Comments on: Embarrassment-based health care.

By: Nancy Ur

Nancy Ur — Thu, 30 Aug 2007 19:54:22 +0000

I have had nothing but headaches with Horizon Blue Cross Blue Shield of New Jersey. I had to deal with them on behalf of my mother, who had Alzheimer’s, and they were just atrocious. Now my niece who has them as her insurer, is being denied a claim for having her childbirth at home (when they told her it WAS covered). The State ought to look into that company for false advertising. I would LOVE to speak with someone at a stockholder’s meeting and let them what is really happening with this company — I personally feel they are fraudulent in their claims.

By: Karl Fogel

Karl Fogel — Fri, 15 Jun 2007 21:12:24 +0000

Danny,

Yeah. But I worry about arms races… As more and more people figure this out, the less weight it will have in each individual case.

Nice blog(s), by the way (dannycolligan.com).

By: Karl Fogel

Karl Fogel — Wed, 13 Jun 2007 07:34:44 +0000

Hmm, but then why do they put up such a fight?

True, in order to ensure that most people don’t bother to contest, BCBS would need to put up some fight in each case (otherwise word would get around, and people would start contesting more). But the insurance company wouldn’t need to fight to the degree they are in Biella’s case (and perhaps in yours). At this point, they may well be near to spending more money resisting Biella’s entreaties than they would just paying out her claim, which wasn’t that large by medical standards.

The “squeaky wheel” theory is sort of like those “satisfaction guaranteed or your money back” offers on cereal boxes. If you take the time to clip off the box top and send it back, along with a letter detailing exactly what you didn’t like, and you’re willing to fill out the form letter they’ll send you as a first response, then you will, in fact, get your money back. The know that only a tiny percentage of people will ever bother.

But by analogy, Biella has already clipped her box top, filled out all the forms, etc. If this were just the squeaky wheel treatment, they’d have paid the claim by now. I think some other policy must be in operation here…

By: Ayse Sercan

Ayse Sercan — Wed, 13 Jun 2007 06:10:18 +0000

It’s “squeaky wheel” economics. As it turns out, if you deny just about everybody coverage, only a small proportion of the population will contest it. This saves you money. This is why BCBS is currently engaging in an intense argument with my doctor about my menstrual cycle, believe it or not.

By: Danny Colligan

Danny Colligan — Tue, 12 Jun 2007 19:31:05 +0000

Often times, the most effective way to get quick reactions out of large organizations like this is to embarrass them. That lesson is not lost on folks that are undergraduates at American universities, for one, these days. Also see the related tactic “I know a lawyer who will threaten probably ridiculous but certainly expensive (for you, the defendant) legal action and therefore it makes economic sense for you to address my complaints now instead of facing a drawn-out legal battle.”