Article

FATAL SHOOTING NOT GOOD PR FOR CRIME-ADDLED CITY … BHS OCTOPUS EXEMPLIFIES A CAUTIONARY TALE, or WHAT’s WRONG WITH GETTING SICK IN AMERICA

By DAN VALENTI

PLANET VALENTI News and Commentary

ADD 1 MONDAY, DEC. 5, 2011

Fatal Shooting Brings Crime Situation in City of Pittsfield to the Front

The city of Pittsfield’s latest shooting, this one fatal and looking now like a murder, brings us around again to the crime wave sweeping through town. A 23-year-old man was found lying dead in the street  on Wellington Avenue and Lincoln Street from gunshot wounds. Police reported getting 911 calls about gunfire at 11:30 p.m. last night. They are treating it as a homicide.

It appears that the recent reports in crime (not just those reported in the press but all crime from the police blotter) indicate more of a systemic breakdown than a freak spike in crime for other temporary reasons. The large numbers of the city’s population considered “in need” seems to have drawn with it a large market in crime, violence, drug abuse, and other such plagues.

One of the more interesting aspects of the BHS story is the company’s description of the region it serves. It is interesting to use BHS’ view of the area with the descriptions given, for example, by the city of Pittsfield in its “commercials” advertising the city for economic or tourist purposes and groups such as the Chamber of Commerce.

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(FORTRESS OF SOLITUDE, MONDAY, DEC. 5, 2011) — For those who are interested, THE PLANET shall be on the radio tomorrow morning with our good friend, “The Fat Man,” Bill Sturgeon, at my old electronic playpen, WBRK. We shall be on the air at 11 a.m., but we won’t be doing our famous bird calls. It would also take a bit of pleading to do our Johnny Most, John Wayne, Ed Sullivan, or James Mason impressions. We have a hard enough time impersonating “Dan Valenti.”

THE PLANET set a new record for Friday, Saturday, and Sunday hits (no, don’t ask for the numbers. We keep those to ourselves, since this site is non-commercial in every sense and also because it’s one of the whims we can indulge “just because.” Or as Papa John Creech would say, “I can drink all the liquor in Costa Rica, ain’t nobody’s  business but my own”). We also set a new high for comments.

Today will be a recap, mop-up, and recon day for the Berkshire Health Systems story. Allow a few random observations, please, doctor.

* THE OCTOPUS — In the late 19th century, Frank Norris wrote an epic novel on the railroad trusts and how the monopolies maintained by the RR barons nearly strangled American democracy. Such was the power consolidated in the rail trusts, whose long tentacles reached into every facet of American’s life. Norris called the stranglehold of the rail trusts “The Octopus,” the title of his great book. A commentator to this site referred to BHS as The Octopus, and it works for us. If you consider how from little Pittsfield General Hospital the organization mushroomed into a 27-tentacle monster (one arm for each of BHS’ companies) and what a powerful place BHS occupies not just in serving the health care needs of the Berkshire County region but also its place economically, politically, and socially, you can see how the name would stick under a reasonable definition of monopoly and a fair-minded application of its local relevance pursuant to healthcare.

* CALLING DR. HOWARD, DR. FINE, DR. HOWARD — If we step back and take a hawk’s view of THE PLANET’s presentation of “The Octopus” story, we see an over-arching, plot-driven idea. We believe this story has generated so much response and readership for two reasons: (1) The nearly omnipresent nature of BHS in the region and particularly the county seat, i.e.,, the city of Pittsfield (see above) and (2) the light the BHS story sheds on the nature of health care in America today. Health care in America is broken. “Bean counting” mega-corporations, the kind that hide assets in the Cayman Islands yet claim to be “non-profit” and take advantage off tax advantages that politicians have written into the law at behest of the healthcare industry’s lobbyists, have replaced Marcus Welby, MD or even Dr. Howard, Dr. Fine, and Dr. Howard.  BHS, The Octopus, look what your type hath wrought in America. See the next items.

* BIG MONEY WINS, THE LITTLE GUY LOSES — What to do about healthcare, a broken systems that has taken the Hippocratic Oath and replaced it with the Hypocritic Oath? Healthcare reform, so-called, is all the rage every national election. The windbag politicians open their bovine jaws, pretending to listen to the Little Guy, the Mary Jane and Joe Kapanskis out there, but in the end, they cave into the political contributions that comes from Octopi like BHS, the pharmaceutical companies, and the insurance thieves. And before BHS apologists serve up their usual salted red herring, THE PLANET is not criticizing the abilities of the dedicated doctors, nurses, and staff, who are in many ways as co-opted by the Leviathan as the rest of the hoi polloi. Just as THE PLANET has not alleged wrongdoing in raising questions about BHS structure and operations (for example, asking why does a non-profit choose to park financial assets in a notorious tax-dodge haven such as the Cayman Islands?), we are not making any disparaging claims about the quality of health care available at BHS companies.

* WHAT AILS THE PATIENT — If the patient is Health Care in America, the prognosis looks grim. Consider this long list of symptoms, adapted from businessinsider.com (what’s wrong the the healthcare system):

Bad Moon on the Rise, and So Are Costs: America spends $7,290 a year on healthcare for every man, woman and child, far more than other countries. Do the math: multiply the US population (312,723,520 as of this morning) times $7,290.  In fact, if the healthcare costs in America were its own country, it would be the 7th largest economy in the world.

— A System Built on Greed and Balanced on the Broken Backs of We The People — The nearly $3 trillion America will spend on health care this year equals the amount that all Americas will pay for food, clothing, and for the Pentagon and National Defense budget, combined. The common factor to this unimaginable amount of money is greed on the part of the big shots in healthcare: Hospitals or rather, Health Systems; the major pharmaceuticals, and the insurance companies. Our national, state, and local politicians are nearly all bought and paid for by this money.

Up, Up, and Away: From 2000 to 2010, health care premiums jumped 15%. In that same time frame, inflation rose 2.8%

Bum’s Rush: A majority of Americans complain their doctors neither spend enough time with them nor respect them. Doctors, rather, too often maintain a superior and dismissive attitude.

E-Health: In the United Kingdom, which provides national health insurance to its citizens, 90 percent of all physicians use electronic records. In America, that number is 28%. Remember, this is an average figure. Some hospitals will do better and some worse.

Singing for Your Supper: Most of the physicians in Europe get paid based on the quality of their work, in other words, their performance. In America, this is true with only 30% of doctors. Please spare us, “Well if you like Europe so much, why don’t you move there”? The point is that we should look at the best practices of countries doing health care better than the United States. Maybe we would do better off losing our insidious Ugly American attitude and learn from the best.

Is This What America Has Become?: Businessinsider.com reports that 41% of U.S. adults have problems paying medical bills. Collection agencies unleashed by hospitals hound many of them (while the free-loaders get gratis healthcare). What is the cost in emotional distress? Who can even understand the cavalcade of forms, bills, and other paperwork even a five-stich cut generates? Speaking of that, why does a 5-inch stitch job cost $14 in Japan and, what, $1,000 here?

