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

In yesterday’sLA Times – if you missed it – there was an editorial about a dispute betweenBlue Shield and the UCLA Hospital.  Yetbeyond saying that controlling costs and being efficient are Good Things, theeditorial seemed to miss the point - even though the point is it the text of theeditorial.  Excerpt below:

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Blue Shield of California has suspended itsrelationship with UCLA Medical Center, one of the state's top hospitals, in a dispute overthe cost of treating patients there. It's a disturbing sign of things to comein the healthcare industry, as insurers become increasingly resistant to thecost increases that they routinely passed along in previous years. Although thestandoff is hard on the patients who've lost access to UCLA, Blue Shield isright about one thing: The healthcare industry is on an unsustainable path, andevery segment must start focusing on cost control.

…Hospitals costs have risen particularly rapidly, with the averagedaily fee for a bed in an acute-care ward more than tripling since 2000. UCLA'sreimbursements from Blue Shield have almost doubled in the last five yearsalone, the insurer says. That's partlybecause the university has been shifting onto Blue Shield some of the expenseof treating patients with Medicare, Medi-Cal or no insurance. But it's a trendthat even University of California officials acknowledge cannot continue.

…UChealth officials say they've gotten the message; that's why they created the Centerfor Healthcare Quality and Innovation in October 2010 to find ways todeliver more effective healthcare services and to control costs. The universitysystem and Blue Shield also have agreed on a new approach at UC San FranciscoMedical Center that shares the financial risk of providing care for certainpolicyholders, holding cost increases at or below the rate of inflation. Thequestion is how to bring that focus on efficiency and value to UCLA and therest of the UC system. Here's hoping the two sides find an answer soon.

Full editorial at http://www.latimes.com/news/opinion/opinionla/la-ed-blueshield-20120213,0,3668965.story

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In short, a key problem – according to the editorial itself –is an external one reflecting the cost shifting that goes on in the currentsystem of national health which requires providers to care for the non-insuredand to make up for government programs that provide less than fullreimbursement.

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*“Burying the lede” is a common stylistic error injournalism. To bury a lede (rhymes with “bead”) is to hide the most importantinformation within a news story instead of putting it up front where readerscan find it immediately.  Source: http://www.avwrites.com/?p=15

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Meanwhile, ourbest advice is not to get sick: