The AP has a puff piece on the greatness of Karen Ignagni. Well greatness if greatness is defined as doing anything it takes to screw the nation on behalf of her organization’s members, all the while telling bold face lies about their activities. But the lies of Karen Ignagni have been well documented here on THCB and we don’t need to rehash them now.
But then the AP reporter Erica Werner quotes Uwe Reinhardt and has this somewhat remarkable passage:
"Whatever AHIP pays her, it's not enough. She's unbelievably effective," said Princeton economist Uwe Reinhardt. "It's just amazing what she's achieved for them against all odds." Ignagni's total compensation, according to AHIP's most recent filing from 2007, was $1.58 million, which includes $700,000 in base salary, $370,000 in deferred compensation and a bonus. Ignagni won't say how many hours a week she works. The number's so high it's embarrassing, she said.
Among successes cited by Reinhardt and others is helping persuade the Bush administration to develop private insurance plans within Medicare that are producing unexpectedly high payments for private insurers. When Congress was considering expanding a children's health insurance program in 2007 by taking money from the private Medicare Advantage plans, Ignagni worked successfully to stop it. Those private plans are being targeted again by Obama, who wants to squeeze them to pay for his health care agenda. Ignagni's industry group is organizing older people to defend the plans.
There’s lots of more puffery about how she’s good at building consensus among the diverse interests in her group. My take on that is “we’ll see”.
AHIP has been unified because it had a pliant Administration in place for the last eight years that encouraged private businesses to rip off the taxpayer. And Medicare Advantage and private FFS plans were keen to step up to the plate. All the while the big plans (the old GHAA plans) gave up managing care and instead started imitating the bad behavior of the old HIAA mob. HIAA boss Chip Kahn may have lost the job when HIAA merged with AAHP, but Ignagni has well represented the transition from old style population-health managed care into a combination of sucking off the public teat and turbocharging the screwing over of the individual market. The two signal events in all of this were United Healthgroup’s purchase of looney Rooney’s Golden Rule for the better part of a billion dollars, and the merger of AAHP with HIAA (the smaller plans). That showed that big for-profit plans (and the rest of them) were happy to exploit the new Republican reality of no reform and no regulation for all it was worth. The piling on in the Medicare Modernization Act, with the introduction of private Medicare FFS and the vast (and unnecessary) increases in payments to Medicare Advantage plans, was just health care’s version of taking Halliburton’s lessons.
Now things are different and that leads to a problem for AHIP. The smaller plans in AHIP make all, and plenty of the larger ones make lots, of their money from shenanigans in the individual market. Blue Shield of California this very week is in court to defend its practice of recissions. Blue Shield says that it wants reform that would obviate the need for that kind of scummy behavior, but I’m not sure if that view is universal within the AHIP board. Ignagni has apparently sheparded the insurers towards that opinion. George Halvorson (of KP) is quoted in the AP piece as saying she got them to the agreement on giving up underwriting. He also essentially came to the conclusion that there’s no room for the schlockmeisters when I interviewed him in April.
But we’ll actually see when the final deal is cut whether the insurer coalition holds, and whether Ignagni continues to front for the interests of profit-maximization for her members by telling a pack of lies, or whether she (and AHIP) accept a deal which will turn them into regulated utilities that perform a useful role in the health care system a la Switzerland.
But really, did Uwe actually mean that Ignagni securing huge payments for Medicare Advantage and worse denying kids insurance at the cost of her members profits were “achievements”? I think not. My guess is that Uwe was being gently ironic and that the AP reporter missed the joke. On the other hand, Uwe says that she did all this against the odds?
Hardly. Getting Tom Delay to help you loot the Federal government was not a tough job. Getting the health insurers to take a reasonable and rational role in the future of health care will be.
Categories: Matthew Holt