Dear Pffft,
Oh Dear.
What a pity that the Board did not think about how to minimize the inevitable negative reaction to such a severance agreement, never mind the negative public reaction to the fact that BCBS Board members get, shall we say, rather generous yearly compensation for their efforts, which seem to consist mostly of lending their experience and good reputations as successful business persons and community leaders to a health insurance company.
A non-profit health insurance company to be sure, but nevertheless a health insurance company that seems to increasingly decrease it’s enrollees’ coverage in direct relation to an increase in premiums. (Well it seems that way anyway.)
And that’s the rub – Blue Cross Blue Shield is a non profit company and they have to file all kinds of information with the federal government and the Massachusetts Secretary of State and the Massachusetts Attorney General and most of it can make them look bad, if printed on the front page of a newspaper.
Every non profit needs somebody on staff to go around and rip those blinders and earplugs off of the senior staff and the board and remind them that this country is going through a transparency epidemic and they need to think about how their actions and activities would look to their squinty eyed, jealous sister in law.
This press debacle will go away, but not soon and will be burped up into a third paragraph every time poor Andrew announces BCBS most recent data confirming their cost control successes.
I’m tired of hearing about “cost controls” of the health insurance industry, as if they are a good thing. They aren’t.
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p>I built back-end systems for the health insurance industry while employed by IBM. The purpose of these “health care information systems” is to provide the health insurer with technology needed to deny coverage to as many people as possible. New and better systems allow the companies that purchase them to construct ever more complex policies for denying coverage. More weasel-wording, so that folks who need expensive care discover — when they try to get reimbursed — that it isn’t actually covered.
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p>The business model is simple: the department that purchases this system is measured by the dollar amount of claims that are successfully rejected. A system that costs $30M and results in $60M/year in rejected claims is hugely successful.
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p>The “cost control successes” that you describe directly translate to necessary medical treatment that is denied.
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p>People die as a result.
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p>The press debacle should not go away. It should, instead, be just beginning. Health insurers are evil and greedy and need to be destroyed.
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p>We need government-sponsored single-payer health care.
beneficial Medicare would be for everyone, especially both big businesses and the small businessman. How in the world can our businesses compete with Asian businesses when they have the extra burden of health coverage? And it has nothing to do with “Big Brother”; no one is asking for something for nothing. A VAT or even luxury tax on unhealthy products would cover the cost: no deficit spending, no passing the buck to someone else for payment. And, finally, let’s put an end to all of this petty jealousy re insurance coverage of public employees and others. As Americans we should take pride in being able to see to the good health of all of our citizens.
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p>They can’t. See Detroit.
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p>No New Taxes! Luxury tax = socialism, wealth distribution, etc., etc. etc. No New Taxes!
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p>Should. But that would be unamerican. We’re not our brother’s keeper anymore. See: socialism, Detroit, etc.
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p>I know you’re tongue in cheek, but just to point out:
* Cigarette taxes have a long history
* Some portion of gas tax goes toward ensuring groundwater safety
* The Affordable Care Act rolled out a tax on tanning salon beds which, like cigarettes, are remarkably effective at stimulating cancer
* Some states have no sales tax on items which increase health [contrapositive of unhealthy tax], including prescription drugs and medical devices
* mass transit is subsidized
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p>Of course, tUSA also does the opposite — subsidizes unhealthy products. These include, but are not limited to
* oil and natural gas and coal which, when burned, leads to lots of short and long term health problems
* candy is tax free in MA!
* alcohol has a lower total tax in MA than Shakespeare’s works
* big homes are subsidized more than small homes [in dollar terms and, because marginal tax rate increases with income, in percent terms as well] despite the clear understanding that big homes correlate with sprawl, which correlates with obesity, increased air pollution, etc etc.
* state and local road users don’t pay the full cost of the road through gas tax; property and income tax subsidizes
Reading your separate diary, one has to be a bit horrified over the BCBS’ decisions with regard to chronic care. That’s certainly a side effect of employer-based coverage: it’s in the interest of each insurer to put off major medical expenses to the next insurer.
