The following editorial first appeared in the Lincoln Journal Star.

When elephants fight, it is the grass that suffers.

--African proverb

The dispute between Blue Cross Blue Shield of Nebraska and Catholic Health Initiatives is complex. Both sides have valid points to make.

But there’s no doubt that consumers are facing a major disruption in health care.

The expiration of the contract between CHI’s UniNet and Blue Cross means that consumers insured by Blue Cross will have to pay higher out-of-network costs if they use hospitals and doctors associated with CHI.

Patients are scrambling to determine which doctors and which hospitals are in-network.

In some cases patients are leaving doctors that they have had for years rather than pay significantly higher costs.

Take, for example, a standard physical examination with a cost of $144. If a patient has already met their deductible, Blue Cross will pay $133.81 for an in-network doctor. For an out-of-network doctor, Blue Cross will pay only $88.48.

Across the state, some patients are now required to drive long distances to use an in-network hospital. In Grand Island, for example, the only hospital is operated by CHI health.

And it can get much more complicated, depending on a patient’s circumstances. For example, Blue Cross said that patients in the midst of treatment, such as cancer patients, can continue with in-network coverage regardless of their current provider under a “continuity of care” provision.

Patients and doctors are struggling to get rulings on whether specific cases will be included under that provision. Some patients have reported receiving inaccurate information from one side or the other.

Worst of all, the confusion and uncertainty add stress at a time when patients already are trying to cope with illnesses and injuries.

Meanwhile, employers are watching the standoff uneasily. They face decisions on the group policies they will offer their employees next year. Conceivably some business executives might consider switching insurance companies.

Blue Cross says the impasse is about costs that are 10 to 30 percent higher at CHI Health. In a Local View column ("Setting the record straight," 9/9) CHI representatives said cuts demanded by Blue Cross would devastate its ability to provide patient care, and that Blue Cross is clinging to a fee-for-service model rather than working on long-term reform.

Most Nebraskans probably don’t want to pick sides in this dispute. They just want the two health care giants to find a different way to resolve their differences without being forced to absorb the impact of such a sudden and drastic change.


Load comments