See that Kid? Dope Him: American kids are three times as likely to be prescribed antidepressents than kids in Europe.

Some Prescription: Americans throw away one quarter of all prescriptions because they can’t afford to fill them.

Remember, Many of them (Hello, BHS) are “not-for-profit” (Yeah, Right!): All of corporate America will generate $1.5 trillion in profits this year. Health care profits will double that.

Fearing Fear Itself: U.S. doctors spend $210 billion each year on procedures based on fear of liability and not because of patient need.

Where is Dr. Kildare?: America has half as many doctors per capita as Greece. This is a problem, of course, acutely experienced in Pittsfield. Just a question: Are doctors reluctant to set up practice here, given the lengthy reach of the Octopus’ tentacles?

Large Overhead: Non-profit insurance companies (remember, BHS owns a “captive” insurance company, Berkshire Indemnity Company, SPC, Ltd., in the Cayman Islands) operate with a built-in overhead of 16% Lots of “gold in then thar hills” for a non-profit. Private insurance companies build in 26% for overhead. What, you don’t think that beautiful (former) Berkshire Life building was built on operating efficiency, do you? For comparison, Medicare, which is often the only think that prevents Americas from total healthcare destitution, operates with a 3% overhead. Inefficient practices in processing insurance claims cost Americans more than $200 billion each year.

* Up, Up, and Away, Pt II: Compared to all the other industrialized companies, prescription drugs in American cost 50% more, adjusted for inflation.

* Only Getting Worse: If the healthcare system promulgated by the likes of the BHSs of the world is not reformed, by 2025 (only 12 years from now), healthcare will east up 25% of the untire Gross Domestic Product of America. Today, despite the $$$, the U.S. is ranked lower in life expectancy than Puerto Rico. Without reform, employer-based healthcare costs are expected to rise 166% in the next seven years. By 2019, American businesses, on average, will be paying $28,350 per employee for health insurance.

* Deader than a …: Almost 200,000 people die each year in American hospitals because of medical errors.

Beddy Bye: The number of beds per-person in the U.S. has declined each year, every year, since 1988. Hospitals and insurance companies make much more money if they treat you then boot you out. More turnover, more profits.

* You really want health care coverage? Knock off a Liquor Store: America spends $4.5 billion each year to provide health care coverage for inmates in prison. That’s the taxpayers who pays. See him, over there in the corner, trying to find two nickels to rub together. In America, 8% of healthcare costs go to insurance administration. In Finland the total is 2%.

Enough? No, there’s much more, but, like Sophie Tucker, we have found there is much more to do on THE PLANET and not enough time to do it in. As always, we invite you to continue this discussion.

We would like to leave BHS with three simple questions:

(1) What is the value of the entire BHS holdings?

(2) What, specifically, is the “substantial” (Mr. Colbert’s word) payment to the city of Pittsfield, in lieu of taxes (as a “non-profit,” BHS pays no property, excise, or sales taxes. In short, those rules don’t apply to them. Yes, it’s all legal. Remember, “crime” is merely a legal construct. We can’t agree on “Monopoly,” so let’s see how we do with “substantial.” Only then can we make an assessment of your claim’s accuracy.

(3) What is the value of the BHS holdings in the Cayman Islands? What is the nature of those holdings?

We await, breathlessly. We do not ask these questions because we think anything is amiss. That has been one of BHS’ (via Steven Colbert) standard dismissals, calling questioners “negative,” “conspiracy” hunters, and other such disrespectful names. In fact, based on what we currently know, we shall assume all the “i”s are dotted and “t”s crossed. Everything appears legal, above board, and proper. Why, then, do we ask these questions?

We ask these questions so that common, everyday, citizens can begin to understand its major healthcare provider a little bit better. Does that spoil a vast, eternal plan?

THE PLANET thinks such knowledge is to the benefit of the entire community, and we would ask BHS to take our questions in this light. Since the Boring Broadsheet (or any other local mainstream medium) will not do (and has not done) its fiduciary job in covering a story like this, we have and will.

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ON AND ON AND ON WE GO.

“OPEN THE WINDOW, AUNT MILLIE.”

LOVE TO ALL.

 

 

 

 

 

45 Responses to “FATAL SHOOTING NOT GOOD PR FOR CRIME-ADDLED CITY … BHS OCTOPUS EXEMPLIFIES A CAUTIONARY TALE, or WHAT’s WRONG WITH GETTING SICK IN AMERICA”

  1. Hilly Billy 2 in Ward 4
    December 5, 2011 at 10:52 am #

    In case you missed it Councilor Krol, here is my question from this morning…. could you explain why you removed the “underwritten by Berkshire Health Systems” from the bottom of your web page, http://www.goodmorningpittsfield.com ?? Dare you respond for all Planet Valenti’s viewers to see?? I saw it on Friday and then checked back today and viloa…it magically disappeared, care to explain?

    • Hilly Billy 2 in Ward 4
      December 5, 2011 at 1:54 pm #

      Hey Steve c’mon up to my cabin in the hills…it ain’t got no locks or phone…just an outhouse and a 12 guage with some buckshot

      • Scott
        December 5, 2011 at 5:30 pm #

        Any deer yet this year? I’m going out tomorrow. While we’re on the subject looks like tight Ma gun laws are working hey? In fact I believe if more people had guns and were armed you would see less crime which leaves me to wonder is this a robbery gone bad or perhaps a drug deal? Was the young man who got shot the mugger, was this a hate crime or over a girl? Lots of questions that need to be answered. If you can legally pack I recommend that you do especially during the holiday season if you’re going to be shopping. My wife and my one year old I worry about because a petite woman with a baby makes an easy target potentially. I’m always on her to carry her 9 but she’s not scared and she shouldn’t be but this is the society that we have created and what we live in. Be safe out there.

  2. Steven Colbert
    December 5, 2011 at 11:14 am #

    Keep holding your breath, Danny. I do believe one of the reasons your site had so many hits over the past few days was the incessant blogging of… me. I must account for a few thousand hits at least.

    Addressing a few of your points – no one disagrees that healthcare spending is out of control. It’s not a local issue, it’s a national one, and I sadly doubt that national healthcare reform will bring it under control.

    I am sorry your health insurer hit you with a double digit increase in premiums. BHS employees recently renewed their health plans under open enrollment with a zero percent increase in premiums, thanks largely to good management and our company wellness program. And before you begin accusing us of providing “bad” coverage, that could not be farther from the truth…iness. While your insurer is telling you they “need” that double digit increase, they are telling hospitals that they “need” to pay less for the provision of care, so who exactly do you think is making that huge profit? Ask the president of Blue Cross.

    Electronic health records – while the nation may be at 28%, BHS has had comprehensive electronic health records in place in its hospitals for over ten years, and it is also in place in its own physician practices, while it is aiding private practices to have it implemented in those sites.

