Wednesday, March 22, 2006

Blue Cross Blue Shield Announces 65% Solution

Breaking News in Health Care

In a major announcement today, the Blue Cross Blue Shield Health Insurance company revealed it's new nationwide initiative entitled, "The 65% Solution."

In a well staged press conference, breathless spokesperson I. M. Inshured2BadUrKnot stated, "The 65% Solution" is likely to be the answer to controlling health care costs in all health care situations involving surgical procedures. "

I.M. Inshured reviewed the key points. "The major step is to insure that the surgeon gets 65% of every claim. Only 35% of surgical costs can be spent on support services, anesthesia, surgical rooms, medical supplies, or janitorial services or even nurses unless they are on the surgical team. Sixty-five percent of all claims must go directly to surgical services."

When questioned about where the idea came from, Blue Cross Blue Shield spokespeople freely admitted they stole the idea from First Class Education.

I. M. Insured stated, "State legislatures everywhere are applying the 65% solution to education and are requiring 65% of all education costs to be spent on instruction."

When asked where the research base was to support the 65% threshold the Blue Cross spokesperson grinned and said, "The same place First Class Education got their research on the 65% solution. They pulled it out of their heads or somewhere else."


At Wednesday, March 22, 2006, Anonymous Anonymous said...

I know this is intended as satire; but Super, it amazes me how you can be so persistent in either misunderstanding or purposfully misrepresenting these various "reform" ideas. To be clear, I am NOT a fan of the "65 percent solution." The varying definitions of "classroom" expenses are a big part of the problem. And even if it were well-defined, then I think 65% would be way too low! (Once again, we fall victim to low expectations.)

But to make your satirical analogy correct, you'd have to say that BCBS's new policy requires that at least 65% of surgery costs be spent on things that happen in the surgery room. That would INCLUDE anesthesia, supplies, nurses, etc -- not exclude them.

One of the problems with public education is that even when classroom expenses are inclusive of all the things really happening there, we still get a far too small percentage of funds making it to the classroom. Administrators hate this suggestion and try very hard to 1) minimize the real costs of education (right around $10,000 per kid, not $5-6000 as is often portrayed) and 2) broadly define what happens in the classroom (beyond teachers, supplies, facilities, etc.). But no matter how you crunch the numbers, we still have far too little money (in most cases, less than 65%) making it to the classroom.

I would bet that a MUCH higher percentage of health care costs make it to the surgery room, the patient room or the examining table. Why can't we do the same thing with the classroom?

At Thursday, March 23, 2006, Anonymous Anonymous said...

This is funny. However, reality shows that 78% or more (up to 90%) of premiums are used for medical expenses. The rest is for administrative overhead and profit. I have no clue what BC/BS medical loss ratio is but I know they pay their top people incredibly well and the physicians love them. Strange they can do both at once.

I would truly love to see the education dollars need to follow the child. I bet you would have even lower administrative cost and more dollars in the classroom. Sorry, I think there is too much duplication in education dollars at the administrative level which takes dollars directly out of the classroom. Yes, I know districts have huge costs associated with transportation and maintenance. These are needed. However, I believe if schools were allowed to build their budget from the ground up, fewer dollars would be in central administration and more in the classroom. Now to figure out how to prove this. It is being done in San Francisco and other school distrists. funny if it ended up being 65% was the right number...

Just my thoughts --


At Thursday, March 23, 2006, Blogger Indiana Public School Superintendent said...

It was just meant to be funny. It isn't the best fitting satire piece around.

The idea came from an article on the 65% solution in the Atlanta Journal Constitution that used the surgeon analogy.

I am open to some better fitting satirical analogies. :-)

At Thursday, March 23, 2006, Anonymous bambootcha said...

Elizabeth, I am curious as to what data you are using as a basis of your assertion that "there is too much duplication in education dollars at the administrative level which takes dollars directly out of the classroom."

I am not familiar with that research, but I would certainly be happy to consider it.

I would also be interested in your definition of an adminstrator as well as your definition of what constitutes an adminstrative expense.

At Friday, March 24, 2006, Blogger EdWonk said...

You know that we had to link this post. We just couldn't help ourselves. :-)


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