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September 9th, 2009
11:12 AM ET

Face to Face with the Faceless Bureaucrat

By David S. Martin
CNN Medical Senior Producer

President Obama is scheduled to address a joint session of Congress tonight in an effort to breathe new life into his health care overhaul. Critics have gone after the cost of his proposal and claimed the president’s plan is a first step in a government takeover of health care. Central to this second charge is the specter of a faceless government bureaucrat standing between you and your doctor.

I thought of this the other day when a neighbor approached me, his voice shaking with frustration. He had just received a letter from Blue Cross Blue Shield, rejecting his application for health insurance. The letter was signed, if that's the word, "Sincerely, Underwriting Department L 24.”

What makes this case curious is that Blue Cross Blue Shield had been insuring my neighbor and his family for the past 15 or so years through his wife's state job. When she resigned to stay home with their 1-year-old, he never dreamed Blue Cross Blue Shield would not accept his application to purchase private insurance. After all, he thought, the insurance company was familiar with his family’s medical history. There are no expensive chronic diseases such as diabetes or expensive life-threatening ailments such as cancer on their record. My neighbor says he occasionally suffers from allergies. That’s it. His 1-year-old is healthy. To further confuse matters, Blue Cross Blue Shield accepted his wife and teenage daughter for health insurance.

The whole story sounded strange. I asked him if he’d mind if I called Blue Cross Blue Shield. Here is the response I got:

To protect the privacy of our members and their medical information, Blue Cross and Blue Shield of Nebraska (BCBSNE) does not comment on the specifics of individual cases. In general terms, however, each individual application for medical coverage is reviewed thoroughly and carefully, based on standard criteria which differs between individual and employer group business. BCBSNE accepts most applicants, but there are occasional denials based on health conditions and eligibility requirements.

I asked Blue Cross Blue Shield about L 24 and was told that’s not a person but the code for the form letter my neighbor received. As we listen to the president make his case for health care reform, we should remember “L 24” and know that the government does not have a monopoly on faceless bureaucrats.

Has a faceless bureaucrat ever stood between you and your doctor?

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


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