Thoughts On Gov. Bryant's Ex. Order For BCBS To Play Nice?

[Deltamud77]

As many of you may know, HMA (which runs River Oaks Hospital, Women's, CMMC and 7 other hospitals in MS) is having a contract dispute over reimbursement with Blue Cross/Blue Shield. BCBS has taken the 10 HMA hospitals out of network. Of those that have health insurance in MS, 80% have it with BCBS.

HMA filed a law suit against BCBS in Rankin County in order to force them to honor their contract. That suit has not been heard as of yet.

Gov. Bryant issued an Executive Order which effectively forces BCBS to return to their previous dealing with HMA until their law suit is adjudicated.

Basically, Bryant has pulled an Obama and used government "authority" to force two private entities to contract with one another...really no different than Obama forcing a private individual to enter into an agreement with a private company to purchase insurance.

As a result of the executive order, BCBS has filed a lawsuit against Phil Bryant in federal court for an injunction to be entered barring the implementation of his executive order.

I would not be surprised if this picks up national traction in the coming days and weeks.

What are your thoughts?

My personal belief is that Bryant has absolutely no constitutional or statutory authority to force to private entities to contract with one another. Moreover, for someone that has been rightfully and overtly against Obamacare, his inability to see his own hypocrisy really makes me call his true leadership into question and wonder if he is simply a partisan mouthpiece without substance.

[deltadukman]

What are your thoughts?

My personal belief is that Bryant has absolutely no constitutional or statutory authority to force to private entities to contract with one another. Moreover, for someone that has been rightfully and overtly against Obamacare, his inability to see his own hypocrisy really makes me call his true leadership into question and wonder if he is simply a partisan mouthpiece without substance.

Exactly my thoughts when I heard about it yesterday. How can he make two private business's "do" anything? Seems like a democrat move to me.

[sevenhead]

As many of you may know, HMA (which runs River Oaks Hospital, Women's, CMMC and 7 other hospitals in MS) is having a contract dispute over reimbursement with Blue Cross/Blue Shield. BCBS has taken the 10 HMA hospitals out of network. Of those that have health insurance in MS, 80% have it with BCBS.

HMA filed a law suit against BCBS in Rankin County in order to force them to honor their contract. That suit has not been heard as of yet.

Gov. Bryant issued an Executive Order which effectively forces BCBS to return to their previous dealing with HMA until their law suit is adjudicated.

Basically, Bryant has pulled an Obama and used government "authority" to force two private entities to contract with one another...really no different than Obama forcing a private individual to enter into an agreement with a private company to purchase insurance.

As a result of the executive order, BCBS has filed a lawsuit against Phil Bryant in federal court for an injunction to be entered barring the implementation of his executive order.

I would not be surprised if this picks up national traction in the coming days and weeks.

What are your thoughts?


My personal belief is that Bryant has absolutely no constitutional or statutory authority to force to private entities to contract with one another. Moreover, for someone that has been rightfully and overtly against Obamacare, his inability to see his own hypocrisy really makes me call his true leadership into question and wonder if he is simply a partisan mouthpiece without substance.

Is there really anything else to say?? You've pretty much summed it up.

[fireplug]

I agree. I think he used it as a bluff at first and when they called his bluff he felt like he had to take action.

Best way to solve the BCBS monopoly in Ms is to open the borders to any and all insurance companies to come
offer healthcare here. Republicans preach opening the borders for insurance companies to compete openly here,
then why don't they pass the law and give the insurance comm. the resources to handle it.

[Deltaquack]

This goes a lot deeper than "making two private businesses do something". He absolutely should do what he's up to. I don't like the majority of what BCBS nor HMA do. I'm on the other side of the page.........BCBS either doesn't pay or pays very poorly for most services. HMA usually recruits doctors that'll take less pay and is a number crunching business. Guess what, the patient is usually the one that suffers from both sides. The problem is we've all allowed the BCBS monopoly to form. We need to put a stop to it real quick while we have the chance. The state got smart and took away from BCBS and gave the CHIPS management contract to United Healthcare.