    Physicians – in the past ten years, BHS has helped to recruit 150 new physicians to the Berkshires, with a net increase in the number of physicians today being 40 over what was here ten years ago (as you must account for retirements and those who choose to leave the area).

    It is indeed difficult to recruit physicians here, not because of an imaginary octopus, but because most young physicians coming out of medical school want to work in big markets and at major hospitals. The same factors that make it tough to bring new business here (distance to large markets, lack of a direct interstate in all but one section of the county) also make it difficult to bring in new doctors. The recruitment of those doctors, by the way, was done largely in collaboration with private practices. BHS paid start up costs for the new physicians, including those in private practice, as well as the cost of advertising and travel to bring them here. How selfish!

    There is a national physician shortage, and by that I mean it’s national, in case you didn’t understand the reference. Your attack on what physicians earn is also inaccurate, especially when you consider the primary care physician barely makes ends meet these days due to very low reimbursement. There is no real excuse for your doctor to be nasty – mine isn’t, he’s always very nice and respectful, I’d be happy to give you his name if you want to see him – but one can see how the economics of healthcare can make any doctor jaded these days.

    I may try an experiment – I’ll stop blogging on this comment thread and let’s see if you even come close to those numbers you got in the past few days. Colbert Out.

    • danvalenti
      December 5, 2011 at 11:23 am #

      STEVEN
      Uh, we hate to burst your inflated balloon, but THE PLANET was here before you arrived. We do think you have accounted for some of the traffic, i.e. your own, and by those disbelievers who are gasping in shock that anyone associated with The Octopus would engage the public in this fashion. We will send along a royalty payment of a free coffee, on us, if and when we have a mano-et-mano.

      You do have to read more carefully, though, Steven. Note how THE PLANET said the BHS story provided a good springboard for the “larger view” — that is, a discussion of the national disgrace known as The Healthcare Industry. BHS may be better in some areas that you mention, worse in others, as it may be. We do find this discussion valuable to have as a community, and we congratulate BHS for being the impetus or spur by virtue the circumstances of events (including the remarkable coincidences we’ve mentioned earlier with respect to current city councilor and the current city attorney and they past connections (one former, one current) to BHS.

  3. Hilly Billy 2 in Ward 4
    December 5, 2011 at 11:59 am #

    Its not a former connection if BHS is underwriting Councilor Krol’s http://www.goodmorningpittsfield.com as the website itself stated on Friday before it was abruptly taken down over the weekend..Its a current connection

    • Hilly Billy 2 in Ward 4
      December 5, 2011 at 1:41 pm #

      My blog, unlike you, Steve Wade, is relavant to the topic at hand and still goes unanswered by the normally responsive Councilors KROL AND WARD…

      And no I don’t have a picture of Krolly on my wall…Do you have a picture of me having a picture of Krol on your wall…whats with your obsessiveness of my posts anyway? Maybe you are John Krol? And if not, why are you protecting him so much? Maybe its you that has his picture on your wall as you seem to be the BIG fan..And if you are actually Krolly, then I’m SURE he has HIS OWN picture on his wall, like he does on his website, the better to be able to view himself in between looking in the mirror…
      How exactly are you advancing the discussion with your posts that are more humourous, as they reveal your teenage viewpoint, than they are annoying? Answer is YOUR NOT!

      • Steve Wade
        December 5, 2011 at 1:53 pm #

        Hilly Just showing how much you write about Krol. Can’t you coment on something else once in awhile? xxx Steve

      • Mike Ward
        December 5, 2011 at 3:55 pm #

        Sorry Hilly — I had to go back to yesterday’s post to see what you are talking about. No, I do not maintain the GMP website. And I no longer work for Lenox Softworks.

        • Hilly Billy 2 in Ward 4
          December 6, 2011 at 9:06 am #

          Thanks Councilor…SOrry to see you go. You have served our Ward well…good luck in future endevours

      • Luxor Rex
        December 5, 2011 at 4:54 pm #

        Agree. Hilly makes sense. Wade wants to drag the disucssion down.

  4. Ray Ovac
    December 5, 2011 at 2:45 pm #

    DV, how convenient that ‘Steven Colbert’ now decides suddenly to “stop blogging on this comment thread” as soon as he’s asked to provide specifics and be forthcoming — almost as if corporate counsel (John Rogers) told SC to pipe down. SC offers the same lack of clarity and specificity in response to yesterday’s questions.No answer to the simple query of just how much in assets are being sheltered in the Caymans, and just why a US not-for-profit would even need to set up a subsidiary in such a legal hideaway rather than on home turf here in Massachusetts. SC continues to posture and preen and strut but still not a single straightforward answer.

    • danvalenti
      December 5, 2011 at 2:55 pm #

      RAY O
      The night is young. Should he stop now, we thank him for his contributions to the discussion.
      We ended our column today with three simple questions for BHS. We have not received, as yet, and answers.
      As “Steven Colber” is not a real identity, and since his comments have been made unofficially and not on BHS letterhead as it were, technically our contact is not officially representing BHS in any official way.We do believe his information. It leads us to wonder how much BHS approved (or didn’t approve) of Mr. Colbert’s comments and if he has been muzzled.

      We have found Mr. Colbert to be an honest, forthright man, exemplary in many ways, based on a long history. We realize his obligations to his employer, and we commend BHS for having Mr. C on board. Colbert is an example of the many fine people BHS has working for it.

    • Joe Pinhead
      December 5, 2011 at 5:10 pm #

      Steven Colbert:
      I hope I haven’t offended you or put you at risk at BHS for asking the pointed but I believe fair questions surrounding the healthcare issue and the way it is delivered here in Berkshire County.
      I did notice that you didn’t reply to my reply posts on 12/2/11 10:56 or the 12/3/11 7:27 pm post either.
      I thought I left fair and respectful questions to issues that we must understand as both healthcare consumers and as the national healthcare discussions take place. You indicate that the healthcare debate isn’t a local issue but a national one. While I agree in principle one also has to be reasonable as well, I would bet the public at large here in the City could not name 2 hospital or healthcare concerns in Iowa, nor should they be able to- the debate has to be understood locally before it can be had nationally with any kind of understanding and validity or it will boil down to a red and blue issue and we will all lose due to the issue coming down to a popularity contest instead of a reasoned discussion.
      That brings this full circle my questions were relevant and meaningful to the discussion and for whatever reason you decided not to engage in that type of dialog. You did tell us how many time you hit the site up adding to is volume. What to its quality Mr. Truthiness? You know the BHS and all of its subsidiaries add a lot of value to our community both in and out of the Healthcare area. I openly say it and truly believe it. With that they also must carry an equal amount of social responsibility; a healthy body must also have a healthy mindset.
      All please take a look at the link below, it is the testimony of Darlene Rodwicz the CFO of BMC:
      Division of Health Care Finance & Policy
      Executive Office of Health and Human Services

