Readers Speak Out

We like to hear from our readers. From time to time the Federal Diary prints a "speak out" column featuring your thoughts. The Nov. 26 and subsequent columns on planned changes in the Blue Cross/Blue Shield standard option insurance plan for federal employees generated lots of comments.

Among the changes, patients will pay 100 percent of the cost of an operation by an out-of-network physician, up to $7,500 "per surgeon, per surgical day." Currently the rate is 25 percent of what the company sets for a procedure, plus any difference between that and the billed amount.

Here are some of the letters addressing the change.

Doctors Opting Out

More and more physicians are opting out of health-care plans, including BCBS, simply because dealing with the insurance companies is so difficult and time consuming. Thus, more and more physicians -- especially the better ones -- are out-of-plan doctors. My own family doctor is considering going to a full cash-payment system with no health-care insurance involved at all. I might actually consider that. But, of course, he doesn't do operations, so I don't run the risk of having a huge bill from him. Not so with surgeons. Since reading your column, my wife and I are reviewing options and considering switching away from BCBS. . . . The change is outrageous, especially on top of a significant increase in the premium.

-- John Jennrich
Reston

War Against Surgeons

An unnoticed purpose of this change amounts to a War Against Surgeons. Using the federal employees as a weapon, CareFirst [the Blues' operation in the D.C. area] is attempting to force surgeons who do not participate to sign up with the Blues or face a great and intolerable loss of patients. In addition, they are effectively removing the only bargaining chip possessed by physicians in private practice when negotiating with CareFirst -- i.e., the threat of dropping out of participation. I would suggest that you investigate the number of orthopedic surgeons participating with the Blues in D.C. and Chevy Chase and check into the scheduled reimbursements for January 1, which will be below Medicare rates, and draw your own conclusion about the coming limited access for patients as physicians trim their practices, do office practice instead of surgery or seek early retirement. This area is already at the bottom of the national ladder of reimbursements by all carriers, and the inflow of new docs will slow, compounding the access-to-care issue.

I am a 71-year-old, actively practicing, CareFirst-participating surgeon, but why should I continue?

-- R. Marshall Ackerman, M.D.
Potomac

Abysmal Dental Benefits

The increase in dental costs has skyrocketed over the past decade. Unfortunately, the "benefits" offered by the OPM [Office of Personnel Management] plans do not reflect these increased costs.

As a result of the woefully inadequate coverage offered by the OPM-negotiated plans, many federal employees/retirees will be unable to afford the necessary medical treatment required to maintain their dental health.

There can be little quarrel that the OPM has done an abysmal job in negotiating dental coverage with its "approved" carriers. This conclusion is further compelled considering the tremendous leverage enjoyed by the OPM when it negotiates health-insurance contracts with carriers.

-- A. David Lafer
Washington

My Dec. 2 column, "Room at the Top for More Diversity" generated a range of responses.

Total Disagreement

I have read your article . . . in the Federal Diary and I am in total disagreement with you.

Diversity at the top is great in theory, but in reality it degrades our government.

We should be hiring the best and brightest possible. If they happen to be people of color or any other group, it should not matter. That is racist thinking.

I have worked in Washington, D.C. in the federal workforce, and I saw firsthand the problems that occur in hiring of people for ethnic reasons. I finally left government because of this.

We need the best, and I do not believe skin color should dictate that decision.

By the way, we did elect the best this time.

-- Marvin L. Nichols
Louisville

Feeling Invisible

Why are Asian Americans and Native Americans not mentioned at all in this article? Are we no longer minorities? Talk about being made to feel invisible! I was immediately interested in reading the article once I saw its title, and then felt excluded yet again upon finishing it.

Diversity is obviously an important issue, especially in the government sector because it serves the public good and should represent the public in its diversity. I strongly support diversity for all kinds of groups. But, it is extremely discouraging to see in article after article in the Post that Asian Americans and Native Americans are not mentioned, as if we did not have a voice in this ongoing discussion.

Most of the time, the diversity issue seems to be treated as a white and African American issue, with sometimes Hispanic/Latino Americans included, but only rarely are Asian Americans and Native Americans included in the mix.

-- Eilin Chiang
Alexandria

Let us hear your thoughts. Contact Joe Davidson at federaldiary@washpost.com.

-Joe Davidson

By Terri Rupar  |  December 5, 2008; 9:04 AM ET  | Category:  Health Care
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