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I Heart Stanford Hospitals. Anthem? Not So Much

The Breakdown in Negotiations Between Stanford and Anthem is a Lesson In Public Relations. Some Get It. Others Don't.

Seventeen and half years ago, when I was thirty-four weeks pregnant, my water broke and I went into preterm labor. I was rushed to Stanford Hospital and spent fourteen days and nights praying my baby would be safe, that somehow he would hold on just long enough to be born healthy. 

The nurses and doctors who cared for us were kind, efficient, and knowledgeable. They did everything they could to prevent an early delivery. My son? He was just too eager for this world and insisted on making his debut six weeks ahead of schedule.

For the next ten days I held vigil at neonatal intensive care unit. I was the first  one there in the morning and the last one to leave at night. My days were filled with worry and tears for my own child and sadness for the other babies who didn’t have parents to comfort them. 

In the end, my son came home as small as a football and colicky as all hell. His deep-throated screams were forgiven; he was healthy and perfect in every way. 

My experience established a life long love affair with Stanford and it’s sister Lucille Packard Children’s Hospital. Because my family and I are generally healthy, the good news is I get to love them from afar. Like the nerdy girl in the back of the room, Stanford doesn’t even know I exist and I like it that way. But, if I need Stanford, I know it’s always there. 

At least I did until my insurance company, Anthem, decided it wanted a divorce. I got a letter recently telling me Stanford/Packard is now “out-of network,” which means it is simply far too expensive for me to take my family to my beloved community hospitals. 

One of the many reasons I love Our Fair City is the excellent medical services we have available to us right down the street. To be told I can’t use them, or rather I can at great personal expense, is more that a little discomfiting. For others, it means life and death.

I read a comment by a woman named Safeena whose husband has been fighting cancer at Stanford for many years. She was furious with Anthem and wrote, “Because we will no longer be able to afford your services, this move will result in the sooner than necessary death of my husband.” Anthem, are you listening to this?

I called Annette, a friendly Anthem customer service representative. She promised my care will not be compromised. I just have to drive up and down the peninsula when there is an emergency in an effort to find a hospital that will accept my insurance. And, I better find new doctors because the Menlo Medical Clinic, Stanford Family Medicine, and Stanford Medical Group are now “out-of-pocket” as well. 

Not compromised? Really? How can that be? I am being told I can’t go to one of the best hospitals in the country or get preventive care from some of the best doctors in the area and my care won’t be compromised?

Anthem, a subsidiary of the for-profit company WellPoint, has had troubles with other attempts to grab more profits in recent years. In the past, their target wasn’t the hospitals or doctors, it was the actual customers themselves. Last year Anthem, which insures over 800,000 Californians, created an uproar when it decided to raise individual premiums by as much as 51%.

While Anthem is making enemies, Wellpoint has made lots of friends on Wall Street as its stock price continues to rise. Two years ago it was trading in the low $30s. It reached a high of $80 in July of this year and despite the recent financial turmoil, has only dropped down to around $70. Meanwhile, profits have continued to sizzle. Now, I like a good investment as much as my neighbors, but profiting off of others pain? Not so much.

Meanwhile, the Stanford Hospitals continue to shine. Instead of punishing their patients, they have decided to honor the previous in-network pricing while the contract negotiations continue.

Gary Midgol, a spokesperson for Stanford says, “We are continuing to treat all patients, regardless of their insurance benefit, procedure or authorization status. This means that during this period we will honor patients’ in-network rates, so that their out-of-pocket costs are no higher than they normally would be.”

When I asked him why, he said, they wanted to do the right thing. “We recognized that patients had some confusion over their ability to receive or continue their care at Stanford Hospital & Clinics and Lucile Packard Children's Hospital--and over the impact to their pocketbooks--and we want to eliminate all confusion.”

All marriages have their ups and downs and who knows what the real story is behind the closed doors. But the failed negotiations between Stanford and Anthem brings home the deep flaws with our insurance system. 

I have been lucky. Thanks to my husband’s work, I have medical coverage even if it is now inconvenient and perhaps less than world class. What of the 51 million Americans across this land who don’t have the luxury of complaining they are inconvenienced because they  don’t even have insurance. Something is so deeply wrong with this system. 

I can only hope our leaders will find solutions that work. Then again, perhaps hoping is simply not good enough anymore.

In the meantime, my love affair with Stanford remains unabated. Patients like Safeena’s husband will not be put in jeopardy and I, and my family, can rest more easily.

The Stanford Hospitals are not perfect. Like all of us, they have their flaws, but when pressed, they know community matters and they do the right thing.

Are you listening, Anthem?

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