Tuesday, February 14, 2012

LA Times Editorial on UCLA Hospital/Blue Shield Dispute Has a Buried Lede*

In yesterday’s LA Times – if you missed it – there was an editorial about a dispute between Blue Shield and the UCLA Hospital.  Yet beyond saying that controlling costs and being efficient are Good Things, the editorial seemed to miss the point - even though the point is it the text of the editorial.  Excerpt below:
Blue Shield of California has suspended its relationship with UCLA Medical Center, one of the state's top hospitals, in a dispute over the cost of treating patients there. It's a disturbing sign of things to come in the healthcare industry, as insurers become increasingly resistant to the cost increases that they routinely passed along in previous years. Although the standoff is hard on the patients who've lost access to UCLA, Blue Shield is right about one thing: The healthcare industry is on an unsustainable path, and every segment must start focusing on cost control.
…Hospitals costs have risen particularly rapidly, with the average daily fee for a bed in an acute-care ward more than tripling since 2000. UCLA's reimbursements from Blue Shield have almost doubled in the last five years alone, the insurer says. That's partly because the university has been shifting onto Blue Shield some of the expense of treating patients with Medicare, Medi-Cal or no insurance. But it's a trend that even University of California officials acknowledge cannot continue.

…UC health officials say they've gotten the message; that's why they created the Center for Healthcare Quality and Innovation in October 2010 to find ways to deliver more effective healthcare services and to control costs. The university system and Blue Shield also have agreed on a new approach at UC San Francisco Medical Center that shares the financial risk of providing care for certain policyholders, holding cost increases at or below the rate of inflation. The question is how to bring that focus on efficiency and value to UCLA and the rest of the UC system. Here's hoping the two sides find an answer soon.
In short, a key problem – according to the editorial itself – is an external one reflecting the cost shifting that goes on in the current system of national health which requires providers to care for the non-insured and to make up for government programs that provide less than full reimbursement.
*“Burying the lede” is a common stylistic error in journalism. To bury a lede (rhymes with “bead”) is to hide the most important information within a news story instead of putting it up front where readers can find it immediately.  Source:
Meanwhile, our best advice is not to get sick:

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