It was a big moment in the biggest economic policy issue facing Massachusetts this year. So imagine Blue Cross chief Andrew Dreyfus stepping onto the virtual podium of public opinion as a hush falls over the room. Picture Dreyfus, resplendent in a pin-striped suit, stepping up to a lectern and softly tapping the microphone.
What followed was nothing short of stunning. Healthcare finance is complex, dense stuff, so I want to be extremely precise. So here, inside the following parentheses, is exactly what he said publicly when his moment came: ( )
Nothing. Silence. Cue the crickets.
Partners HealthCare, the state’s hospital behemoth whose outsized market power clout has helped make Massachusetts medical rates the nation’s most expensive, wants to get even bigger. Partners runs some of the best hospitals on the planet. But this is a discussion about healthcare economics. And its move to gobble up three more community hospitals and their physician affiliates would worsen an already unbalanced system.
Attorney General Martha Coakley and the US Justice Department considered a lawsuit to block the expansion. They examined what the Globe reported was a cozy relationship between Partners and Blue Cross. In the end, Coakley hammered out a settlement that is now under a judge’s review.
Hospitals, economists, antitrust experts have all weighed in. But Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts, whose 2.8 million members outnumber those of all other state health insurers combined, did not. Why? Apparently cured of laryngitis, he got on the phone to explain.
“I’m not trying to be cute, but we’ve been neutral,’’ said Dreyfus, whose company accounts for about half of Partners’ commercial business. “It was our judgment that [Coakley’s office] got the best deal they could. We weren’t going to substitute our judgment for theirs.’’
Dreyfus is better than the sum of that quote. A group of antitrust experts called flatly for rejection of the settlement. The state’s Health Policy Commission estimates the expansion could smother competition and hike health care spending by $49 million a year. Dreyfus’s competitors, a group of other insurers, have raised red flags, and a coalition of Partners hospital competitors have said the deal will drive up costs.
Andrew Dreyfus is a smart national voice in America’s raging healthcare debate. He’s a sought-after speaker across the country, for good reason. He has held down costs. He’s been a proven leader. But not this time.
That role now falls to Superior Court Judge Janet L. Sanders, who will hold a hearing on the settlement next week. The deal is so dense there are about 50 people in the state who have mastered its details.
I don’t pretend to be one of them. But I know this: There are enough credible specialists crying foul and enough high-profile people, like Dreyfus, taking a pass that this deal should be killed or postponed until the current political season expires.
I know life is no Frank Capra movie. So, sadly, I don’t expect Coakley or her Republican opponent, Charlie Baker, to place principle above pragmatism and denounce this deal for the stinker that it is. Partners is the state’s largest private employer and a political colossus. Coakley and Baker want to be governor. So there will be no “Mr. Smith Goes to Washington” moment here.
Leadership like that will have to come from Judge Sanders’ courtroom.
Thomas Farragher is a Globe columnist. He can be reached at thomas.farragher@