Monday, April 19, 2010

The LuLac Edition #1155, Apr. 19th, 2010



Crafting a public relations image is both challenging and painstaking. Good companies become great by accentuating their positives and then telling the world about them via the media. You’d think this would be easy enough to accomplish but sometimes little unforeseen events get in the way. When that happens the truly media savvy companies rise to the occasion. Others just flounder. I thought of that last week when it was revealed that the Geisinger Health system insurance wing denied coverage to a new enrollee seeking health care insurance. Like all insurance companies, save for Blue Cross of Northeastern Pennsylvania non group individual plans, health insurance companies deny coverage all the time for one reason or another. But Geisinger denied coverage to a young man who served as a spokesman for how wonderful the staff was while he recovered from a stroke. To be sure the Geisinger staff has been praised to the hilt. No less an authority than one Barack Obama has sung their praises once or twice. That’s a public relations bonanza. But like all compliments and love shown in the 24 hour news cycle, that fame can be fleeting. The Times Leader reported that Nanticoke musician Lou Marino was denied coverage by the very same health care company he was promoting in TV ads last year. So now the media was all over the story telling us how the young man recovered nicely due to the care he got and how he eloquently talked about his dealings with Geisinger staff. If this doesn’t make the point for health care reform, nothing does. (And I cannot for the life of me try to understand why the young man was opposed to President Obama’s Health Care Plan but that’s a discussion for another day). The Geisinger hierarchy pulled out the Thesaurus and Media playbook and responded in a predictable manner.
"Our decision to decline your application for insurance was based on the following reasons: STROKE,” the letter stated. “According to the non-group underwriting standards and guidelines, the above mentioned condition is disqualifying.”
The letter stated Marino’s medical information was reviewed and did not meet the medical underwriting criteria required by Geisinger Choice.
Then they said this: Geisinger Health System provides care for all patients who seek services from our medical professionals, without regard to their ability to pay for that care. ” We have been and will continue to be privileged to provide health care services for Lou M., as well as every patient who comes through our doors.”
So is Geisinger saying they will provide free health care service to Lou because he ambles through the door but won’t cover him because he wants to pay? Well hey, let’s quit our plans and let Geisinger take care of all of us!!
The bottom line is this, somewhere along the line there was a screw up. And it could have been prevented very easily had Geisinger Insurance employed sharp people. If Health Care is supposed to be a business, then how come the industry hasn’t adapted to the 21st century. In the new business model, employees need to take total ownership and interest in their companies. Companies provide intranets for employees with updates on everything from growth projection to media buys. It is inexcusable for a high profile situation like this to occur. Someone in some department should have realized who this guy was and reacted accordingly. But unfortunately the workforce on the scene today is very narrow in its focus. Especially in health care. No one goes out of the realm of their own department. There are many specialists but very few generalists. It’s one of the reasons why you might see a claim denied in one department and then overturned in another. The fact that a Geisinger employee suggested disability to a guy not only willing to work but willing to pay for his health insurance suggests to me that Geisinger has employees who either have no answers at their disposal, or are so narrow focused in their own departments and areas of expertise that they miss the big picture. In my employment history I have had the opportunity to work with a few great, talented people. On the other hand I have also worked with some pretty awful individuals who had neither an appreciation or an understanding of what the basic mission of the company was. As an example, at Travelocity I worked with a college graduate who didn’t realize Hawaii was a state. And at Blue Cross I worked with a woman who thought she’d have to testify at a deposition about a claim because a co worker uttered the phrase, “the jury’s still out on that one” about an unrelated matter. And with unemployment so high in this area it is incomprehensible to me how many of them still have jobs. ( A friend of mine recently was laid off from a health care entity said the thing she was most angry about was not that she was let go but that some pretty stupid people were kept on. I understand that completely. Some of my former co-workers, not at just one facility mind you are the most vapid and lazy people God ever created). My point here is that if some person in some department looked at that guy’s name and realized who he was, Geisinger could have handled this matter internally. But instead, the story got in the media and a good company looks at best foolish and at the very worst heartless.
The Health care company did itself no favors in responding to the story. The party line given by the Medical Director and the PR guy only muddied the waters. People can’t stand insurance companies to begin with. This did not endear them to Geisinger. What the average Joe saw here was that a guy the insurance company used to promote itself denied him health coverage he was willing to pay for because of the condition their parent company helped to improve. And no matter how much they try to spin it, Geisinger at all levels of its employees blundered. Badly. There are many reasons we could speculate on but if there was at least one employee who was aware enough of the company’s mission, goals and use of the media, Mr.Marino would be talking to a Geisinger rep about a payment rather than to a newspaper and WNEP TV.
A few of my acquaintances (if you think you ever make friends at work you’re delusional) still employed at Blue Cross of Northeastern Pennsylvania and Cigna have expressed concern for their jobs given the latest health care bill passed and the uncertainty it brings with it. They need not worry. All they need do is dumb down their IQ by 30 points and Geisinger’s Insurance department would welcome them with open arms.


At 12:57 AM, Blogger D.B. Echo said...

It seems to me that what Geisinger did was both honest and consistent. They would have denied coverage to anyone with such a pre-existing conditon. To make ab exception in this case simply because that would have allowed them to avoid bad publicity would be dishonest - and possibly illegal. If they can make an exception for this guy, what about all the other people they deny who have pre-existing conditions?

Fortunately the recently-passed health care reform law (which was so vigorously and vocally opposed by certain groups and individuals) will address the "pre-existing condition" issue, though not immediately...and we can count on the Insurance industry to find some other way to keep the people who actually need insurance from being able to get it.

At 5:14 AM, Blogger Pizza Pete said...

So your former employer does not disqualify people for pre existing conditions? Free pizza for BC.

At 11:35 AM, Anonymous Anonymous said...

the fact is that Obama's plan would not really help him. According to reports he IS eligible for Cobra, but can not afford the premium. So even if Obamacare was in place, I would bet that with his condition, he would be charged a higher rate and still not be able to afford it.

At 8:11 PM, Anonymous Anonymous said...

Dave, Dave, Dave: I'd hate to have you as my boss. You think because someone has a job with a company that they should be aware of every nuance regarding the company? Harsh.

At 11:08 PM, Blogger Pizza Pete said...

This guy is a complete idiot! He is turned down due to a pre existing condition and then he states he is against Health Care Reofrm. Dumb Ass deseves what he got but he will not get a pizza. He wouldn't know how to eat it. My guess is that he would fold it NY style and that's just wrong!


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