Legislation:

It's time for change

"Those who are crazy enough to think they can change the world usually do." - Steve Jobs

This website finds itself in the right place at the right time. America is divided, with a major 2024 political election on the horizon. Healthcare is a major issue. Pennsylvania is a battleground state. By demonstrating the outrageous behavior that is taking place at Independence Blue Cross, the company will become a focused lightening rod about what's wrong with health care. Each candidate needs to be evaluated on the following question: "How would you protect Joe the worker from companies like Independence Blue Cross?"

Independence Blue Cross is an organization aggressively engaging in self promotion efforts such as advertising and social media. The organization portrays itself as a leader in health insurance. The reality for consumers is much different. For example, according to Reddit.com, Independence Blue Cross scores 1.7 stars out of 5. Some comments include:

“Never once had a satisfactory experience talking to a Independence Rep“

“I called before physical therapy to confirm it was covered. I was told I could receive 35 sessions! Went to physical therapy and the insurance (Independence) rejected the claim. I was being charged $6,000 dollars!“

“Just don't understand why the insurance commissioner allows them to get away with this crap. If enough people would bother to write to the Pa. Insurance Commissioner if would force an investigation.“

“Speaking as a practitioner that's dealt with IBX for many years, this company does not care about people. It's total profit-focused garbage.

Quotes Taken from this website on 04/30/2024

Proposed Legislation

The insulin EOB law: There are legitimate reasons to deny insulin. The insurance companies will be able to maintain their right to deny. However, any time there is a denial of insulin, the health insurance provider is required to print on the EOB that insulin is available over the counter. This is a simple measure that places no significant financial burden on the insurance companies, but is capable saving life and improving the quality thereof

Revamping of Section 1519(c) of the Pennsylvania Vehicle Code: The process is "blind". That's appropriate. It protects innocent people who are seeking to protect the public from retribution. However, the same concept protects perpetrators who would weaponize the system. Under the proposed system changes, the submitter of the complaint's information would be held confidently by the state. If it's later determined that the submission was nefarious, the state can then then use the submitter information to present criminal charges to a district attorney.

Outside auditing: A big problem here is that independence Blue Cross works autonomously. They are the judge, jury, and executioner of all things within their walls. With any complaint they receive, they have full and soul ability to address or deny at their discretion without consequences. They are able to act in a god like manner. Under proposed legislation, the consumer would be able to take their complaint to a third party assigned by the government. It's clearly a no-brainer that if you call a health insurance company, and then receive a fake driver's license suspension stating the dates that you called, that the insurance company is involved. It was physically possible for information to be communicated in any other way.

Health insurance must maintain insurance also: Per Dr Richard Snyder, of Independence Blue Cross, the company does not maintain any type of errors and emissions insurance. Under the proposed law, the insurance companies will be required to maintain an insurance such that if a major incident were to occur at their causing, the patient would be able to file a claim against the health insurance's insurance.

National Medical Card (NMC): Under thid proposal, when a patient is diagnosed with a life long illness such as heart disease or diabetes, the National Medical Card will ensure the patient has access to the drugs associated with the diagnosis. The patient will be able to present themselves to any pharmacy nationwide, and have the right to purchase the drugs regardless of whether they have health insurance or not via the permanent prescription encoded in the card.

Pandemic protection: The COVID-19 Coronavirus Pandemic has taught us that we need to work together. The virus did not ask anyone who was their insurance provider before it infected them. Therefore, it's a great disparity that some persons were able to get access to coronavirus resources such as vaccines, and treatment, and others weren't. Under the proposed law, if there is a significant contagion in the community, all health insurance providers will be REQUIRED to maintain a certain minimum set of behaviors. No one will be denied access to pandemic care simply because they are a financial burden to an insurance company.

Blind Diagnosis - This concept is borrowed from the e-Commerce industry, and is capable of protecting both the patient and the insurance company. in e-Commerce, many small mom and pop type businesses would like to sell on the Internet. However, accepting credit cards over the Internet is risky and dangerous due to ongoing and ever increasing cybercrime. This issue is resolved through merchant services. When the consumer goes to complete a transaction to one of these websites, they are seamlessly bounced from the vendor's website to the merchant services vendor. The merchant services vendor handles the credit card information, and then passes back a result to the vendor website as to whether the sale was successful or not. The vendor is protected because never can the consumer claim that the vendor had their credit card information, because in fact they never do have it. Likewise, in a blind diagnosis scenario, medical providers would submit diagnosis information directly to a government agency. The government agency will then pass a message to the insurance company such as Independence Blue Cross, as to whether the claim is payable or not. The patient would not be able to claim, as I do, that the insurance company weaponized the diagnosis information, because it's impossible as they never had it.

Refunding of Premiums - If it is determined that any insurance company has denied access to care for a period of 365 days, the insurance company will be required to return all of the premiums for that patient for that year. The premiums do not necessarily need to be returned to the patient, we don't want to encourage anyone to force premium returns. The money collected could go into a catastrophic fund for other Healthcare victims.
This small change makes a fundamental difference: When the insurance company collects premiums for a period of one year, and provides no service, they make 100% margin on the money they receive. If they are forced to return premiums, they make 0% margin on the same patient. Nobody wants to work for nothing. Independence Blue Cross is a very skilled financial organization. If we force them into a scenario where they make less money when they don't perform, their performance will increase.