Wednesday, September 24, 2014

I made note last week of the strange silence from our state's largest insurance company, Blue Cross Blue Shield, with regard to the pending antitrust settlement between the Attorney General and Partners Healthcare System.  The impetus for my column was a strong statement by the state's other insurers that the proposed deal would be bad for the state's health care system and consumers.

But I didn't make it personal.  The Boston Globe's Thomas Farragher has now done so in a column in which he asks the CEO of BCBS why the company has been silent on the issue:

Apparently cured of laryngitis, he got on the phone to explain.

“I’m not trying to be cute, but we’ve been neutral,’’ said Dreyfus, whose company accounts for about half of Partners’ commercial business. “It was our judgment that [Coakley’s office] got the best deal they could. We weren’t going to substitute our judgment for theirs.’’

What Farragher makes clear is that silence is not neutrality.  Silence is assent.  This CEO is sophisticated and thoughtful and understands that point as well as anybody in the state.

Dreyfus is better than the sum of that quote. A group of antitrust experts called flatly for rejection of the settlement. The state’s Health Policy Commission estimates the expansion could smother competition and hike health care spending by $49 million a year. Dreyfus’s competitors, a group of other insurers, have raised red flags, and a coalition of Partners hospital competitors have said the deal will drive up costs.

Andrew Dreyfus is a smart national voice in America’s raging healthcare debate. He’s a sought-after speaker across the country, for good reason. He has held down costs. He’s been a proven leader. But not this time.

We cannot always know what incents people to act in certain ways.  We can, however, judge the import of their decisions. Last week, I put it this way:

[BCBS'] actions over the years and its silence now join it irrevocably with Partners as an advocate for higher health care costs in Massachusetts.


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