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submitted 4 days ago by robocall@lemmy.world to c/memes@lemmy.world
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[-] jqubed@lemmy.world 26 points 4 days ago

I’m not sure if it’s still the largest in the state, but Blue Cross Blue Shield of North Carolina is a non-profit, but they don’t seem to run in a very not-for-profit way. A long time ago, maybe 20 years ago, the board tried to switch it to a for-profit organization with the stated goal of going public and issuing stock options. The state didn’t allow them to do that, so the board started giving themselves lavish pay raises and arranging executive “retreats” in prime vacation destinations like Hawaii.

I don’t know how their denial rate compares to for-profit insurers, but they are a giant pain to deal with, and we have no other real options for the doctors we see and medications we take.

[-] Spitefire@lemmy.world 7 points 4 days ago

I've worked for the non-profit insurance subsidiary of a charity hospital system, and part of the problem is that ANY of the competition is for profit. What that means is that the for-profit companies are effectively setting the baseline of coverage. Healthy people (or the HR department at the company) aren't as concerned with richness of benefit as they are with the lowest premium. Sick people, though? They've got a list of doctors and drugs they want to make sure are covered. So if the non-profit benefit is too rich it attracts all the sick people and suddenly the operating costs of the non-profit skyrocket and they go out of business. It's a weird model that can't be AS good as the mission wants to be.

In my case the hospital system actually created a generic drug manufacturer themselves to undercut for-profit drug manufacturers. THAT was less daunting than trying to impact the insurance side any more than they already do.

this post was submitted on 18 Dec 2024
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