Editor’s Note:
The California Department of Managed Health Care hearing concerning Blue Cross of California, originally set for July 19, has been rescheduled to 10 a.m. Tuesday, Aug. 7 at a new venue: Junipero Serra Building, Carmel Room Auditorium, 320 W. 4th St, Los Angeles.
Dr. David Aizuss, sworn in last week as president of the Los Angeles County Medical Association, isn’t shy about sounding off on a variety of issues affecting fellow doctors.
His biggest cause du jour is the proposal by Gov. Arnold Schwarzenegger that would have doctors contribute a portion of their income to help achieve universal coverage.
“It’s like having a tax on teachers to fund education,” he said. “It’s just not logical.”
Aizuss, an ophthalmologist and partner at Ophthalmology Associates of the Valley in Encino and West Hills, prefers an alternative crafted by Senate President Pro Tem Don Perata, D-Oakland, and Assembly Speaker Fabian N & #250; & #324;ez, D-Los Angeles, though he is not totally satisfied.
Like the governor’s plan, it requires employers who don’t offer health coverage to contribute a percentage of their payroll to fund health care for the uninsured. Schwarzenegger has proposed a 4 percent levy, but the Democrats raise that to 7.5 percent while eliminating funding contributions by doctors and hospitals based on revenues.
Aizuss’ hope is that the doctors’ fee stays out of any compromise proposal worked out between Democratic leaders and the governor.
Meanwhile, Aizuss said he was pleased to hear that the California Department of Managed Health Care will hold a public hearing in Los Angeles on Thursday to hear complaints about how Blue Cross of California’s parent company, WellPoint Inc., has conducted business since the 2004 merger that moved its corporate headquarters out of state.
Blue Cross has generated headlines over its alleged practice of retroactively canceling individual insurance policies of seriously ill patients after finding sometimes only small clerical errors.
However, Aizuss is also concerned about how Blue Cross recently implemented a unilateral change in its fee schedule for its contracted physicians and hospitals. That change lowers reimbursements for many primary care and specialty procedures, such as the cataract surgeries he routinely performs, by as much as 30 percent.
“There’s this apparent disregard of the value of what physicians do for their patients by insurance companies, hospital companies, pharmaceutical companies and the government,” he said. “We have to work hard to preserve the doctor-patient relationship.”
The July 19 DMHC hearing starts at 10 a.m. in the auditorium of the Ronald Reagan State Building, 300 South Spring St. in downtown L.A.
Study Proves Healthy Perceptions
Though often accused of living in a LaLa fantasy land, Angelenos actually happen to have a more realistic perception of the state of their health than the typical American, according to a recent survey commissioned by CIGNA HealthCare.
The survey, which CIGNA hopes will help guide employers in crafting more effective wellness programs, found that while most Americans think they are in excellent or very good health, their actions when it comes to exercising, maintaining a healthy weight and managing stress don’t always match their words.
“Generally there’s this gap between how healthy people think they are and how healthy they really are,” said Dr. Steven Halpern, senior market medical director for Cigna’s Glendale-based Southern California operations. “But perception is actually closer to reality in L.A.”
More than half of those surveyed nationally said they are in “excellent or very good health,” and one in six reports being in better health than a year ago. Yet slightly more than half agree that others would say they actually need to lose at least 10 pounds. And while three-quarters of respondents would agree that others would say they are in good physical shape, only 49 percent exercise vigorously three times each week.
In comparison, Los Angeles residents who participated in the telephone survey of 1,150 adults in nine cities around the country tended to believe they could do better. For example, only 67 percent said they ate a well-balanced diet, compared to 75 percent of Americans.
“Los Angeles residents also tend to trust their employers more for providing health information, and that’s probably because more companies offer some kind of wellness program,” Halpern said. “There’s a culture of wellness in Los Angeles and the rest of California that I really see with the companies I work with here. And the survey indicates that employees appreciate that.”
Staff Reporter Deborah Crowe can be reached at (323) 549-5225, ext. 232, or at
[email protected]
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