There are a lot of laws and contracts out there that BCBS is basically throwing to the curb b/c no one usually calls their bluff. I hope he sticks to it.

[fireplug]

I hope he sticks to it.

He probably will try to stick to it. Whether or not it's legal, that's a whole other issue. State congress needs to step up and end this game
fast. I have BCBS. It hasn't affected me....Yet and I hope it doesn't. Time for the boys to gather in Jackson and kick the lobbiest to the curb
and make this thing right for Ms. Open the door for competition and see how fast BCBS changes their tune.

[turkeyman]

As a BCBS member I pay out the butt for my monthly payments. I'm also a patient who has to go every 6 months for cat scan do to cancer I had and I can't afford out of pocket to have my stuff done that often. So yes I think he should step in and at least try bc we deserve what we pay for to this company while they fight with the hma hospital.

[Deltamud77]

This goes a lot deeper than "making two private businesses do something". He absolutely should do what he's up to. I don't like the majority of what BCBS nor HMA do. I'm on the other side of the page.........BCBS either doesn't pay or pays very poorly for most services. HMA usually recruits doctors that'll take less pay and is a number crunching business. Guess what, the patient is usually the one that suffers from both sides. The problem is we've all allowed the BCBS monopoly to form. We need to put a stop to it real quick while we have the chance. The state got smart and took away from BCBS and gave the CHIPS management contract to United Healthcare.

There are a lot of laws and contracts out there that BCBS is basically throwing to the curb b/c no one usually calls their bluff. I hope he sticks to it.

The problem is he doesn't have the authority to issue this executive order any more than he has the authority to take away guns by executive order. I predict things end badly for him at the federal court as well...which will be bad for the state.

IMHO, if the state wants to do something, they should give notice they are going to cancel the contract they have with state employees and BCBS for cause based on their actions and open state employee insurance up for RFP.

[Chuckle12]

As a primary care physician that sees both clinic and hospital patients on a daily basis (rare breed) that works for HMA, I think it's great. BCBS has bullied hospitals & patients around for years. Someone has to call their bluff and make them pay. I see 50-60 patients a day between inpatient & clinic and it affects a lot of them. Some aren't getting necessary care and others have had to go to hospitals that I don't have privileges for because of it - and they were NOT happy with that. Is iut legal, I don't know, but every once and a while a monopoly like BCBS of MS has needs to be brought to it's knees b y SOMEONE, cause they sure don't give a chit about the patients it affects. CMMC has been providing care for BCBS patients out of pocket since this started, now you tell me it's all about the bottom dollar for HMA all the time. Also tell me a little more about how HMA only hires cut rate physicians, since both myself and my partners (one of which is my father) are employed by them.

[Deltamud77]

Sam, I agree that BCBS needs to be brought down to size...my argument is relative to the slippery slope that is created when a governor, be it democrat, republican or communist, exercises or attempts to exercise authority that is not vested in them over private matters.

There will be a day in MS, probably within 20 years, in which a conservative will not sniff winning a statewide election in MS because the blacks will outnumber the whites.

When that day comes and when that liberal governor attempts to use executive order to take away guns or hunting rights or whatever other constitutional right, they will be able to reference what Bryant has done as a precedent, unless it is rescinded or shot down by a court.

There are ways of handling this that do not involve taking a dump on the constitution.

[deltadukman]

I agree something needs to be done, just not sure this is the way it needs to happen. I hate BCBS with a passion if anyone wants to know my stance. But I dont solely think they are 100% in the wrong. I think both are to blame but this stand off needs to end.

