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It always sounded like a lot, didn’t it?

Blue Cross Blue Shield of North Carolina gets plenty of attention around here. From lobbying tactics to executive pay, from sponsorship of lavish events to outsourcing IT, we’re all over Blue. So it’s nice to see someone else get in on the action. Consumers Union, publisher of the OCD-beloved Consumer Reports, has a great new study on how so many nonprofit BCBS’s have ended up with so much “surplus” – which in any other context would be known as profit. Seems BCBSNC is not alone in holding on to more than state law requires even as it jacks up premiums annually. “In our sampling of ten diverse nonprofit BCBS plans, we found that 7 out of 10 of the plans held more than three times the amount of surplus that regulators consider to be the minimum amount needed for solvency protection.”

To be fair, our Blue isn’t the worst Blue there is: “For example, as of the end of 2009, BCBS of Arizona has surplus more than seven times the regulatory minimum. Health Care Service Corporation, a mutual insurer doing business as BCBS of Texas, Illinois, New Mexico and Oklahoma, has five times the regulatory minimum. Meanwhile, over the past three years both insurers continued to raise their rates.” Wow. Still:

Blue Cross Blue Shield of North Carolina raised rates on some individuals and families 18.44% in 2008, 8.5% in 2009, and 12.24% in 2010, while growing surplus to $1.4 billion in 2009, about 4.5 times the regulatory minimum.”

How is that helpful? To the insured, I mean. I know they need some surplus, but how does it help me for BCBSNC to hike my rates during the biggest recession in years when it’s already sitting on 4.5 times the cash its required to have on hand? How are their rate increases approved when we all know they’re sitting on a big ole surplus? “[M]ost states do not put limits on how much surplus insurers can accumulate and most do not have an explicit mandate to consider whether surplus levels are sufficient or too high when deciding to approve or disapprove a requested rate increase.” Hmmmm.

Of course it’s important for BCBSNC to have some surplus, I’m not denying that. But do they need so much? Couldn’t they use some to offset rates increases? Or, at the very least, couldn’t they stop directing a set portion of the increases to surplus, particularly since they’re operating in a stable environment?

Four of the ten plans studied experienced no periods of underwriting loss during the nine-year period (Arizona, North Carolina, Tennessee, and Wyoming). Annual gains among those plans varied, on average, from 2.9% (North Carolina) to 7.7% (Arizona). … That shows that … the underwriting cycle was far tamer than that on which … insurers and regulators may still rely today to develop target surplus ranges.”

There’s a whole lot more in the reports, including lots of sexy math and some actuarial action, but the upshot is clear.

To realize the promise of health reform, our collective challenge is to ensure that health insurance coverage is affordable. Some nonprofit health insurance companies continue to stockpile large amounts of surplus, funded by premium dollars. Health advocates, local grassroots organizations, concerned consumers, and some policymakers need to tackle the issue of potentially excessive surplus funds.”

Grassroots organizations and concerned consumers, that sounds like us, doesn’t it? Wouldn’t it be great if we a had big, cool buddy to help us? The summary of the report concludes:

Based on its findings, Consumers Union is recommending state insurance commissioners examine these surpluses, develop appropriate ranges for minimum and maximum surplus, and disapprove or reduce rate increases, particularly on individual market plans, when the company has more surplus than is necessary for solvency protection.

Whatcha say, Wayne?

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Can a Supreme Sing a Different Song?

Howsoever one may feel about Justice Clarence Thomas – I, frankly, find him fascinating – one must have feelings about this story from Solitary Watch, by way of truthout. The reticent reactionary’s rightful shock and anger over his nephew’s poor treatment at the hands of Louisiana hospital staff may augur changes in his view of prisoners and the mentally ill, who are all too often one and the same.

Our jails are now the largest mental health facilities in the nation, and they are filled with people who are there because they exhibited behavior common to untreated mental illness, including drug abuse, assault, and ‘quality of life’ crimes.”

Reality is but a tissue compared to ideology, of course, and Justice Thomas may never change his mind about what constitutes cruel and unusual punishment. However he soon may have more opportunities to revisit those views. If other states cut services with the alacrity that North Carolina has, how long can it be before someone seeks redress in the courts?

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The Old Fashioned Way Indeed

Howdy y’all! It has been awhile, hasn’t it? I was busy reading the Epic of Gilgamesh in Sumerian. Not really. I was teaching myself capoeira. No, that’s not true either. I moved. Not to Durham, though. Familiar readers (bless you!) will recall my love for the Bull City, but Durham is a dream deferred. I’m now a proud Chapel Hillian and, what with this and that, haven’t paid as much attention to state politics as a good Pulsie should. Last night, as I sat amid lists of things to do and plotted elaborate renovations that will never come to pass, the State Highway Patrol saga broke through the relocation fog that has hung over me these several months. I can see clearly now and the pain ain’t gone.