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p>Cost controls are necessary, though, whether insurance comes from private insurers or the government. I’m reminded of the market for herbal supplements: lots of people mistakenly believe that they are absolutely dependent on herbal medications whose efficacy is at best anecdotal. The ability to believe that some magic thing can result in a cure can easily extend to things more expensive than echinacea.
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p>Republicans, extending their War on Arithmetic to every front, seem to imagine that cost controls would be unnecessary government intrusion if decided by public government panels, but that they are somehow magically absent from private insurers — or that the magic of the market makes them disappear.
When each individual health insurer designs its own “cost control” program, it does so in a context where the consequences of denying needed care are borne by somebody else (usually the victim). So long as cost controls are imposed in this context, people will die as a result.
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p>From the perspective of any of my former health insurance company clients, denying payouts for valid and life-saving care for chronic conditions is indistinguishable from denying payouts for herbal medications and crystal-squeezers. Since the payouts made for valid and life-saving care dwarf those made for quackery (yes, this is still true), then the lion’s share of payout reductions will come from denying needed care. That is simple arithmetic, it is just the way the beast works.
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p>Big Pharma and Big Medicine prefers to invest in creating successful (and highly profitable) treatment for long-term chronic conditions, that is in the nature of that beast. A prescription medication that costs a fortune, effectively treats but cannot cure a life-threatening disorder, and that extends the life (and therefore the cash-flow) of its recipient is a gold-mine (at least until its generic substitute hits the market).
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p>The combination of those two means that the adversarial relationship between private health insurance cost containment and private pharma and medicine profit incentive creates a huge and relentless financial incentive for health insurance providers to create ways to deny needed care.
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p>Americans who need health care are caught in the crossfire, and the relentlessly deteriorating outcomes and relentlessly skyrocketing out-of-pocket costs show the result.
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p>The reason why “cost control” in the context of government-sponsored single-payer health care can work without killing people is that it will reflect the greatly-multiplied cost of improperly denying coverage at the same time that it shows the immediate payout reductions.
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p>More importantly, the context of government-sponsored single-payer health care is far more likely to show the benefit of investing in life-style changes and public health programs than the current disconnected hodge-podge.
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p>The most effective long-term health care cost containment programs will those that result in a population that walks more and rides less, a population that eats healthier and fresher food, and a population that relies on early preventative care rather than deferred emergency care.
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p>The experience of most of the western world, especially in Europe, demonstrates that governments are far better at this than the much-vaunted “free market” approach that is currently killing Americans.
Private sector, stock and options can make the initial payout look more modest. Besides, that way you’re gambling on the continued health of the company.
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p>All BCBS had to do was purchase an annuity, perhaps even 25 year with survivorship, for the desired amount. No lump sum bonanza, but no media embarassment either, adn security for the recipient.
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p>Odd they didn’t think of it seeing as how they’re in the insurance business.
Really. I wonder why they didn’t think of that. Maybe the hiring contract forbade it?
http://www.usmessageboard.com/…
What troubles me is the incestuous Boston-insider deal-makers (hacks in more expensive suits) that promote these compensation packages….lining their buddy’s pockets and their own while taxpayers get fleeced.
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p>Step up Martha…., Deval – roll up the sleeves.
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p>Paul Guzzi, Bobby Haynes and Ralph C. Martin II and other members of the good ole boys club – gold star version are all in the tank for casinos too! They smile and pat each other on the back and suck the blood out of the Commonwealth. How effing cozy!
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p>We have all heard Bobby Haynes bellowing at conventions and speeches about the “working man” when he is raking in dough with sweet gigs that increase the costs for the poor bastards who are out of work and pay his salary.
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p>Bullshit.
is more forgiving than I.
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p>Anyone still wondering why Brown won? I am embarrassed to be a democrat when I read and witness this $hit.
…why the Governor not only refused to call them out publicly for this, but got rather impatient rather quickly when pressed?