[the tree]

BCBS is private business servicing health care needs without creating debt. BCBS insures 80% because they are very good with providing health care, they know the cost of insuring their policy holders and can beat their competition. When you have a problem, pull out your card, call the customer service and speak to a customer rep from your home state in English. Sure they're expensive, but most doctors accept their card. Perhaps they are a monopoly, but that is a status they've earned. Cuss them all you want, but respect their fight, and consider them a better alternative to Obamacare.

[REBEL DUCK]

As a agent I don't understand when you say open up the state to other companies. You don't have to have bcbs many other ins companies are in ms bcbs is just the best. Sign up in the exchange if you don't like bcbs

[Deltaquack]

As a primary care physician that sees both clinic and hospital patients on a daily basis (rare breed) that works for HMA, I think it's great. BCBS has bullied hospitals & patients around for years. Someone has to call their bluff and make them pay. I see 50-60 patients a day between inpatient & clinic and it affects a lot of them. Some aren't getting necessary care and others have had to go to hospitals that I don't have privileges for because of it - and they were NOT happy with that. Is iut legal, I don't know, but every once and a while a monopoly like BCBS of MS has needs to be brought to it's knees b y SOMEONE, cause they sure don't give a chit about the patients it affects. CMMC has been providing care for BCBS patients out of pocket since this started, now you tell me it's all about the bottom dollar for HMA all the time. Also tell me a little more about how HMA only hires cut rate physicians, since both myself and my partners (one of which is my father) are employed by them.

I didn't say "HMA only hires cut rate physicians." I said they usually recruit them and I mean by that.......usually surgeons for specialties like ENT, Ortho, etc. I have talked at length with multiple HMA CEO's and one of their CFO's so many times I can't remember on the subject. Go to your HMA hospitals in places like Clarksdale and Batesville. Their insurance requires you to see doctors in their facilities if available or they'll deny the claim if you try to go to out of network. So, they get at least one provider in every specialty on staff. Heck, Lifepoint does it too. In those situations, they go find that doctor that just retired or is at the end of their career somewhere. They bring them in, give them a 2 hour block a week in surgery..........and guess what, they now meet the requirement that forces you to see them or go pay out of pocket to a good surgeon at another facility. I'm on staff in surgery at three different hospitals in the delta. I know the game very well. One of the attorneys on here helped me fight this exact thing in the past. My own son needed Adenoidectomy, Tonsilectomy, and PE Tubes. There was no ENT on staff for a two month period or so......lucky for me.......so we raced to Baptist in Jackson. Well, the week the surgery was scheduled, they signed a contract with a 72 yo ENT that hadn't been practicing for years. They tried to force me to see him. Needless to say, I won and they gladly paid the claim. I see it all the time. It's all a game to the hospitals and insurance companies.
I can name over 10 doctors right now that have surgery privileges in HMA hospitals that have NEVER completed a residency. Yes, you read that right. They have privileges in Batesville and in a few around Jackson, Canton areas. Blows my mind on the liability WHEN something happens and patients are forced to see them b/c they are the only ones in network through that facility.

[thcobb1]

I think what the gov did was correct and public health in mind. BCBS got where they are due to being granted not for profit status over 40 years ago. This is what allowed them to gain 81% market share, NOT great customer service. Once they choked other insurance companies from they decided to return to a for profit status and become the bully they are today. Once they accepted not for profit status they accepted a responsibility to the citizens of the State of MS, private company or not.

This is much further reaching than just if patients can be treated at an HMA facility. If you take 81% of the commercial insurance patients from the pool these 10 hospitals likely won't survive. That alone is why the Gov needed to intervene. If you live in the Jackson Metro then you still have options, but the other facilities are reaching capacity. Once they do, now what?? If you live in Clarksdale, Amory, Batesville, etc where will you go and what will you do if these facilities close??? Take the BCBS patients out, what will the other residents of these towns do? Where will they get care? How will they get there?

I don't think the Gov really wanted to be in the middle of this, but as the Gov he has to think about the welfare everyone in the state, not just HMA or BCBS.