      Office of the Attorney General

      Hearings Concerning Health Care Provider and Insurer Costs and Cost Trends
      There is nothing unusual about such testimony nor does it or I allege any wrong doing it does shed some light upon the long post by Mr. Colbert regarding his defining the word monopoly; it also starts with a telling discussion of the economic situation of the market that the hospital serves. Please ask your Council person and or the Mayor to define how the latest iteration of Spice and the Beacon have driven the number of insured up or down. And the end of the testimony describes rates and negotiated rates that I was asking about in the post. There is no smoking gun but there is some interesting information that can and should be used to help form an opinion regarding the economic health of the City.
      Please follow the link then you will need to select the number 7 document

      http://www.mass.gov/eohhs/searchresults.html?output=xml_no_dtd&client=massgov&proxystylesheet=massgov&ie=UTF-8&sort=date%3AD%3AL%3Ad1&oe=UTF-8&q=berkshire+health&site=EOHHSx&x=37&y=14
      Once again I thank Mr Colbert and all who engaged in a meaningful way
      Please keep up the great work Planet. There is no other place we can have this kind of discussion
      :-)

      • Steven Colbert
        December 5, 2011 at 6:35 pm #

        Joe, you are a thoughtful man, and I thank you for pointing out Ms. Rodowicz’s comments, which contain a tremendous amount of information that is useful in understanding the complexities of healthcare, especially from a reimbursement view.

        I beg to differ on your characterization that the debate is local and not national. Reimbursement contraction is happening all over the US, as part of national reform. The government has to find areas to trim Medicare, and they have done so by implementing numerous changes that will impact on providers, both hospitals and physicians. The majority of any hospital’s reimbursement is Medicare, as you can see from Darlene’s comments. Medicaid, which is the state-funded reimbursement program, reimburses even less, and the state, in its own healthcare reform program, is continuing to trim reimbursement to balance the state budget.

        The truth is, as Darlene pointed out, we live in a county that is predominantly lower income, and the majority of those who come through the hospital’s doors are on Medicare, Medicaid or uninsured or under-insured. As a result, private insurers helped to subsidize that loss through their contracts with hospitals (not just BMC, this is common all over the state and nation). As public demand rightfully focuses on ways to trim the burgeoning cost of healthcare, these insurers are now also demanding cuts in reimbursement. I wish I could tell you that will result in a lower cost of coverage for you, but it likely will not.

        As you can see from her testimony, the rates paid to BMC by Blue Cross are not exorbitant, though it has become the trend for the insurers to proclaim that hospitals like BMC, which have little competition in the inpatient market, can “demand” high reimbursements due to their exclusivity. I don’t think an increase in one year of 2.7%, as she indicated, is high.

        Darlene also makes valid points about competition. BMC has an obligation to serve the entire community. I won’t point fingers, but if you were to call a certain center providing endoscopy services and told them you were on Medicaid, they would tell you to call the hospital, sorry, we don’t deal with the likes of you, not enough money to make there. But if you’re insured by Blue Cross, come on down! This was the same that occurred with the former radiological practice on North Street. It’s called “cherry picking,” and it’s more common than one would think, but that being said, most physicians in our community see almost everyone and are committed to providing good care, and that’s not “our” physicians, but those in private practice, as well. I know many of them, they are fine people.

        I’m getting very long with this, but I think the commentary that Darlene gave speaks volumes and puts a lot of what’s going on in healthcare in perspective.

        I appreciate your commentary as it’s non-confrontational, unlike some other comments. I also appreciate Dan making this forum available. Despite our back and forth, I have known him for a long time and he is a man of good character and has an unquenchable thirst for knowledge.

        • Kevin
          December 5, 2011 at 8:07 pm #

          Now that last exchange between Mr. Pinhead and Mr. Colbert is what this is all about. Good honest exchange of info, rationale respectful and polite. Also I thought the acknowledgements that Mr. Valenti and Mr. C nodded to each other to be a good thing. This whole conversation shows we can have sharing viewpoints without going carazy on each other. thanks, JP, SC, and DV

          • danvalenti
            December 5, 2011 at 9:46 pm #

            KEVIN
            We agree. Thanks.

        • Joe Pinhead
          December 5, 2011 at 8:57 pm #

          Mr. Colbert
          First I thank you for contributing to the dialog and I agree Dan is always on the hunt for knowledge, as importantly is his desire and ability to share that knowledge.
          We do differ on the healthcare debate and while I acknowledge that reimbursements are being cut curtailed and squeezed on a national level I contend that the debate has to be local, You said today that BHS was able to offer the same rates this year as last to its employees on its health plan due in part to its wellness plan. The entire local community needs to hear that and to see that it has both an obligation to themselves and in part to the larger community to ensure they are taking care of itself. As you pointed out Medicaid and Medicare are funded from and by 2 sources one being the State the other the Federal government. If we have an educated, informed group of consumers locally, who are both versed and able to speak to healthcare issues we stand a better chance of making our voice and our choice heard. If more people understood the economics of healthcare we could ensure that candidates carried to the State house and to Washington our message not the lobbyists. Also the proposal De jur from the current Administration is to let the States experiment, his words not mine. How about this Mr. President lets allow Cities, Counties and States inform educate one another and participate in developing a method that is best for all parties concerned. That’s why it is local in my mind; however I realize I’m a dreamer but bear in mind this opportunity for change may not come again in our lifetimes.
          Also I think the economics of the area will play a large role, with so many 75% in our area using public insurance would it be a wise choice to secure economic development funds to help in offsetting healthcare costs rather than funds to renovate a restaurant ? I know its hard to direct that type of investment towards the chosen few but its worth some thought.
          Once again thanks Mr Colbert
          :-)

          • Steven Colbert
            December 6, 2011 at 7:21 am #

            Thanks, Joe. It’s a very complex environment and you see the picture quite well. Your candor is welcome and debate is always good.

        • danvalenti
          December 5, 2011 at 9:46 pm #

          STEVE
          Many thanks. You are a man or honor.

  5. Concern
    December 5, 2011 at 2:59 pm #

    Buckshot!!!! good thing BMC has a E.R. just in case someone is hit. Haha

  6. Scott
    December 5, 2011 at 5:23 pm #

    There was a time in my life when I got into knowing about my health and how the human body works and started trying new things you know natural things I even used to be so naive that if something said it would help with digestion but that the statement has not been approved by the FDA and deemed safe then I should be concerned. The health care system is corrupt and flawed just like everything else. There are wonderful Dr’s and people who work in this field just like there are in gov’t you know people who really care about people but the system is still flawed. Part of what is wrong with this country is all the crap people eat. these vultures the insurance agencies, health care providers, Dr’s and drug manufacturers are just opportunist. You have to look through all the propaganda on health and really see that a balanced diet consisting of lean proteins, fruits and veggies you know real food is the best health care plan you can invest in. If you get colon cancer is a lemon grass enema gonna cure you? I don’t know I’m not a doctor but I will say this I brush and floss my teeth on a regular basis not because I have gingivitis but because it’s preventative maintenance so I don’t get gingivitis. You always hear dentist say that term “preventative maintenance”. Internally what you put in to your body determines how well it functions so this same philosophy applies. There are also environmental factors as well of course. If you really want to stick it to them put your OCW 1% signs down and pick up some leafy green veggies and some bright colored fruit. (This statement has not been approved by the FDA and only a drug can cure or prevent a disease.)

