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Sep 2, 2009 1:53 PMPublication: The East Hampton Press

No new progress in Empire, Alliance talks

Sep 2, 2009 1:53 PM

In his Sag Harbor store on Monday, Emporium Hardware owner Frank D’Angelo, who gets his health insurance from Empire Blue Cross Blue Shield, vented frustration over the fact that his health plan is not currently being accepted at East End hospitals.

Mr. D’Angelo is in the same predicament as thousands of East End employees who get their Empire health insurance through municipalities, school districts and hospitals.

“Right now I don’t have a hospital to go to in the local area,” Mr. D’Angelo said. “If I need some kind of elective treatment, I have to go all the way up-island.”

Since August 1, when their contract ended, the East End Health Alliance’s member hospitals—Southampton Hospital, Peconic Bay Medical Center in Riverhead and Eastern Long Island Hospital in Greenport—have been out of Empire’s coverage network, meaning Empire insurance is not accepted at those hospitals for anything other than emergency and maternity care and pre-approved procedures and treatment.

And though both sides reached a settlement on Empire’s Mediblue plan last week, which targets senior citizens, no other agreements have been reached.

Empire spokesman Craig Andrews has said the hospitals are requesting an unreasonable rate increase of 40 to 60 percent above rates established in the expired contract, which was agreed to last year. Hospital officials argue that Empire, the largest health insurance company in the state, reimburses hospitals so little that hospitals lose money by treating Empire patients.

Hospital and Empire representatives declined to comment on the ongoing negotiations this week, citing a “quiet period” that both sides agreed to in order to focus energies on reaching a settlement. The quiet period ends on September 8.

Negotiating teams for Alliance and Empire met in New York State Department of Insurance offices in Manhattan on August 26, but no new settlements were reached, Mr. Andrews said. “We’re continuing negotiations, as we have been,” he added.

Meanwhile, area officials, doctors and residents expressed concerns over the deadlock.

Among the Alliance member hospitals, only Peconic Bay Medical Center gets its own health insurance from Empire. But 750 Southampton Town employees, retirees and spouses have Empire insurance, according to Ryan Horn, spokesman for Southampton Town Supervisor Linda Kabot.

“All of these people are affected by the hospital thing,” Mr. Horn said. “There are a lot of employees that are on the insurance and the town is a significant [employer] in this area.”

Suffolk County, which employes about 10,000 people, also buys its insurance from Empire, said 1st District County Legislator Ed Romaine, whose legislative district includes Peconic Bay Medical Center and Eastern Long Island Hospital.

“I am gravely concerned with Empire Blue Cross Blue Shield and their seeming inability to reach a settlement with the three hospitals,” Mr. Romaine said.

Hundreds of employees and retirees with Riverhead and East Hampton towns, which are serviced by Alliance hospitals, also subscribe to Empire. More than 880 employees, retirees and family members in Riverhead and 385 in East Hampton are Empire subscribers, officials there said.

Southampton Village also provides Empire insurance to its 158 employees and retirees, Village Treasurer Stephen Funsch said. “The hope is that they reach a settlement,” Mr. Funsch said.

And employees of at least two area school districts, Sag Harbor and Bridgehampton, receive Empire insurance through their respective districts, officials said. Sag Harbor has about 150 school employees, said School Board President Walter Wilcoxen.

“I just think this whole thing is a joke, it’s a travesty,” Mr. Wilcoxen said of the deadlock.

Some residents expressed hope that the two sides will reach a settlement soon.

After living without health insurance for years, Helen Dykeman, a Southampton resident, said she had something to be happy about this week: she just became a subscriber to United Health Care. But Ms. Dykeman was critical of the ongoing negotiations between Alliance hospitals and Empire, which insures a majority of East End residents.

“It’s ridiculous,” Ms. Dykeman said. “Half the people out here are insured by them, and they can’t even go to the hospital in the community they live in, because of greed.”

