Open Letter to Dan Hilferty, CEO, Independence Blue Cross
It was with mixed feelings that I read your expensive full page ad in the Inquirer, “Let’s Get Healthcare Right, A Message of Hope.” I certainly agree that both political parties should work together to provide access to affordable health insurance to all. As you said, this is a “moral obligation.”
However, I am convinced that instead of your suggestion of “using the power of our free enterprise system to provide competition and choice for all,” the “distinctly American” solution must provide a federal government plan to compete with the private insurance companies in every market nationwide. Only a Medicare for all option will force private health insurance companies to cover best practices medical care for affordable premiums. I am not calling for mandating a single payer / government-only system. My favorite proposal, which some Democrats introduced in 2009, is that private companies must compete with a government-provided option for every citizen’s coverage. If they can’t, they will fade away and we will eventually have a single payer. Ideally, the power of this hybrid system will encourage improved coverage at lower prices and both public and private coverage plans will remain viable options to everyone nationwide.
Furthermore, if you are sincere in your attempt to craft “a message of hope,” you must immediately change your illegal coverage policies for those suffering from substance use disorder. The Federal Parity Act of 2008 dictates that the mentally ill and addicted are entitled to best practices medical care just as medical / surgical patients. End the unnecessary, wasteful, stressful and deadly 7-day review process and provide coverage for best medical practice long term care. Everyone knows that no one reaches recovery in 7, 14, 21 or even 28 days. Most experts agree a continuum of at least 90 days of care is most often required to reach remission. This policy change will not only save lives but also money by drastically decreasing deadly and expensive relapses that are so prevalent with shorter-term treatment regimens.
“Providing hope” also means that Independence Blue Cross must also cover medication-assisted treatment regimens. Research indicates this approach is up to 300% more effective than abstinence- only treatment in preventing deadly and costly relapses. It is not only illegal, but immoral that your firm does not cover FDA-approved and scientifically-proven effective medications in treating addiction.
My son, Brendan, who died last year at 23 of a heroin overdose after remaining clean and sober for over 90 days, was denied coverage by IBC when he reported to a treatment facility because he feared succumbing to urges to relapse. IBC and other private insurance companies have turned ASAM criterion on its head by misinterpreting the edict that if a patient reports to a facility requesting treatment while intoxicated, he or she cannot be denied treatment. They have implemented a deadly and immoral policy that if a patient reports to a facility requesting treatment while sober, he or she is not entitled to treatment. That is no way to enable your policy holders to “live fearless.” This is not a Brendan story, but a common one I heard across the region as I ran for Congress last spring.
As you know, I presented these reform recommendations to your senior management team in March and have been denied any further communication with IBC. 74 candidates from both parties running for office in PA this past year also endorsed this policy platform.
As you said, let’s work together to get healthcare right!
Co-Founder, Opioid Crisis Action Network