Several days ago, Ed Cone, once again got on my last nerve. It birthed two posts - this one (which got waylaid in my drafts folder for a while) and this one (on Walter Reed).
I hate it when Ed plays patrician know-it-all who knows best. When he doesn’t.
It all started with a post at Word-Up (appropriately called “open warfare”) in which I brought up the very un-neighborly move of Cone Hospital stepping onto High Point Regional’s turf (with the blessing of the state). Forget the furniture market going to Vegas, the city of High Point needs look no further for knives in the chest than its “friends” next door.
What Cone wants, Cone gets.
During the thread, HRH Prince Edward Cone of “the Cones” offered up this gem, “Non-profit hospitals are not necessarily obligated to serve the poor.”
Oh REALLY, Ed? Would you like to explain that (as you whine about getting “nothing” for too much, and push for what amounts to socialized medicine) to the majority of the general public that thinks/expects otherwise?
I know that I, as a young doctor trying to pay down my medical school debt, expected MORE of non-profits, when I signed on the dotted line with Randolph Hospital, the NC Deparment of Rural Health and the National Health Service Corps. I expected that, because these organizations were accountable to the taxpayer, that they would adhere to (and be held to) higher standards.
I turned down the elaborate incentive program in favor of collecting a reasonable salary (far less than what the docs there make now), because I was under the impression that I worked for a public charity. If I wanted to make the big bucks, I could go into private practice. Actually, these days, it’s pretty much the other way around. Of course, had I made the jump to private practice, I would have threatened the bottom line of the hospital’s much-beloved “controlled affiliate”.
Turning down the incentives and insisting we stick to our mission put a target on my back. Gotta love that “free market”.
Of course, I was incredibly naive. After all, I live in North Carolina, the land of pay-to-play Jim Black. And non-profits here get away with murder.
In my case, Randolph Hospital executives got away with perjury, contempt and fraud after throwing me out on the street for defying them to do right by a patient in the middle of the night . . . AND (let’s not forget) suing me for telling the government I served the truth about what was going on (this leads into my next post on the Walter Reed mess).
Not that anyone on that medical staff gives a rat’s tail about administrative ethics. As long as their practices and lives are not affected (or their pocket-books are even enhanced by the lack of competition), they’re quite happy to let a colleague twist in the wind.
Despite my pleas for help, the great state of North Carolina, led by the oh-so-honorable Mike Easley and Jim Black, stood by and watched. Roy Cooper, the state’s lead law enforcement officer (and DHHS’s lawyer), never had the guts to step in and protect one of the state’s own public servants. And the NC State Bar winks and nods as it covers the tails of its own.
Meanwhile, the NC Medical Board’s lead attorney (Thomas Mansfield) speaks with all of the arrogance of a man in a powerful position, not accustomed to any one talking back (much less a lowly doctor who isn’t a member of the NC Medical Society). In this case, here’s a man who never hears the word no (even when he’s wrong) brushing off a physician who has never heard anything but the word no, (when she’s absoulutely right).
I’m digressing again. We’v e got non-profits in the news. Let’s get to it.
First, there’s Blue Cross Blue Shield of North Carolina. This “non-profit” insurer (which for years had a virtual monopoly on individual policies in the state) posted record profits last year: Blue Cross and Blue Shield of North Carolina generated 65 percent higher income in the fourth quarter compared to the same period a year ago, with the bulk coming from more premiums.
And because of his mad skills in sticking it to policy holders, Blue Cross gave CEO Bob Greczyn a big fat raise: Blue Cross and Blue Shield of North Carolina, which has come under fire for big profits and premium increases, paid its top executive $3.1 million last year, a 22 percent raise.
Several senior executives also received double-digit raises. Three earned more than $1 million in annual compensation for the first time, according to the company’s annual report.
Not everybody is cool with that: Adam Searing, director of the N.C. Health Access Coalition and a frequent Blue Cross critic, pointed out that Blue Cross became what it is today by receiving tax breaks for decades.
“They are rolling in money, and the legislature sits by and lets it happen,” Searing said. “I don’t want to hear another person complain about increasing health-care costs if they’re not willing to rein in outrageous profits and executive compensation at Blue Cross.”
Now Greczyn’s raise got front page coverage in the Courier Tribune (days after the Raleigh papers but we won’t quibble). I wondered what was up with that. Then I realized. It may actually be a way for David & Bonnie Renfro to “justify” the salaries of the big boys at Randolph (I’ve really got to get around to updating that page).
The subliminal message is, “Why Bob Morrison and Steve Eblin don’t make so much. Just look what Bob Greczyn makes!”
Bob and Steve certainly saved a sizable chunk of change when they lied under Oath and swindled Dr. Mary Johnson at settlement . . . after destoying (and absorbing for their own) her Pediatric practice . . . and using the hospital’s deep, publicly-subsidized pockets to finance a bogus “libel” lawsuit. What a great round of business moves!
Sayeth the Randolph Hospital Board of Directors, “Let’s not fire these two geniuses because the black and white of contracts and sworn discovery documents say they’re liars and cheats, let’s ignore it all and give them raises!”
Blue Cross acutally copied that SLAPP-suit move (more premium dollars diverted to lawyers’ pockets) when it sued ProCare for talking about private jets and golf extravaganzas for VIPS. And then there’s the one million dollars to put their name on an atrium at a performing arts center.
Blue Cross justifies Greczyn’s raise by saying it “lagged behind” that of the CEO’s of other big insurers . . . and comparing his salary to that of the CEO at the very much “for-profit” pharmaceutical company, GlaxoSmithKline.
More from the N&O article: Executive compensation has become a lightning rod for criticism in recent years, especially as raises slowed for lower-level employees. Regulators now require publicly traded companies to disclose more details on pay. And some investors are pushing to rein in executive pay.
Nonprofit organizations have also come under scrutiny. Last year, Forbes magazine reported that pay increases for nonprofit executives had outpaced, on a percentage basis, that received by CEOs of the 500 biggest American companies.
Asheboro can certainly prove that one.
Blue Cross’ income and executive compensation have drawn criticism before from consumer advocates, some lawmakers and regulators. Hospitals, doctors and other health-care providers also have complained the insurer is squeezing their payments even as it makes more money.
This is the morsel of rationalization that killed me: Of every $1 members paid in premiums, less than one penny pays for the compensation of Blue Cross’ top nine executives, Stinneford said. Medical care ate 82 cents of every $1 in premiums last year.
“If these executives didn’t get paid at all, it wouldn’t be noticeable in premiums,” he said.
Translation: The money is there (because of the tax breaks and raised premiums and screwing doctors to the wall). Never mind that the costs of doing medical business are still going up (for a variety of reasons). Just give more to the executives. They “earned” it.
Pretty lame if you asked me. Who’d have ever thought that you could get rich by running a “non-profit”?
To answer that question, we step over to the N&R, that reported, a builder once associated with Project Homestead was served with a lawsuit in January by four Greensboro contractors for nonpayment of work done on more than a dozen homes in south High Point.
Project Homestead: Just another case where it would be nice if a local DA had a spine.
Share of North Carolina, a nonprofit builder founded by Bill Waller, began working with the city of High Point on the homes in 2003.
The city gave Share about $142,500 worth of property — roughly 28 lots — to build affordable single-family homes in the Macedonia neighborhood as part of a revitalization effort.
In this case, homeowners are caught in the middle with liens filed against their properties by warring businessmen.
Like a Pediatrician from Asheboro, these people are out-of-luck because no one is holding non-profits in North Carolina accountable.