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Blue Shield, Sutter Impasse About More Than Money

(Getty Images)

(Getty Images)

Contract breakdowns between insurance companies and health care providers are nothing new and often blow over after public posturing. But the current failure of Blue Shield and Sutter Health to come to terms on a new contract may be harder to resolve. That’s because the main issues appear to be about much more than money.

To the average patient, a request to arbitrate disputes doesn’t sound like a big deal. But this is different.
While the negotiations grind on, more than 250,000 people in individual and family plans are waiting to see what happens. The contract between Blue Shield and Sutter terminated on Dec. 31.

To be sure, money is a factor. Sutter says that Blue Shield is “demanding reductions in what they pay our organization … that would have a devastating impact,” said Bill Gleeson, a spokesman for Sutter. He says Sutter has asked for “less than a 1 percent increase.”

But Blue Shield claims Sutter is pushing the insurer to accept “new and unprecedented contractual provisions,” says Steven Shivinsky, spokesman for Blue Shield. Continue reading

Blue Shield CEO: Challenge, Opportunity in 2013 and Beyond

By Alvin Tran and Sarah Barr, Kaiser Health News

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

As chairman and CEO, Bruce Bodaken led Blue Shield of California to become one of the fastest growing health plans in the state — it currently has more than three million members. But after 12 years of service, the 61-year-old recently announced his plans to retire at the end of 2012.

Bodaken’s successor, Paul Markovich (the chief operating officer), may not have an easy time of it. He’ll have to implement provisions of the federal health law while trying to keep costs as low as possible. “That will be the biggest challenge that I think any health plan CEO will face over the next several years,” Bodaken said.

Bodaken’s views on the health law and the current state of the insurance industry were among the many topics during a recent interview with Kaiser Health News. Here are edited excerpts:

Q. Why retire now?

A. One thing I told my board when I first came on, after a decade or so, you need to think about changing your CEO as a policy matter. There is a time for these things for any corporation, for any person. I’ve been doing this for 12 years. I don’t see this retirement as me dropping out of sight.

Q. What do you think insurers will have to contend with as they head to 2014, when the federal health law will fully kick in? Continue reading

Health Insurance Executive Is Longtime Backer of Universal Coverage

Bruce Bodaken is CEO of Blue Shield of California. (Photo Courtesy of Blue Shield)

Bruce Bodaken is CEO of Blue Shield of California. (Photo: Cindy Charles)

To those who haven’t followed the health care debate closely until now, you might be surprised by one of California’s leading proponents of universal coverage. It’s Bruce Bodaken, CEO of Blue Shield of California, one of California’s largest health insurance companies. He first proposed a system of universal coverage for Californians ten years ago.

“At that time, there was 20 percent of Californians without coverage,” he said in an interview with KQED. “We looked at that in one of the richest societies in the world and said, ‘Simply unacceptable for people not to have at least basic health care.’ So we proposed that all people in California have at least basic coverage. Those that can’t afford it would be subsidized and all groups and individuals would be mandated to be covered.”

It sounds a lot like the Affordable Care Act (ACA) being considered by the Supreme Court this week. Tomorrow, the Court will hear oral arguments about the constitutionality of the individual mandate — the requirement that all Americans have health insurance. Those opposed say that Congress has exceeded its authority in requiring Americans to purchase a product. Continue reading