March 8, 2009
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Real foundation story was buried
Ouch, I always thought that "man bites dog" was the standard newspaper litmus test ("Foundations are feeling the pinch; Recent investment losses mean smaller grants to charities," March 3). When I read the article, the fact that foundation corpses have suffered in the economic downturn (duh) eclipses the real man biting the dog story which falls to the fifth to the last paragraph, sans headlines to direct your readers to it. Buried deep are the local stars, the Melville Charitable Trust, the Barr Foundation, the Highland Street Foundation, and the Yawkey Foundation, which have either made the brave decision to hold their funding levels constant or to increase funding in these dire times. Editors, those are the headlines the Globe should be touting.

Claudia Jacobs

Little incentive to start spending
Mark Jewell's financial column asks "save or spend" ("Save or spend? It's a vexing question when recession-era bargains abound," March 4). But what is there to spend it on? The house and both cars are paid for. A second house would just collapse from inattention. A third car seems excessive since I ride a bicycle for transportation, even in this weather. I have cash because my record with stocks was terrible even in an up market. So cash in the bank remains, even after some 7 or 8 percent of salary per year to charities.

If you need to stimulate the economy with my cash, you need to convince me that you have something to sell that is worth having. Someone else's house with more than 3,000 square feet does not fit that description.

Michael Wilson

Blue Cross CEO doing good job
This article ("Blue Cross CEO's pay rose 26%; Salary, bonus totaled $3.5 million as insurer's net income slid 49%," Feb. 28) is a perfect example of how select data and statistics can mislead us, in this case leading us to believe that Blue Cross is the least desirable of the health plan providers. It doesn't ask the most relevant question: "How is it that Harvard Pilgrim Health Care and Tufts did a better job in 2008 in containing costs than Blue Cross and Blue Shield of Massachusetts?"

Just looking at the mental health part of their benefits with which I'm familiar, we can see that Blue Cross-Blue Shield reimburses its network providers - psychologists, psychiatrists, social workers - an average of 25 to 44 percent more (depending on the procedure) than Tufts or Harvard Pilgrim. In addition, the authorization process for continued care at Tufts and Harvard Pilgrim requires much more nonreimbursed time of providers than does Blue Cross-Blue Shield, and imposes a higher administrative burden, thus passing the costs along to their network providers and participants.

Furthermore, Blue Cross-Blue Shield invested a significant amount of money in 2008 in funding an independent blind research study across its membership. It was designed to contribute to our overall knowledge of effective mental health practices and to contain costs in the long haul. The study took into account the administrative costs to providers. In contrast, Harvard Pilgrim's mental health carve-out funded a "first alert" program which inserts the insurer into people's treatment by, for example, calling them at home or notifying their providers to "alert" them to obvious symptoms which they believe the doctor may have missed.

These philosophical differences between insurers can't help but lead the most well-established providers to resign from the Tufts and Harvard Pilgrim networks. Once again, this leads to Harvard Pilgrim and Tufts passing the cost along to their members, as members sometimes choose to pay out of pocket to retain a trusted doctor or therapist. But providers stay with Blue Cross-Blue Shield, because it demonstrates concern for both its providers and the families it insures. Note that I can speak with knowledge only of the mental health aspects of each insurer's benefits. But one can extrapolate that these business practices may extend beyond their mental health benefits.

In this economic crisis, employers choosing health plans may gravitate toward lower cost plans. However, as employees encounter the artificial obstacles to access to healthcare that are called "cost containment," and as our economy improves, no doubt this trend will reverse itself. From my perspective, Cleve Killingsworth appears to be doing a good job.

Christine Musello

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