While it’s nerve-wracking for residents in and around Calhoun County, the public dispute between Regional Medical Center and Blue Cross Blue Shield of Alabama is a ready-made campaign issue for a savvy politician.
- Unless RMC and Blue Cross strike a deal between now and Sept. 12, the health insurance company will likely not cover many non-emergency room treatments at RMC’s Anniston facilities.
- The dispute is over reimbursements for treatment. RMC wants more money. Blue Cross says higher payments to the hospital network will result in more costly premiums for customers.
- Blue Cross Blue Shield of Alabama owns 95 percent of the private health-insurance market in the state. It sits in the most dominant position of any insurer in any state, according to a national survey.
- Given that, RMC is bargaining from a considerably weakened position. “Or else what? Watch a third of your revenue walk out the door?” insurance company execs can confidently ask the hospital’s negotiators on the other side of the table. There are really no viable alternatives for Regional Medical Center other than to cut the best deal it can with Blue Cross.
- As we learned in late July when Blue Cross went public with this dispute, alerting policyholders that treatment at RMC might not be covered is bound to panic people. And rightly so. Attempting to pay for major health care out of pocket is a sure way to go bankrupt.
Tom Miller, of the conservative American Enterprise Institute, told The Star last week, “If there’s a single insurer, they are no longer the price takers, they’re the price givers.”
A 2013 report from the American Medical Association agrees. “In far too many states, one or two insurance companies dominate the market, which can hurt patients, physicians and employers,” said Dr. Ardis Dee Hoven, AMA president. “Without rivals to compete against, a large health insurance company can take advantage of patients by raising premiums and dictating important aspects of patient care.”
Here is the point where an Alabama politician with his or her heart and head in the right place can strike a chord with the state’s voters. Alabama, like all states, has the power to regulate health insurers. State lawmakers and the governor could promise to do something to increase competition among health insurers across the state.
Gov. Robert Bentley frequently complains that Obamacare “threatens to dismantle what I believe is one of the most trusted relationships, that of doctors and their patient.”
He and his like-minded colleagues in Montgomery should take a look at Anniston, where a financial dispute between a hospital network and a health insurer that totally dominates the state is doing the same thing.