LETTERS: PROVIDING HEALTH CARE AT 3 A.M.

To the editor:

There has been considerable attention paid to MedAmerica HealthNet, Blue Cross-Blue Shield and their HealthNet Blue product. This product was developed as a joint effort of area hospitals, physicians and Blue Cross-Blue Shield. The motive behind this was to continue providing quality medical services while controlling costs.

Providers need detailed information to establish utilization-review and quality-assurance guidelines. Getting this information was part of the HealthNet Blue mission. The partner gathering this information, Blue Cross-Blue Shield, has refused to provide that information to the providers. The main argument for not providing it -- patient confidentiality -- is without merit. The information came from the providers in the first place. Blue Cross-Blue Shield was just supposed to be gathering, collating and organizing it.

In order to ensure HealthNet Blue's competitiveness, providers agreed to accept significant reimbursement discounts. Since its inception, the providers have never asked for nor received any increase. During that same period, Blue Cross-Blue Shield premiums for HealthNet Blue have increased over 50 percent. Blue Cross-Blue Shield refuses to provide any financial data regarding the HeathNet Blue product.

Blue Cross-Blue Shield's lack of cooperation has been mentioned by executives from both MedAmerica HealthNet and Missouri Consolidated. Such comments coming from two separate professionals should have more credence than any self-serving comments from Blue Cross-Blue Shield.

Blue Cross-Blue Shield executives have stated their intent to continue to provide and support the HealthNet Blue product. This quote is from a Feb. 10 letter from a Blue Cross-Blue Shield vice president: "We will need to transition members from the HealthNet Blue product to a similar Alliance PPO program. To ensure that your patients will continue to receive the highest level of benefits when receiving services from you, we invite you to participate in our Alliance PPO network." I believe the conclusions are obvious regarding Blue Cross-Blue Shield's intentions for HealthNet Blue.

A business director has been critical in a letter to the editor of HealthNet Blue as well as area providers in general. This comes from the person who sends his employees to St. Louis for care, has done so for many years and only seeks excuses to justify his choices. The HealthNet Blue product was a viable and beneficial one. Its failure is a direct result of Blue Cross-Blue Shield's actions.

Physicians and hospital personnel work, live and shop in this area. They have a vested interest for their families that the region continues to have a first-rate health-care system. Insurance premiums go outside the region to pay million-dollar salaries and buy real estate. Please remember whom you depend on for health care at 3 a.m. It isn't a Blue Cross-Blue Shield exec living in St. Louis or even your local insurance agent. It's your doctor and his support team at your hospital.

GERALD L. NICHOLSON

Cape Girardeau