Sara Whitman

Call Out Blue Cross Blue Shield's Ridiculous Policy Change

Filed By Sara Whitman | March 26, 2009 3:30 PM | comments

Filed in: Living, Transgender & Intersex
Tags: Blue Cross, Blue Shield, gender reassignment surgery, health care reform, Michigan, transgender, transphobia

Blue Cross Blue Shield of Michigan recently removed the coverage of gender reassignment surgery from their "covered" list. "Michigan Messenger reported Tuesday that BCBS of Michigan had received permission from state regulators to change insurance coverage offerings, and elimination of gender reassignment surgery was one of those approved changes."

The reason? It was "simply a matter of aligning their product with what is currently offered in the market." After the company posted a 133 million dollar loss, they needed to make changes.

Um... call me crazy, but I can't imagine there was a line out the door at hospitals with people looking to have the surgery. When asked, by Todd Heywood, Helen Stojic, spokesperson for Blue Cross Blue Shield of Michigan, said she could not provide how much of the loss was due to gender reassignment surgery.

Then how do they know it's a good business decision? Since health care is no longer about health, at least be a good business person. Why not address the number of unnecessary Cesarean sections performed? Or use of emergency rooms for minor patient care?

Nope. Gender reassignment makes the best fiscal sense. Even though they have no idea how much it has cost the company.

It is bad enough that our health care system is now based on a for profit business model. But when they blow it on a common sense level, it's hard to not see it for what it is- discrimination.

I suggest it might be time for Ms. Stojic to hear from the community. Please feel free to contact her at 313 549 9884. The more the merrier. Because the reality of this decision and their "reasoning" is total bullshit.

You can quote me on that.


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I feel compelled to note this:

For about 10 to 15 years the TGs activists have been very very busy bees telling people that they don't need surgery and most trans people don't as well. At the same time they have effectively silenced the voices of classic transsexuals who, by definition, DO need the surgery. What did anyone think was going to happen because of this? Exactly what has.

Fifteen years ago transsexual women, in particular, had done a great job of educating the public about classic transsexuality. By first forced inclusion under the term "transgender" and then "education" that normally ignores the reality of classic transsexuality, this is largely been undone.

Blame the TGs as well as the insurance company, they gave the insurance companies cover on this.

For about 10 to 15 years the TGs activists have been very very busy bees telling people that they don't need surgery and most trans people don't as well.

Would you fill in the blanks for those of us who have not been following this for very long? Thanks.

The measured cost in the short term of covering surgery is 2c per insured person per month.

Data from the Wisconsin Prison System, where TS inmates are refused all treatment due to the "Inmates Sex Change Prevention Act" show that it in the longer term it actually costs more in psychiatric treatment to deal with the consequent suicidal depression and funeral expenses for completed suicides than the treatment itself would cost.

This isn't a financial issue - they're willing to pay a little bit extra because they'd prefer us dead rather than alive. That may sound like hyperbole and rhetoric, but those are the facts as found by the courts, and attested to by the Medical people in the Wisconsin correctional system charged with enforcing the policy.

I note that this has flown under the radar of GLB groups, as so much to do with the T situation has.

In this case, I suspect no-one actually crunched the numbers. They saw that no other insurer covered it, so thought they'd follow suit in the expectation of cutting costs, not increasing them.

Extraordinary claims require extraordinary proof - see this news report. I'm still trying to locate the court transcripts.

Earlier, Kevin Kallas, a psychiatrist and mental health director for Wisconsin's prisons, testified he opposed the law banning hormones.

Besides in federal prisons, hormones are given in all of the Midwestern states surveyed by the Department of Corrections, he said. Kallas called hormones a "medically necessary" treatment in some, though not all, cases.

Kallas said patients who are taken off hormones typically need counseling, drugs and hospital stays instead, treatments that are more expensive than the hormones, which cost $675 to $1,600 a year. Kallas said he did not know of any other medical treatment that the state Legislature has banned in prisons.

Gerri Ladene | March 28, 2009 6:19 PM

BC/BS! Insurance company? Drop the BC and what do you get! Elimination of coverage stands for, your on own TS, nothing really changes there! Hmmmm, that's making change, right!

I'd say that Michigan's BCBS was probably an exception in covering SRS in the first place. In my state, coverage of SRS by health insurance companies chartered in KY is prohibited by state law, as is performance of SRS in any state supported clinic or hospital (which is, effectively, all of them). That's not a good thing at all, but it's probably not politically possible to repeal it anytime in the next decade or more.

There's a lot of work to be done in the area of health coverage. We know Obama and the Congress are going to come up with some sort of universal health care program, at some point. Most states have laws regulating and managing health care coverages, and KY is not the only one that specifically bans SRS. Also, US health insurance companies do not cover overseas surgeries, for the most part, and I'd estimate the majority of US SRS patients are going outside the US for their surgeries, at this time.

I don't like saying "someone ought to do this", without suggesting a person, but someone T who truly understands the byzantine world of (mis)managed care, the health insurance system, and the inner workings of the health care cost-assessment system, really needs to be in on the drafting of said universal health care plan. I doubt that will happen, and don't know who such a person would be.

I highly doubt that MI BCBS was sitting around, looking for something to cut, when someone thought out loud, "Hey, those new-agey transgender activists are always saying that one doesn't have to undergo surgery to be live as the gender they identify as and to be respected as that gender! Why don't we cut SRS?"

This is a dumb cut, since it won't save much money for them. But it's the easy one to make because so many people probably don't like it.

I am outraged and cannot fathom how in this day and age it is still socially sanctioned to deprive the TS community of the dignity and care they deserve. I don't know whether it will make a difference, but I have written a letter to Obama on the White house website describing my outrage and trying to appeal to his sense of reason and integrity. I know he's got a lot on his plate and this is probably a non priority, but if any of you out there are as devastated and outraged as I am, I would consider shooting off a letter to the president too. Let your voices be heard! Here's a link:
http://www.whitehouse.gov/CONTACT/

I just think that it is discriminatory towards all transexuals when 1) the medical insurance co's drop srs coverage 2) we cannot go to another state incurance co that does cover this without having to give up our job and livelyhood inorder to have a proceedure covered which we now cannot afford because we have no job making what we were making before we had to move to a new state to get this coverage.

Aki
totally totally f'd that we let people who with out a doubt do not know what they are doing run this country and states and make decisions for us when they are not really quallified !