You're the Real Cost 

Spinning health-care reform to the end game

Picketers from Idaho Main Street Alliance demanded reform recently outside Regence Blue Shield.

Nathaniel Hoffman

Picketers from Idaho Main Street Alliance demanded reform recently outside Regence Blue Shield.

The Regence Group, which sells Blue Cross and Blue Shield health insurance in Idaho, Washington, Utah and Oregon, has launched a high-tech political and marketing campaign that the company says helps people understand health-care reform. But critics say the campaign places blame on doctors and patients and ignores the role of the insurance industry in skyrocketing rates, lack of coverage and administrative waste.

The campaigns, which include a well-designed Flash-based Web site called*, television commercials airing on some stations and--making the rounds on the Web--a new branding headlined "Share the Well" and a fading Facebook/Twitter push, ask people to take more command over their health, including challenging doctors and pharmacists.

"The whole goal of this campaign is a consumer education cost campaign," said Georganne Benjamin, who works in public affairs at Regence in Boise and helped to design the games on the Web site, including one called Resist the System. "How you win at that one is by challenging the system and not just being compliant with what she's suggesting."

Don McCanne, a senior health policy fellow at Physicians for a National Health Plan, which advocates for a single public or quasi-public health insurer, argues that the administrative expenses at private health insurance companies are the largest wasted cost in the system.

"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 30 years of my very busy family practice, I cannot recall one single patient with such a request. Yet the thrust of this Regence Blue Cross Blue Shield campaign is to blame the patient for requesting too much health care," McCanne wrote in his daily health-care reform e-mail.

Mike Tatko, media and public relations manger at Regence in Lewiston, said the company is not playing a blame game.

"It's more of a take charge, take a little bit of personal responsibility in your life," he said. "We talk a lot about personal responsibility."

What about responsibility at the company?

"Our administrative costs are about 9 cents on the dollar," Tatko said. "We'd like to be at 7, we're not there."

Bob Vestal, a retired medical director at the Veterans Administration Medical Center in Boise and a steering committee co-chairman at Idaho Health Care for All, PNHP's local affiliate, said Regence has a point about personal responsibility.

"I think people in this country do need to take more responsibility for their health and well-being and make good choices," Vestal said. "There's no way to deny that. On the other hand, what it looks like the insurance industry is doing is shifting the blame. I think they have abused their role in the health-care system by creating difficult challenges for policy holders and making it impossible for some people to afford and retain health insurance. I continue to ask the question, 'what is the value added that insurance companies bring to the health-care system?'"

With both houses of Congress considering viable health-care reform bills, neither single payer advocates nor the health insurance industry are satisfied.

John Geyman, author of Do Not Resuscitate, a book that argues for dismantling the private insurance industry, said health insurers say they want reform, but really want universal coverage, or 50 million new subscribers.

"I think the insurance industry as a whole is trying to posture like they are reformers and want to help make health care affordable, control prices and all that but they're a big part of the problem themselves." Geyman said.

*Correction: The whatstherealcost Web address has been corrected.
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