Governor Perdue’s announcement yesterday of tough (ha!) measures to restore the SHP’s integrity was stunning in its lameness. At least two of her four measures are already in place. Strangely, Perdue’s proclaiming it “a new day” didn’t cause a shift in the time-space continuum to make that any less obvious or true. Nor did predicting “a little bit of a flavor change” have the same effect as actually firing the people in charge of the wayward department. If you want to restore public confidence in the highway patrol, Guv’ner, start with the people in charge. They don’t deserve to keep their jobs, especially if it’s true, as you say, that a few bad seeds are ruining the reputation of the whole force. It’s time to cut bait, starting with the man at the top.

That brings us to the ultimate embarrassment of yesterday’s presser. Having her spokeswoman rush the governor offstage practically mid-sentence was not commanding or confidence-inspiring. While it was clear to all, even those of us befuddled by moving, that Perdue was painting herself into a corner pretty spectacularly, it was pathetic to see her hustled offstage like someone’s drunk-ass dad doing an Arnold Schwarzenegger impression at a rehearsal dinner. (What? You’ve never seen that?) Spokeslady’s giving Glover the hook a few moments later only reinforced the impression that those two have something to hide. Is it really any wonder they can’t manage to shake up the management at SHP enough to make a real change? Is it any wonder that questions about ethics and integrity cling like a Code Orange fug to the whole department? Today the majority of troopers, dedicated and honest professionals, have their commander and their governor to thank for that.

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Old Phonies Never Die

They don’t even fade away. Case in point: Charles W. Colson.

‘When you get to be a Christian, and you are serious about it, all the pleasures of the flesh disappear. If I had an indulgence, it would be sports cars, but I can’t afford to be seen driving one. I had one, but I sold it.'”

I guess hypocrisy isn’t a pleasure of the flesh. It probably pays well, though.

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Sins of the Fathers

I was Catholic once (…and young), so I’m going to dive into the ocean of commentary on the Church’s sex abuse scandal. Yesterday, Ross Douthat offered an idea for the “Are you f&^$%ing kidding me with this s@*!?!” file:

In reality, the scandal implicates left and right alike. The permissive sexual culture that prevailed everywhere, seminaries included, during the silly season of the ’70s deserves a share of the blame, as does that era’s overemphasis on therapy. (Again and again, bishops relied on psychiatrists rather than common sense in deciding how to handle abusive clerics.) But it was the church’s conservative instincts — the insistence on institutional loyalty, obedience and the absolute authority of clerics — that allowed the abuse to spread unpunished.”

I hardly know where to begin with this utterly ludicrous contribution.

While Douthat seems to be doing his Fox News-fair-and-balanced best to implicate the left here, he’s gone a league too far. “The silly 70s,” Ross? Really? We’re not talking about slap and tickle at the seminary – a tradition I would have to guess is roughly as old as time – we’re talking about sexual predators who for years upon years made children their victims. Children. Surely Douthat doesn’t mean to suggest that those poor deaf choir boys were running around in Studio 54 hot pants, and, yet, what else are we to take from his assertion that the culture is to blame?

It’s easy to set psychiatry up here too, isn’t it? Those MDs with their newfangled notions! That too fails the sniff test. In Germany, a psychiatrist repeatedly warned Church officials that an abusive priest must be kept away from children, but he was ignored. No, the blame here – and there is so, so much – belongs to the priests who abused children and the bishops and archbishops and cardinals who abetted them. Their crimes should not be called “cover ups”, they should be called what they are: the criminally negligent actions that “allowed the abuse to spread unpunished.”

I know Ross still wants to protect the Church hierarchy and its ancient customs, but it’s time for the tortured attempts to blame a permissive culture to end. It’s time for the attempts to blame anyone or anything other than the Roman Catholic Church’s hierarchy to end. Catholics have endured more of these scandals than any other denomination because of their peculiar insistence on celibacy for priests. As long as the Church offers refuge to men who are unable or unwilling to integrate sexuality into their adult identities, there will be problems. For not only does the Church give them a haven to hide from an important part of their humanity, it elevates them for doing so. That’s a recipe for tragedy, the kind of tragedy that is being visited upon the Catholic faithful around the world during this Holy Week. Again.