
address fears that a public program would drive private insurers from the
market." [New York Times, 5/5/09]

 Speaker Pelosi Is
Looking For A Public Option To Make Private Insurers More Competitive.
to Bloomberg: "House Speaker Nancy
Pelosi said the House this year will consider health-care legislation including
an option for a government-run program that would compete with insurers. 'This
is a big agenda, and I believe it should have a public option in it for it to
be really substantial,' Pelosi told reporters at her weekly news conference in
the U.S. Capitol. Pelosi said the Democratic-controlled House will be 'aggressive'
in its approach to a health-care overhaul, which is a centerpiece of Obama's
agenda. She said a government role in health care will help U.S. companies be more competitive."
[Bloomberg, 3/26/09]

The Administration
Advocates For Health Care Reform That Will "Reduce Long-Term Growth Of Health
Care Costs For Businesses And Government."
According to the White House: "The
Administration believes that comprehensive health reform should:

  • Reduce long-term growth of health care costs for businesses and government
  • Protect families from bankruptcy or debt because of health care costs
  • Guarantee choice of doctors and health plans
  • Invest in prevention and wellness
  • Improve patient safety and quality of care
  • Assure affordable, quality health coverage for all Americans
  • Maintain coverage when you change or lose your job
  • End barriers to coverage for people with pre-existing medical conditions"

[WhiteHouse.gov, accessed 5/11/09]

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