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ASSESSING THE HEALTH RISKS

. . . OF A HIGHMARK-BLUE CROSS MERGER

PUBLIC "information hearings" have started on the proposed merger of Independence Blue Cross and Highmark Inc. that could create the largest health-insurance company in Pennsylvania.

The key word is "information." The state Insurance Department will review Blue Cross and Highmark data to determine if the new mega-insurer, which will cover about 50 percent of the statewide market, meets state standards for businesses, and how it would affect competition and the consumer.

But the "information hearings" don't allow for an independent public advocate to question the two insurers about their plans. Consumer groups filed a petition with interim Insurance Commissioner Joel Ario asking for an independent public advocate and for the hearings be more like a trial, with evidence and cross-examination.

We think this was a reasonable request - which was turned down. It's even more reasonable considering that the state's advisers in this matter, the Blackstone Group and LECG, will have their hefty multimillion-dollar bills paid by Blue Cross and Highmark, the same companies they're helping to scrutinize. Though this setup isn't unusual in the complex world of health-insurance consulting and mergers ( some consultants have recommended that mergers be rejected), it still gives us pause.

For consumers already buffeted by confounding health-care costs, the perception of fairness is important. What harm could an independent advocate do, except look out for the public interest?

Ario, who will make the final ruling, has a reputation for consumer advocacy. Still, much is at stake - particularly, $650 million in health insurance that Blue Cross/Highmark said it would provide to the underinsured, $1 billion in promised economic savings and the merger's impact on Gov. Rendell's Prescription for Pennsylvania health-care plan.

It would've been better to err on the side of caution and have another voice to reduce the chance that consumers will get taken to the cleaners.

Federal agencies have ruled that the merger wouldn't violate anti-trust laws. But that is really no great reassurance. The scrutiny on the local level needs to be as complete and thorough as possible. An independent public advocate would have been an important watchdog in any merger deliberations. *

The Philadelphia hearing is set for July 15 at the Sheraton, 201 N. 17th St., starting at 9 a.m., with evening sessions at 7. To offer a written comment, e-mail rbrackbill@state.pa.us.

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