ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, September 15, 1996 TAG: 9609180010
SECTION: EDITORIAL PAGE: 3 EDITION: METRO
SOURCE: JULIE LAPHAM
HOW WE DO our public business is what gives us a vibrant system of government that has lasted since the first days of Jamestown. In Virginia, we are faced with a proposal that illustrates how this system works - or rather, should work.
The proposal to convert Trigon Blue Cross Blue Shield to a for-profit company starts with a few basic questions: How does a nonprofit, nonstock company convert into a for-profit stock company? What are the considerations? Who is responsible for the oversight? Where is the public forum that allows citizens to ask questions and raise concerns? Is this a good idea? Will health care in Virginia suffer or benefit? What are the consequences?
These are just a few of many questions that are being raised and have not begun to be answered. The Virginia code is practically void of guidance in this particular matter. After all, who would ever have suspected that a nonprofit nonstock would ever want to convert? Now, after 60 years of operation, Trigon wants to do just that.
Has the system of state government become impotent in this case? Maybe. The State Corporation Commission has the responsibility to authorize the conversion. This regulatory commission provides oversight and guidance to corporations throughout Virginia.
But it is somewhat restricted because its scope is limited by the laws and regulations already on the books. The Bureau of Insurance, an entity within the commission, is also guided by law and regulation. The question ``Is this good for Virginia?'' will not be raised here.
The office of the attorney general is, by law, charged with representing the interests of the people. The attorney general settled with Trigon for $159 million in return for support of the application. Initially designed to be set aside in the form of a foundation to support medical research and education, this money was increased to $175 million and diverted into the state treasury during the last General Assembly session. The question ``Is this good for Virginia?'' will not be raised by this attorney general or his staff.
House Majority Leader Richard Cranwell led the fight for Trigon's legislation that narrowed public participation while he was also employed as one of Trigon's attorneys. He accepted thousands of dollars to his law firm, and contributions to his own campaign, from Trigon. When he eventually bowed to public pressure and resigned from Trigon's payroll, his fellow lawmakers voted to narrow legislation that eventually forced the Virginia Citizens Consumer Council to withdraw from the case.
Lawmakers listened to a barrage of lavish lobbying by Trigon and saw an opportunity to stopgap the state's budget shortfall with the $175 million secured by Attorney General Gilmore. They also knew that nearly 2 million shares from the state employees' health-care program would be given to them for distribution.
Some of these same lawmakers also received thousands of dollars in campaign contributions from Trigon. Some of the funds were distributed during the legislative session. The question ``Is this good for Virginia?'' will not be raised by the members of the General Assembly.
Main Street will certainly not speak out. Stockbrokers stand to make hundreds of thousands of dollars in trading stock on this venture. The underwriting firm hired by Trigon is paid $100,000 each month and will make considerably more in the near future. Big and small businesses are silenced - they are receiving shares of stock and cash. The trail of kinship between board members' affiliations and their potential to profit raises even more questions, and could be a book unto itself.
Traditional voices have been silenced. Doctors, for example, are torn between those already affiliated with HMOs and those who are not. They are faced with choosing between their employers and what is best for their patients.
Churches, a traditional voice for the poor and downtrodden, have been receiving Trigon's charitable gifts for years. Some churches are policyholders. Their voice has been silent. Organized groups such as labor, public employees and the elderly are the recipients of either stock, cash or charitable grants. Their voice, too, is silent.
Soon the SCC will render its decision on Trigon's application, and public policy will have had no adequate forum. The thorough process that would give the public not only answers to their questions, but also an opportunity to raise their voices and understand the intricate details in this matter, will have been silenced - silenced by the numerous conflicting interests that have a hand in this unique configuration.
Trigon is everywhere. Their tentacles have reached into areas the public will never have knowledge of. We can't expect Trigon to raise the question; its only goal, stated publicly and on the record, is to ... just ... get ... bigger.
So who is left to raise the question, ``Is this conversion good for Virginia?''
The silence is more than deafening; it's stifling.
Julie Lapham is executive director of Common Cause of Virginia.
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