Remember the truism that nothing is certain but death and taxes?  I think that needs to be revised to state "nothing is certain but death, taxes and massive annual rate hikes from your health insurer".  Actually that last could probably be better stated as an "annual screwing from your health insurer".

We recieved a letter from our health insurer, BlueCross BlueShield of North Carolina (BCBSNC), that begins as follows:

Dear Valued Blue Cross and Blue Shield of North Carolina Member:

Thank you for choosing Blue Cross and Blue Shield of North Carolina (BCBSNC) for your health insurance needs. We value your continued membership and want to let you know about some upcoming changes to your Blue Advantage premiums and benefits.

Most Blue Advantage subscribers will have a premium adjustment in 2007.   This will be your guaranteed premium until January 1, 2008, unless you switch plans, add dependents or purchase additional coverage.

Blue Advantage is the most popular individual insurance plan in North Carolina and currently serves more than 315,000 members. Your Blue Advantage premium adjustment is based on the health care costs of all Blue Advantage members and is impacted by factors such as where you live, your benefit design, your gender and your age. For example, if you had a birthday in the past year that put you in a new age-bracket category, it may have had an effect on your January 1, 2007 premium adjustment.  Your individual claims do not have an impact on your annual premium changes.

Here’s the thing: our premiums were about $595 a month this year, which was up about 10% over the year before.  This is a 35% increase from ’06 to ’07!  Celeste and I both turned 40 this year and so I went to the BCBSNC rate quote website and found that if I compared rates for us at the age of 38 and 40, the quote for age 40 was about 8% higher.  So where in the heck did the rest of the increase come from?

What kills me is that there are NO factors that say anything about our personal health choices.  Why can’t we get credit for exercise?  Why can’t we get credit for a healthy diet?  Why can’t we get credit for our general health?  They can lump us in with the rest of the people who are individually insured, essentially treating us as a group health plan, but they give us no control over how we might control costs.  This is BS!

Here’s something else that just pisses me off about this: BCBSNC is a non-profit that has been accused in the past of making too much profit and in fact they made a concerted PR push last year to point out that they were reducing their profits.  They were sensitive enough about it that they sued an advocacy group called ProCare over the group’s disclosure of what BCBSNC said were confidential business sources.  Of course that doesn’t mean that ProCare was wrong and one of the documents in dispute detailed how BCBSNC spent $478,000 to sponsor the US Open.  And my old employer, Atlantic Information Services, had a piece in ’05 about how states, including North Carolina, are going after the "Blues" for reserves that are too high.  The point is that non-profits have reasons for existing that go beyond profits which is why they get their special status and treatment from our friends in government, and I can tell you that if the non-profits I worked with spent money the way BCBSNC seems to they’d be in a heap of trouble.

We can change our coverage options (higher premium, higher co-pays, etc.) to bring down our monthly premiums, and we might end up doing that, but we’re also going to seriously consider a Medical Savings Account.  We’ve been looking at MSAs for a while, but we were kind of scared off by the "newness" of them.  I also remember reading about UnitedHealthcare getting ready to offer individual health coverage in NC (right now BCBSNC has a monopoly in the state) and we’re going to check them out as well. BCBSNC has given us a lot of motivation to look at ALL of our alternatives. 

Here’s my final observation about these jokers and another truism in the realm of business communications: any letter that begins with "we value your continued membership" is the setup for a royal screwing and out of kindness should be accompanied by a small package of personal lubricant.

By the way, this experience just gives me further evidence that Dr. Feld is right about the need for true competition and free market reforms in the healthcare marketplace.