    • Luxor Rex
      December 5, 2011 at 6:04 pm #

      Man Scott thats a great comment I too try to eat as best I can avoid junk limit alcohol intake etc. As you say, preventative care.

      • Scott
        December 5, 2011 at 7:23 pm #

        Corporations like Monsanto use propaganda to sway people into thinking that their evil products will feed the world. I bet they hold stock in big drug companies. They set the industry standards on big business it’s why we have FDA agents raiding family farms and making them dump out their raw milk and poor bleach on their organic veggies while they hold them at gun point. everything is controlled not for our best interest that is only a mask for the rel agenda to make money. It’s all tied together. I’m sure I’m on some terrorist watch list for being pro gun and for small farming communities. Big business don’t like that and if big business don’t you can bet your ass the gov’t don’t.

  7. Molly
    December 5, 2011 at 7:30 pm #

    Dan –You made this sound like a “summary” of what was said the last few days and it isn’t, at all. In fact, I don’t agree with a lot of what your current post contains.

    - The Octopus – yes, I agree that BHS has become very large and very powerful – likely too much so. But I think that the topic of tax evasion – legal tax evasion, is an entire topic of its own and is not just happening within BHS, nor just the nation’s health care system, but rather most, if not all, of this nations large corporations, both “for profit” and “not for profit”. Hence, GE didn’t pay ANY taxes last year.

    I believe that the biggest problems with our healthcare are the massive frivolous lawsuits from the likes of John Edwards and many more ambulance chasing lawyers, who have become extremely wealthy on frivolous healthcare-related lawsuits. This is one of the main reasons for the high costs of healthcare. Don’t get me wrong – if a surgeon is proven to be drunk during my surgery and cuts off the wrong leg, I am going to sue! And should! But for the most part, that’s not it – it’s very frivolous lawsuits. It used to be that if you worked in your yard over the weekend and then had a back-ache, you’d go to your doctor who would say that you likely pulled a muscle while working in your yard and tell you to take some aspirin, get some bed rest and if it’s still bothering you in 3-4 days, to give the doc a call back. Now, they are so worried about that less than .1% of the people who DO have something wrong with their back suing them, that now the immediate and ROUTINE response is to order an MRI of the back. And THAT costs a LOT of money! And for the most part, is totally unnecessary from a healthcare stand point, but is totally necessary to protect the doctor from a lawsuit from the 1 in 1,000 that would have a “real problem”. Hence the rise in healthcare and in healthcare insurance premiums – the cost to them has increased! (Not that I’m sticking up for health insurance companies!!!!)

    Putting in a “National Health Care System” would be the absolute worst thing that this country could do. Look at the mess we’ve made of Social Security & Disability! And Medicare! And Medicaid! And I disagree that the US spends the most on healthcare and has the worst healthcare. Quite to the contrary, the U.S. has excellent healthcare and the best healthcare institutions in the world are in the US, including Johns Hopkins, Mayo Clinic, etc. Physicians from all over the world come to the US for advanced training. And patients from all over the world come to the US for quality care. But some (much) of it needs to be improved/fixed. Healthcare Reform IS needed and it should be looked upon as an opportunity to improve our quality of care and to correct the weaknesses that are there. But not to have it be taken over by the Government who can’t run ANYTHING efficiently. One of the reasons (or perhaps a good excuse) for drugs being so expensive is that it takes the FDA (Federal Government) a minimum of 10 years (and hence, high costs) to approve a new drug to be used in the U.S.

    Another “bug-a-boo” with me is the so-called “Entitlements” and “Entitlement Reform” when they are NOT talking about Welfare and Medicaid but are talking about Social Security and Medicare. I have paid into these two “systems” all of my life and when I retire, I expect to collect from each of them and I will NOT feel that someone is “giving me charity”! I’ve paid into them all of my life! They are NOT “entitlements”! What needs to be reformed is the number of people who out and out scam the system and are on SS Disability (of course not all on Disability are scamming, but there are also a lot that are – it’s truly gotten out of hand), which also gets them Medicare, SSI, Medicaid, food stamps, Section 8 housing, heating paid for, and the knowledge that they never have to work again! THAT IS EXPENSIVE and needs to be reformed and those ARE “entitlements” – not those that worked hard all of their lives and are counting on that retirement & health insurance that they paid into all of their lives.

    I don’t think that the “Hippocratic Oath” has been replaced by the “Hipocritic Oath” in the least! The amount of money that a doctor spends on education along with the years it takes to get there (10 years MINIMUM just to get the M.D., plus an additional 2 years of education, fellowships, etc., to be licensed in a particular field) – that’s a LOT! And if they’re going to do that, they DESERVE to receive a good paycheck! And the amount of money they have to pay for Malpractice Insurance is out of sight. Most of the doctors that I have come to know are very caring and compassionate people who do not maintain a superior and dismissive attitude (although for sure, there are some that do, but certainly not the majority). The doctors don’t spend enough time with patients because the health insurance companies don’t allow it! They dictate that now! And for the most part, it is not the doctors who contribute large sums of money to politicians, but rather the pharmaceutical companies, the insurance companies, and the large Medical Centers.

    Are you SURE that “electronic medical records” are a good thing? (This from someone who has made their career in “IT” and believes in the benefits of it!). But perhaps because of that, I can see some of the pitfalls. First, it depends on the electronic system that they are using – some are good and others are horrendous! I’ve been to a doctor that because of the electronic system their “Medical Center” was using, couldn’t keep track of my treatments, scans, on and on. Also, unless every doctor and hospital has the same system, or at least a set of standards that all electronic systems need to adhere to, then one can’t “talk to” the other. And there are NO standards! So when you need your MRI films that were done at BMC to be sent to say a doctor at Mass General, you have to have BMC put those films on a CD and you walk them to Mass General because although each has their own “electronic medical records”, they don’t talk to one another! And Mass General then cannot input those scans (for the most part) onto their electronic medical records. Not to mention HIPAA laws/problems and lawsuits that would need to be dealt with. Have you ever gone to your doctor’s office only to be told that “the computers are down and, therefore, you can’t be seen”? I have. Computers crash all the time! Along with that, most small doctor’s offices don’t have backup generators, not to mention even backups of the medical records! Most small-town doctors aren’t even proficient on computers. I haven’t even talked about the cost of converting reams of paper to electronic format, nor the cost of submitting insurance claims in electronic format. Nor the cost of doing data backups or of getting technical support. For a small-town doctor, it is not doable nor does it improve anything. For a Medical Center, it is both a cost-savings and an improvement and SHOULD BE done. Yet the small-town doctor is going to be forced into retirement because he/she is being forced to go to “electronic records”.

