Enrolling without a full roster

-A A +A
By Melvin L. McCorkle

Regarding the discussion over the change at the lab from United Health Care to Blue Cross Blue Shield NM and the lack of information about it, I have the following observations.

If memory serves me correctly, each time over the last several insurance company changes, the contracts with the local doctors’ practices always lags the requirement for choosing the coverage option. This time is the first time that I can recall that a practice has chosen to make the issue public because the proposed reimbursement rates are inadequate.  Also one could hope that simply because this is the way it has been done in the past does not mean that it is the way it must be done again this time.

Trying to use the BC/BS web page as an aid to choose which option is difficult because that web page represents those doctors who are under contract for 2009 not 2010. So using it as an informational source for an informed decision for 2010 is impossible since the information is not current.

I have read postings on blogs that if a doctor’s practice should choose not to participate in the BC/BS plan they may as well close up shop in Los Alamos County. While I agree with such an assessment, I would hope that it is not Los Alamos National Security’s intention to drive currently practicing doctors out of the county.

I would be so humble as to suggest that in order to attract and retain the skill set they require to be successful in running the laboratory LANS needs a viable medical community in the county.

 Other postings have alluded to the fact that in reality, LANS is self-insured and BC/BS is nothing more than a contractor processing the claims forms. Higher reimbursable rates could result in higher co-pays and/or higher employee or retiree contribution. If that is required to provide for rational health care insurance then so be it. Let’s not create a façade that all is well in Atomic City as if things will work out in the end.

This year there is even more uncertainty because of the national health care debate. The idea that you can cut Medicare by 30 or 40 percent, tax higher wage earners without increasing the national debt and change current insurance contracts creates additional uncertainty. In reality as I understand the current draft legislation, LANS health coverage is exempt because it is regulated by ERISA that provides protection for large self-insured companies.

In closing I suggest a simpler solution, that the insurance option be exactly the same as our elected representatives to the U.S. House, Senate and federal employees receive. This would be an aggressive leadership position and set the standard for what health insurance can be.


Melvin L. McCorkle

White Rock