Blue Shield of California

[Guest guest]

Dear uterinefibroids and embo members,

Are there any women on this list group who are covered by Blue Shield of

California? Are any of you considering uterine artery embolization

(UAE) as a potential option? Are there any members in the approvals or

appeal process right now for UAE? If so, please contact me ASAP at the

following email address:

cdionne@...

cdionne (with an 'e' on the end) for the first half, as I know that

egroups drops the letter before the @ in all email

There will be a meeting in San Francisco this month that will deal with

the issue of approval/denials for uterine artery embolization as a

treatment for uterine fibroids for Blue Shield's members. According to

Blue Shield's 1998 Annual Report, the following is what they've

published about these meetings which are held each year:

" Grappling with the many complex medical devices, cutting-edge

treatments and therapies of our time is one of the most important things

a health plan does. Blue Shield’s Medical Policy Committee on Quality

and Technology, a national model in openness and candor, was once again

on display in 1998. At three different public forums, members of the

community, physicians, researchers and ethicists came together to help

determine what new technologies should be accepted as part of our plan.

Committee decisions are published in medical journals and made

available to the public as part of our multipronged effort to build a

current which will remove mystery, impersonalization and sometimes

distrust in much of healthcare today. "

However, contrary to what Blue Shield has published in their annual

report, it would seem that the public is, in fact, being excluded from

this meeting. Several participants, who are planning on attending this

meeting, called to ask if I will be in attendance also as a patient

advocate. When I indicated " ...no, I wasn't invited... " I was provided

the name and phone number of the Associate Corporate Medical Director to

contact. However, upon inquiry regarding details of time and location I

was told unequivocally that this meeting is NOT a public forum and that

I may NOT attend. In addition, I was told that MY interests would be no

doubt well represented by the physicians who have been invited to

participate. Well, I beg to disagree and take extreme exception to that

statement. No physician can adequately represent ME, the patient, or my

best interests. Not a single one. Are there any invited panel members

attending who have undergone UAE themselves? No. Are there panel

members attending with a financially vested interest in whether or not

UAE becomes an accepted procedure by Blue Shield. Yes. All of them.

Furthermore, Blue Shield insures individual patients who are members of

the public. Those patients (2.1 million according to Blue Shield's

press releases) pay the premiums that make Blue Shield of California a

$2.6 billion per year not-for-profit health plan in California. Not the

physicians. Call me crazy -- but as a member of the public -- not to

mention an active patient advocate -- it would seem that I should have a

right to attend and speak out at a meeting such as this. Not so,

according to Freudman, Associate Corporate Medical Director of

Blue Shield of California.

After acquiring a copy of the 1998 Annual Report with the above

statement indicating that Blue Shield's technical assessment meetings

are indeed public forums, I contacted Blue Shield a second time. Again

I was told it was not a public meeting. When I pointed out the content

of the Annual Report, it was suggested that perhaps the published

information was in error and didn't belong in the Annual Report. Yet,

there it is. Available for your perusal on the internet:

http://www.blueshieldca.com/blue/reports/98annual3.html

How can we, as patients, be heard by our insurers and have our " best

interests " adequately represented if we are excluded from policy review?

" Blue Shield’s Medical Policy Committee on Quality and Technology, a

national model of openness and candor... "

Really? Not from what I've been able to ascertain. Anybody on either

of these list groups have a problem with Blue Shield's stand on refusing

to allow members of the public to attend a meeting they've actively

published on as being open to the public?

Carla Dionne

Patient Advocate

mailto:cdionne@...

http://www.uterinefibroids.com

/list/uterinefibroids

1132 Lucero Street

Camarillo, CA 93010

" Never doubt that a small group of thoughtful committed citizens can

change the world. Indeed it's the only thing that ever has. " Margaret

Mead