    Getting paid for the “quality of work”, although on the surface sure sounds good, has its downfalls as well. For instance, Medicare is about to do this and will pay BHS (for example) a certain amount of money for say a 3-day hospital stay for say pneumonia. But if the patient is released after 3-days (and it’s 3 days only that Medicare will pay for!) and then gets readmitted because there’s still a problem, then BHS gets money deducted. How do you foresee THAT working out? They aren’t going to keep the patient longer than their insurance will pay for and then they won’t re-admit them either! How is that “quality of care”?

    I am certainly a fan of “best practices” and look for and utilize best practices daily. However, who said that Europe “is the best”? I know of many European’s that can’t get the chemo that they need to save their life because it’s rationed. I know of others that can’t even get in to see their doctors as there aren’t nearly enough doctors. There are NUMEROUS problems with European healthcare and to think otherwise is being naive. As I said, there are also numerous problems within the U.S., but I feel certain that it can, and should, be fixed and not be run by the Federal Government.

    - Is this what America has become – 41% of people have problems paying their Medical Bills. The true answer is that “it depends”. How many young adults think that because they are young and healthy, they don’t need health insurance, don’t want to pay for it and, therefore, don’t have any – only to find out they have a major health problem? That’s a risk that they chose to take – albeit a stupid risk. Why should I have to pay for that stupid risk? Or the young couple who decides to “self-insure” and saves the monthly health insurance premium in the bank vs. paying the insurance companies, only to have a medical catastrophe (car accident, disease – whatever) happen down the road and they can’t begin to pay for it. That’s not what America has become, it’s what it always has been – freedom – it was their choice that they were free to make.

    I agree that the cost of health insurance needs to be fixed and as I said, the cost of healthcare overall needs to be fixed. And oh by the way, I (and you and most) DO pay for that person mentioned above because of the laws for “not for profit” hospitals needing to provide free health care for those who can’t afford it. Just like we pay for illegal aliens healthcare – they merely go to the ER and “not for profit” hospitals need to care for them. Who do you think pays for that? Everyone who does have health insurance, everyone that pays for their healthcare, and everyone who pays taxes.

    - Large Overhead: John Stossel took this myth apart not too long ago. Although based upon your summary, it sure appears that Medicare is run much more efficiently than private insurance companies, the reality is that because Medicare, for the most part, has much higher expenses (caring for the elderly), the percentage of total cost, obviously, goes down, creating the appearance that Medicare is a model of administrative efficiency. Oh Plllllllease!!! You obviously don’t have to deal with Medicare at all as I do with my parents! Plus, private health insurance companies also have to include the cost of marketing, etc., etc., etc. When you compare administrative costs on a per-person basis, Medicare’s were 24.8% higher, on average, than private insurers. Again, this looks like I’m sticking up for private health insurance companies when in fact, I detest them – but fair is fair. Would it be fair to say that a private health insurance company very likely spends approx. 10 to 20% administrative costs on preventing fraud as they care if they lose money to fraud? I’d say they care about that. However, Medicare & Medicaid, with its unlimited claim on the public purse, does not – it’s only taxpayer money. There is an estimated 68 BILLION dollars in Medicare fraud a year and roughly a THIRD of Medicare’s $400 billion dollar annual spending goes to procedures that were not necessary. Without an incentive to reduce fraud and abuse and “scamming”, it just continues year after year after year.

    - Up, up and away: Yes – prescription drugs ARE more expensive in the US. However, much of this is due to the Pharmaceutical Industry’s power over Congress (and let’s be blunt – their donations to Congress). And we DO operate in the U.S. with a “free market” – pharmaceutical companies are privately owned companies and, therefore, have the right to set their own “market rates”. That being said, prescription drugs are a necessity of life and thus, people need to pay whatever price the pharmaceuticals set because it’s not a car or an IPad that they can live without. But I agree – Big PhRMA is a rip-off and they rip us all off because our Congress allows it, because of the dollars that are flowing their way. This needs to be fixed! The corruption in our government needs to be fixed. And certainly not add to it by having our government take over US Healthcare!

    • Kevin
      December 5, 2011 at 8:12 pm #

      Molly Good points but I think you are misreading this. I disagree and didn’t read this as a summary of the planets coverage so far on bhs but as Dan says the discussion provide a good diving board to get into the national debate over the health care debacle. One point not like your usual factual style is when you say you disagree that US spends most on healthcare. The actual numbers so you are wrong. Agree with your points on S Security.

      • Molly
        December 5, 2011 at 8:32 pm #

        I’m pretty sure that what I said (or at least what I meant) is that I disagree that the US spends the most on healthcare AND has the worst heathcare. The “and” is very important to what I was saying as I do believe that it all needs to be fixed and made better, but we certainly do not have the worst healthcare in the world.

        Using the past few days topics as a springboard to a national health care debate is fine — but the discussions of the last few days have not been about NATIONAL health care, but rather about the little city of Pittsfield and its own corruptions and politics. But that’s ok – I’m obviously up for a discussion on national health care, too! :-)

    • Joe Pinhead
      December 5, 2011 at 8:28 pm #

      Molly:
      You are spot on in your comments. I too am in the healthcare field and I can tell you that there is supposed to be standards for Electronic records as well as medical images. It is amazing your depth and breadth of understanding the issues.
      I won’t bore you with the I just wasted over an hour responding to a number of the points and you said it better than me I will give you some different examples and retype my post
      On the electronic records there is an event every year called the connect –A-thon and the standards for both DICOM and HL7 are an ever moving target and why? Not because of fast paced technology changes but because the money spent on lobbying the commissions and boards is big money because whoever has the language of choice controls not only the technology but the whole market.
      Example in a cardiac cath lab you have essentially 3 major components to the exam, the X-ray and or imaging portion and the hemo-dynamic/ charting portion and the supply/ inventory portion. If there is such a thing as a standard than all 3 aspects should work in harmony. I can tell you that if you buy all three portions from one vendor then all will be good try to have vendor a communicate with vendor B and C and you have a recipe frustration.
      Couple this with a blend of the community who refuse to take care of themselves, How many people have even a rudimentary understanding of the way their body works? Very few these days, I am not a chemist but I do want to know how or what a particular prescription is doing to my body. As an experiment I asked people one day at a local supermarket if they knew where the lipids were no one knew what a lipid was in that same 20 person sample I asked this question and 18 of them knew What is Britney Spears ex-husbands name about half in an attempt to look smart offered up the names of her children. Do you think they know how to take their medicine in a proper way?
      National health insurance, look at the public schools, the DMV Social Security or any other Government monopoly and that’s what you will have. I promise you 3 things
      1. It won’t do what they claim
      2. It won’t cost what they say
      3. It won’t be ready when they say

