Reply #9: then why would they care about risk exposure...? [View All]

[mike_c]

That doesn't make any sense.

I took a look at their 2008 Annual Report-- the most recent one available on their web site-- and it includes this sentence:

General inflation is outside our scope, so we focus on slowing the growth of medical costs and eliminating unnecessary use. In 2008, Regence programs helped members avoid more than $80 million in unnecessary care.

Again, strange behavior for a non-profit. They also state that only $0.01 from every member premium dollar goes toward investments for maintaining capital reserves. That's exactly what I'd hope to see, yet it begs the question why eliminate coverage for individual children when they have so much money available to pay claims, and are not in the business of generating shareholder profits?

Some of the preachiness about doctors and medicine in the Annual Report is weird for a non-profit-- they're highly critical of the medical profession:

(reasons why insurance costs are rising)

• More testing/defensive medicine. As a society, we are convinced that “more is better” and doctors overtreat to satisfy patient expectations and avert lawsuits.

• Duplication and waste. Our fragmented system’s lack of information sharing lends itself to expensive and potentially dangerous duplicate testing and treatment.

• The dysfunction of our overall system. Our system encourages doctors to practice defensive medicine and it rewards them for doing more.

Finally, I found this, from an Oregon news report about protests and arrests at Regence offices in Portland:

http://www.thelundreport.org/resource/police_arrest_twelve_at_regence

Last year, Regence – a non-profit health plan – took in $600 million in premiums. It spent 86 percent of those dollars on medical care. In Oregon, it spent $42 million on administration, and paid its CEO Mark Ganz at least $1.8 million last year.

And while enrollment shrunk, premiums increased by 26 percent last year and 14 percent already this year.

Rejected for carpal tunnel

According to Gillian Hearst, Regence denied her husband, Patrick Collier, coverage for an individual health plan because of a pre-existing carpal tunnel syndrome.

Sure sounds more like the behavior of a for-profit insurance company. I keep seeing the words "non-profit" on their web sites, but they sure seem to be paying their executives a lot of money!