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

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.

wendy-block.gif

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…

Wendy Block

Reprinted with the author’s permission from The Huffington Post, where it appeared first.


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Comments

  1. Jerry Drucker says

    Thank you Wendy Block. Being a Blue Shield member I really relate to Wendy’s perceptive, annoying,(funny)real experiences. Since I’m a different generation than Wendy, I’ve had different experiences with my Blue Shield 65 Plus. After my provider moved from covering the West Valley, I often had to travel 25 miles to see a specialist. Now that I’ve moved, I’ll have to change from my current coverage, since Blue Shield (Wellspoint) does not cover Ventura County.

    So I’m about to gird my loins and learn the new Dah DEE dah, DAH..dee as I confront about 4 other gangster insurance companies with their corporate bureaucratic clerks who ultimately determine who will live or die for a totally unnecessary profit motive. Oh how I want Single Pay, or at least Public Option.

  2. Matt says

    And you actually think a government bureaucracy will do things so much better than Blue Shield??? LOL!!! Thanks for the comic relief I so desperately needed today!

  3. Bozak says

    I must have missed the point of your article, sorry.
     
    It seems that once you got involved with COBRA, that’s when your problems started. Is COBRA a government entity?
      
    If you were paying Blue Shield directly, “one entity would coordinate everything.”
     
    Besides that, it would be your butt Blue Shield is kissing to keep you as a customer rather than their lobbyist meeting with your congresscritter.

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