      If you think that government rationed and controlled healthcare is the answer look north. Presque Isle Maine has a hospital that flourishes based upon people who get “free” health care in Canada coming to it and paying cash for service. Don’t believe me go to the border crossing and read the signs “if you have had a Nuclear Stress Test ….. You must wait at least 12 hours before attempting to cross the border. Do you think those that came over for the tests were just looking to part with some extra money?
      As Molly said the FDA is a major violator of healthcare it too is up for sale to the highest bidder look who is first to market with most technologies, it’s the companies with the largest lobbyists not those with the first generation of products. This is big business folks don’t kid yourself for a moment. No way is it Marcus Welby rushing in to perform some emergency appendectomy and accepting 4 chickens 8 dozen eggs and a free brake job on the car as payment. Ole Marcus would have Perry Mason up his butt wanting to know if he was certain that the appendix he removed some 30 years ago wasn’t the real cause behind ole auntie Emm’s bad attitude and did he test her crank level both before and after the surgery? Did he provide the level of aftercare she needed? Oh wait so some three months after ole Auntie Emm’s surgery you did what? You went out and celebrated your wedding anniversary? Ladies and gentlemen of the jury did you hear that? He Celebrated. John Edwards made a fortune on pleading and posing Today’s standards on last decade’s patients, whether it was valid or not, that didn’t matter what did was his cut of the settlement. Much of his case law has been disproven in today’s science.
      The above 2 examples are glaring examples of Lawyers negative impact on a scientific endeavor and the funniest thing is these Lawyers have actually convinced you that they have the answers and should be in control of the healthcare system, yup these Lawyers are your Congress and Senate. You go to any Indian reservation and just ask those fine folks if they can be trusted? Listen to the answer but you just take a look around.
      :-)

      • Molly
        December 5, 2011 at 9:18 pm #

        Great comments and examples, Joe – from someone “in the know”. And you’re right about many people not knowing, or caring, what’s going on with their bodies. Just take a drive down the street or walk the mall and the number of people you see who are grossly obese, obviously either don’t know what they’re doing to their own bodies, or they don’t care. Very interesting, though, that they knew everything about Brittany Spears – very sad indeed. Sometimes I wonder if they paid for their own healthcare costs, would they take better care of their bodies? I’m not sure…

        • danvalenti
          December 5, 2011 at 9:46 pm #

          MOLLY AND JOE
          This point about care of the body and (what do we call it? Soul, emotions, spirit, psyche) our overall, holistic health is paramount. Proper nutrition, exercise, and the like have a well-known place in good health. We know how to stay fit: Eat properly (whole, living foods), exercise regularly, don’t smoke, don’t abuse alcohol or drugs. Mr. and Mrs. Planet didn’t buy a Vitamix for its good looks. We care about self- care. Those who choose to be grossly obese, who continues to abuse drugs and booze, who smoke like chimneys, who buy and consume processed junk — exactly what is society’s moral obligation to them? How long can we allow deadbeats to choose their poor health and bad lifestyle choices and expect the rest of us to pay? It won’t be too much longer. The bottom will fall out of this based on simple economic factors (driven by greed, corruption, and an addiction to debt). It is sad, indeed, what you see when you look around downtown Pittsfield, for example, or engage in people watching at a supermarket. i am an optimist but also a realist. It (“it” meaning this grand experiment called the United States of America) is in the beginning phases of its end game. It won’t take another 235 years to bring down the curtain. We give it 20, at the outside. Thank you both, M & J, for being great contributors, not only to this website but to our community.

          • danvalenti
            December 5, 2011 at 10:14 pm #

            Here’s a modest proposal. What say we as a society round up the deadbeats, who have chosen to freeload, and begin “putting them to sleep,” the way they do stray dogs and cats. We then post on FB. We include their picture and text something like: “In seven days, this grotesquely obese, smoker will be removed from his twinkies, cheetos, lottery tickets. Unless someone adopts him and agrees to pay his way, he will be put to sleep.”

            Comments, anyone?

          • Molly
            December 5, 2011 at 10:31 pm #

            Since there is no “reply” button for your “modest proposal” post, I’ll post it here. Are you really trying this hard to stir up a good debate? hahahahahaha Let’s see if anyone takes your bait. :-)

          • Molly
            December 5, 2011 at 10:56 pm #

            Well thank you, Dan! Very nice of you to say. Big debate going on at the BB “comments” section over whether the person who was shot and killed last night should “have any tears shed” for him and if the BB should have printed his violent and criminal past. It’s not a very intelligent debate, though. Interesting that they won’t post any comments from me, nor do they give me a reason that they don’t – they just don’t. When I hit the “submit” button, I get a message that my posting must first be “approved” – I guess they don’t approve!! And I was only trying to comment on the woman who was left stranded by the State Police Trooper who wouldn’t let her continue driving her unregistered and uninsured car. Oh well – I’m sure I won’t lose any sleep over it and would much prefer the quality of debate on this site anyway! Thanks again, Dan, for “Planet Valenti”.

      • Molly
        December 5, 2011 at 9:30 pm #

        And you are right – 60% of US Senators are lawyers. And 35 to 40% of the US House of Representatives are lawyers.

        • Scott
          December 6, 2011 at 5:10 am #

          Dan that’s a horrible thing to propose. Class wars are what is ruining this country it’s why OCW’s new slogan is eat the rich. You guys switch from real American ideas to fascist ones in the blink of an eye so what is it? Is it the rich that are greedy or the fat lazy folks who eat too much who’s fault is it? It’s everyone’s, even yours. It’s very obvious that there’s plenty of money to go around and it’s also obvious that it’s not even money anymore. Don’t worry it’s only a matter of time before big brother steps in and tell’s us what’s good for us. My question to all of you is when the day comes and there’s martial law are you gonna do what they say? We’re heading there fast and steps to militarize the police are already in process. http://www.facebook.com/l.php?u=http%3A%2F%2Fyoutu.be%2FUXKfEsgLLRU&h=CAQFP8phMAQHJTxZHUpWlMq0BBA7n96SPqcYuTSJIAgjPVA

  8. CONCERNED
    December 5, 2011 at 8:09 pm #

    MOLLY Excellent, I agree with your on you article above. To bad couldn’t get Obama and liberals to read it. Never mine they would twist it to say you you are just for the rich people. To me you are for all hard working people, people that need our assistance and not the blood suckings !!!!

    • Molly
      December 5, 2011 at 8:23 pm #

      Exactly! Thank you.

  9. dusty
    December 6, 2011 at 2:34 am #

    As the original topic veers off into the hinterlands with many unanswered questions, I would like to get at least one. What is the generous amount of money BMC/BHS gives to the city of Pittsfield in lieu of taxes? Is Steve just too embarrassed to say or is the number hidden in a drawer somewhere in the Cayman Islands?

