Hat tip to Alicia over at the Awesome Cancer Survivor blog
I hadn't heard about what's going on in Massachusetts, so I'm guessing that a lot of other folks might also be unaware. Tufts Medical Center is a teaching hospital located in Boston. Because of its state-of-the-art equipment and clinical trials, many people with cancer, heart disease and other chronic conditions receive treatment at the Tufts facility.
Blue Cross of Boston, the biggest health insurer in the state, has been engaging in negotiations with Tufts Medical Center over the reimbursement rates that the hospital receives for treating patients. Right now, Tuft and its doctors receive between 20 to 40 percent less than other teaching hospitals in the area and they are seeking a 9% increase. Blue Cross of Boston is refusing to give Tufts the increase they are asking for. This means that Tufts patients who have insurance coverage through Blue Cross of Boston will have to find new doctors, because the hospital will no longer accept their insurance after February 3rd.
This is a potentially life-threatening situation. My doctors had never encountered a patient with chondrosarcoma before. The fact that my oncologists, my rheumatologist, and my general practitioner are all down the hall from each other allows them to manage my care quickly. There have been several times when I had to be ferried down the hall for my other doctors to examine me so that they could decide which condition might be causing the symptoms I was experiencing.
If I had to start over and find a new hospital, I'd have to find--not just one oncologist who was trained to deal with sarcomas--I'd also have to find other doctors who are comfortable treating a patient with so many co-morbid diseases. Without my doctors working together, my conditions simply can't be managed. I know this for a fact. It was a situation that I faced after Hurricane Katrina.
This fight between Tufts and Blue Cross is leaving seriously-ill patients in a dangerous position. Even though Blue Cross is saying that seriously ill patients will have an additional three months after February to receive treatment at Tufts and have those treatments covered by their insurance, it doesn't really change the fact that many people simply can't change hospitals without endangering their life and potentially worsening their condition(s).
I blame Blue Cross of Boston. Tufts isn't asking to be paid at the same reimbursement rates as Blue Cross' highest paid health providers. The 9% increase would simply make them more competitive. If doctors at Tufts are making less money than they would if they went to some place else, then what incentives are there for them to stay? If the hospital can't attract good doctors, then they can't provide the kind of care that their patients need. If patients don't get the best care they could have received, more of them will die. If I hadn't been for the best care that the country had to offer, I'd certainly be dead. For many patients, Tufts is the best facility for them to use.
I don't know what's going to happen but I do know what should happen. Blue Cross should agree to the increase instead of putting patients' lives at risk. Now, I guess we'll have to see what decision they'll make. If anyone has any ideas about how to put pressure on Blue Cross of Boston, please let me know. This deserves attention.