By Jennifer Grimes
Triplicate staff writer
The breakdown in contract talks between Blue Cross and Sutter Health is pushing patient costs higher and may force residents to travel more than 90 miles to have their hospital stays paid for by their insurance.
Some local citizens and doctors say thats not fair.
They are still collecting your money, even though theres no where to get care. Youre purchasing a service and theyre not providing it, said Dr. Thomas Polidore, a local practitioner and surgeon.
Blue Cross and Sutter Health reached an impasse last week and Sutter Health announced it would no longer accept Blue Cross insurance to the same extent it has in the past year.
In Crescent City, patients still can be served at the hospital, but their costs for health care will be significantly higher.
Though Blue Cross and the Sutter Health company, which owns several hospitals, have argued over contracts before, this time the outcome is more serious, according to Polidore.
Its a very serious issue and obviously its not fair to the community, he said.
A dispute over how much Blue Cross pays for Sutter Healths services occurred a few years ago as well. Though the two sides had contractual disputes, the Sutter Coast Hospital in Del Norte County was still allowed to take Blue Cross patients without increasing patient costs, according to Polidore. They played the same cards, but they exempted us because we only have the one hospital, he said. But not this time.
Employee contributions and out-of-pocket costs for health care have already doubled and quadrupled for workers at Pelican Bay State Prison, City of Crescent City, Del Norte County Unified School District, the California Highway Patrol and some local private companies.
We cant continue to afford that, said Jim Coop who is a full-time employee at the prison.
Coop has two children and said his family required three surgeries last year. His share of that cost was $6,000. He said he fears, if more surgeries are required, his share of the costs will be double that figure.
As a result of the breakdown between Blue Cross and Sutter Health, local physicians will have to send patients to Eureka or Medford for even the most minor hospital visits.
Blue Cross is turning up the heat on doctors, too. The company prohibits doctors from practicing where Blue Cross insurance isnt accepted. As a surgeon, this will certainly effect the way I conduct my business, Polidore said.
If his patients are sent 90 miles away from his practice and their homes, Polidore said caring for those patients becomes a tremendous hardship.
The way I look it is that people will likely postpone surgery and other visits because of the increased costs, said Georgene Lesina, an administrator at Dr. Polidores office. That can be dangerous.
Blue Cross is a for-profit corporation and Sutter Health is a non-profit corporation. That causes conflicts. How this problem will be remedied is still not known by local employers and doctors. Polidore said he hopes after this contract lapses on Jan. 1, a new contract will be negotiated within a couple of weeks.
Efforts to reach representatives of Blue Cross were unsuccessful. Administrators for the company are out during the holidays, according to the voice mail messages of two administrators and one press agent of Blue Cross.