Prominent nonprofit health-care provider and insurer organizations across the country, including some nonprofit Blue Cross and Blue Shield plans, have banded together to educate people about the importance of nonprofit health care. One of our chief goals is to combat unnecessary and inappropriate conversions of nonprofit health-care organizations to for-profit.
Incorporated in late 2002, the mission of the Alliance for Advancing Nonprofit Healthcare is to protect and enhance the abilities of nonprofit health-care organizations to serve society and their individual communities.
A for-profit conversion of Washington’s largest nonprofit Blue Cross plan, Premera Blue Cross, is currently being considered. We at the alliance add our voices to the chorus of health-care stakeholders urging Insurance Commissioner Mike Kreidler to reject this conversion.
We have carefully reviewed the evidence in the proposed Premera conversion, and, like the many experts engaged by the Washington state Insurance Commissioner’s office, feel strongly that if allowed to go forward, it will hurt the people of Washington. We found:
* Premera has not made a convincing case about its need for capital.
* Premera has no trouble attracting and retaining management talent, so does not need to become a for-profit to enhance this ability.
* A change from nonprofit to for-profit ownership would fundamentally change the inherent values, motivations and behaviors of the organization, with potentially significant adverse impacts on providers, policyholders and the public.
* A for-profit Premera would likely spend more on administrative costs and less on payment for actual health care.
* Premiums could go up at a rate faster than health-care inflation.
* Relations with health-care providers could deteriorate.
* Patient satisfaction, customer service and attention to certain preventive measures could decline.
* A converted Premera would likely be purchased by a national for-profit insurer. Thirteen of 16 Blues that converted over the past 15 years are now owned by Anthem or Wellpoint – two huge, out-of-state, for-profit insurers that are now seeking to merge.
* A converted Premera purchased by a national for-profit company could focus more on national accounts than on Washington state.
Many nonprofit Blues and other nonprofit health insurers are doing well financially and have adequate access to capital. They provide significant community benefits to enable more people to have more coverage, better care and improved health status.
Nonprofit health-care organizations, whether involved in the financing and/or delivery of services, have long been the backbone of the American health-care system. Americans hold these basic beliefs and values about health care:
* Health care, like education, is a “public good” or “social service,” essential to human dignity and the pursuit of happiness.
* A healthy society rests on the health of its citizens.
* Health care needs differ locally and are best prioritized and addressed within the political, social and economic fabric of each community.
Investor-owned organizations are economically driven and legally obligated to do well financially for their owners. Profits are primary, and are generated for the benefit of individuals.
Nonprofit healthcare organizations are obligated first and foremost to meet society’s needs.
Their overriding purpose is to “do good” for the benefit of their communities.
All health care is local. Nonprofit health care is community-centered, and we leverage our local knowledge. We focus on community health and customer service – even for unprofitable populations such as the sick, the vulnerable and the elderly.
Profits of nonprofit health-care organizations do not go to the benefit of the individuals running the insurance companies. We don’t write checks to shareholders. Instead, we reinvest in our communities. Our earnings are recycled into our local areas for better services and reasonable costs.
Should health care be used to create wealth, or to create health? Which would you rather have as a major player in Washington’s health-care market – a for-profit or nonprofit Premera?
Bruce McPherson is executive director of the Alliance for Advancing Nonprofit Healthcare, a national coalition of nonprofit health-care organizations including nonprofit Blue Cross and Blue Shield plans.
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