    • Scott
      December 6, 2011 at 5:12 am #

      You’ll never know the real amount.

      • Anytime
        December 6, 2011 at 7:05 am #

        I’m wondering too about this amount. Since its paid to the city in lieu of taxes why can’t we get that exact “substantial” number from the city clerk or tax office? Once bhS makes hte payment doesn’t it become the people’s money?

  10. Ray Ovac
    December 6, 2011 at 7:39 am #

    DV, the BB has an article today about 1Berkshire, Inc.. The Eagle reports, “1Berkshire was formed in April 2010 by four county agencies to provide a single point for those interested in doing business in the Berkshires.”

    The level of hypocrisy and disingenuousness here is stunning. Here we have this entity, 1Berkshire, Inc., created ostensibly to attract business to Berkshire County. Yet, now we discover that the largest business conglomerate in the county, a tax-exempt so-called ‘not-for-profit’, which draws the bulk of its revenue stream directly from the wallets of sick and elderly Berkshire County residents, abandoned Berkshire County altogether to set up one of its major subsidiaries in the Caribbean, outside the legal jurisdiction of the USA. Berkshire Health Systems, Inc. exported jobs to the Cayman Islands where BHS, Inc. senior executives went to license Berkshire Indemnity Company, SPC, LTD, a wholly-owned BHS, Inc. insurance subsidiary that self-insures the multitude of companies doing business under BHS, Inc.’s corporate umbrella. Not only that, but BHS, Inc. senior execs then sub-contracted to a local Cayman Islands company, Aon Insurance Managers (Cayman), Ltd., to manage all day-to-day operations of that BHS, Inc. self-insurance subsidiary. Why couldn’t BHS, Inc. have licensed and run that insurance subsidiary in Massachusetts on Berkshire County soil; why couldn’t BHS, Inc. have hired local people to manage those operations? Why doesn’t BHS, Inc. scrap Cayman Islands sub-contractor Aon Insurance RIGHT NOW and move all those good-paying jobs back to Berkshire County?

    • danvalenti
      December 6, 2011 at 7:43 am #

      RAY O
      1Berkshire was formed for other reasons: To create three jobs: A con job, a snow job, and a high-paying job for some executive director whose job will be to see that no economic development happens in Pittsfield. Why? To protect the fiefdoms of The Suits, the GOBs, and the Vested Interests. You don’t think they would want competition for workers, do you?

      Pursuant to your comments on the BHS holdings in the Caymans, we cannot respond intelligently as we would like, since BHs has yet to provide information on its holdings there. We have asked, simply and politely, but it doesn’t appear as they will say exactly what they are up to on The Islands.

      • Molly
        December 6, 2011 at 1:02 pm #

        To play “devil’s advocate” (just for the fun of it!), BHS is a private corporation and as such, can hire whomever they want to, at whatever salary they want to, and to do whatever job description they want him/her to do. Just as The Planet and its subsidiaries are private businesses and as such, have no obligation to report to the public how much money each business makes, what salaries are paid, etc. It’s PRIVATE. However, BHS, as a “not-for-profit” corporation, is required to make certain financial information public. Although I have (and continue to) readily admit that tax laws are certainly not my “forte” to say the least, it is my understanding that the information that they are required to make public is very limited in scope, but does include the info on the IRS Form 990 and the top five salaries of the corporation, which they have done.

        On the other hand, I also understand that as our sole Community Medical Center, which is also “non-profit”, there is a responsibility, an obligation, to the community as a whole to conduct this business in an aboveboard manner. So to some extent, when there is information that makes it APPEAR to the Community that BHS is not conducting its business in an aboveboard manner, they have an obligation to the Community to clear that up and answer whatever questions are needed to do that. But I don’t believe that’s a “legal” obligation at all. However, for the most part, it would be in their best interest to attempt to do so.

        I think that “non profits” CAN make a profit (go figure!), but they must put any surplus (or profit) to the continuing operation of the corporation. Putting these “profits” into a self-insured company, or fund, or whatever in the Cayman Islands would be putting that profit into the continuing operation of the corporation. Unfortunately, hiding money in other countries (like the Cayman Islands), even for tax evasion purposes, IS legal!! We really don’t have any information that suggests that there has been anything illegal done. However, from a “Community Perception” point of view – for the good of the entire Community AND BHS – it would be a good thing for them to answer honestly a few important questions. But they are not required to. Other perceptions that have arisen from The Planet’s discussions concerning local politics and the perceptions of possible corruption and conflicts of interest (i.e., Councilor Krol, Councilor White, the Mayor, etc.), should – from a “Community Relations” point of view, also be addressed. But that’s politics – sleazy politics I agree, but politics (and reality) in our country.

        Perhaps the discussion, at this point, should turn to legal tax evasion and corrupt politics, both from a local viewpoint and a national one, and what can we, as concerned citizens, do about it. Just a thought…

        Playing “Devil’s Advocate” CAN be fun! Maybe I should send my bill for my time to BHS!!! hee hee :-)

        • Bull Durham
          December 6, 2011 at 2:20 pm #

          Google the words “healthcare cayman islands self insurance” and all of your answers will be found. It has nothing to do with tax evasion, which is illegal in all aspects, it has to do with how hospitals self-insure against risk liability, and it’s entirely legal and financially smart. 75% of hospitals are self-insured against liability, and 60% use locations like the Cayman Islands because establishing your own insurance arm in the US or in a state like Massachusetts is like asking for a root canal without novicaine.

          As Annie Savoy says, “You can look it up.”

          • Ray Ovac
            December 6, 2011 at 5:00 pm #

            ‘Bull Durham’, you say “establishing your own insurance arm in the US or in a state like Massachusetts is like asking for a root canal without novocaine.”
            But isn’t that exactly what the rest of us living in Massachusetts have to deal with when we grapple at any time with Mass. state bureaucrats in any state agency? With regard to setting up an insurance carrier, the likely key reason it’s ‘like asking for a root canal’ is because there are consumer protections built into Mass. state law intended to protect against unscrupulous practices in the insurance industry, Further, carriers in Mass. are likely required to provide documentation, financial reports and a level of transparency with which BHS, Inc. would perhaps prefer not to have to comply. If BHS, Inc. (or any other hospital) is in the Cayman’s specifically so that pesky consumer protections can be circumvented, where does that leave the average BHS, Inc. patient, especially the poor schmuck on the receiving end of a screw-up in the OR. (Aren’t high malpractice insurance rates one of the main reasons hospitals self-insure in the first place?) With BHS, Inc.’s insurance subsidiary outside US legal jurisdiction, you honestly think BHS, Inc. is doing it in order to protect patients’ rights and consumer protections? Suggest you ask your own lawyer about this. BHS, Inc.’s Cayman setup reeks! And on top of it, it cost Berkshire County how many jobs?