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I feel the reason people pursue municipal posistions is because of the stability they offer. They may be able to make more money in the private sector but take public jobs for a steady paycheck and acessable health care for thier families. This dynamic is changing.
So for the townships in our area, as well as the county and state, the lazy workers are going to continue to come to work. Your brighter and more motivated people will find better jobs. The benifits just wont out wiegh ...more
By Ebby (75), Sag Harbor on Sep 1, 09 5:42 PM
This is a perfect example of why a public option for healthcare is necessary. How are American businesses expected to compete economically with other countries that provide this very basic service for their citizens? If there were a public option available, you can bet that insurance companies wouldn't be able to hold the health of our friends and neighbors hostage to corporate greed.
By M. O'Connor (147), Southampton on Sep 3, 09 7:28 AM
M. O'Connor, you are oh so right. Not only has empire refused to make a deal with the hospital, they have dropped numerous local doctors from their plan. That's right, doctors have not dropped empire. Empire has dropped the doctors. So what choice does a patient have? Either find a new doctor or enroll with a new for-profit insurance company. If there were a third choice - a public option - I would drop private insurance and they know it which is why they are fighting so hard against the interests ...more
By peoplefirst (787), Southampton on Sep 3, 09 11:33 AM
First: To commener Number 1--local, city, state and county employees pick up your garbage, teach your children and provide health care to you and your family. Private businesses do not provide these services to you and would charge a great deal more (check out the cost of private tuition). In exchange for the lower wages they have no choice about receiving, city, state and local workers receive healthcare and other benefits for a lower price than you may pay, but nonetheless, they pay at a set ...more
By lulubelle1956 (24), Westhampton Beach on Sep 3, 09 6:08 PM
2 members liked this comment
Demonize the auto industry, banks, wall street, and insurance! How about looking in the mirror? A staggering 1.6 trillion dollar defecit and 10 trillion in debt. Mismangaement with OUR money at its best. Our policticians should be the ones on the stand getting grilled. A public otion...I think not. The GVT can not run anything effectively. Its best attempt at socialized medicine (medicare) is a complete financial failure. It will be broke within 10 years and has so many covergage gaps in it that ...more
By razza5350 (1906), East Hampton on Sep 4, 09 12:43 PM
1 member liked this comment
It has been proven everywhere that tort reform has been put into place, that it does little to nothing to drive down costs. This is nothing more than another ludicrous right wing talking point meant to distract people from the real demon: Private Health Insurance.
By peoplefirst (787), Southampton on Sep 4, 09 2:36 PM
People first you are really drinking the kool aid. Please give me an example of where the GVT has run anything half way as effectively as the private sector. They are operating at 10 trillion dollar in debt! The gvt is so full of waste and mismanagement it makes me want to puke. From East Hampton and southampton towns to NY state, to California and yes the top of the heap the federal GVT
By razza5350 (1906), East Hampton on Sep 4, 09 2:50 PM
Lulubelle perhaps refering to anyone as lazy was wrong of me. The point I was attempting to make was that this mess is going to have a negative effect on health insurance policies offered to the towns. Thus, making these jobs less attractive.
By Ebby (75), Sag Harbor on Sep 4, 09 5:45 PM
So, private industry is efficient and government (including government employees), are not?

To quote Barney Frank, what planet are you living on?

Do I need to remind you that private auto companies are so inefficient and missed the market so much they had to be bailed out? That banks, financial and insurance companies and wall street sold such risky investments around the world to make a profit that they had to be bailed out and international economies other than ours are in ...more
By lulubelle1956 (24), Westhampton Beach on Sep 4, 09 5:46 PM
1 member liked this comment
Lulubelle, very well said. Thank you. Who benefits from health care reform with a public option: the middle class (upper and lower) the poor, small business owners, people with pre-existing conditions, those who have lost their jobs, the sick, the healthy, the young, the old, republicans, democrats, independents, whites, blacks, asians, latinos . . . Who benefits from killing reform? Insurance companies.

Ask yourself this question: what does private insurance contribute to your health? ...more
By dagdavid (646), southampton on Sep 4, 09 6:30 PM
1 member liked this comment
Nice speech but you never answered the question. Give me an example of ANYTHING the GVT has run that hasnt bleed red ink. Please do not compare the noble services of civil services such as the police and fire department. Thats what the GVT is supposed to do. Not invade the private sector and takeover banks, insurance, and car companies.
By razza5350 (1906), East Hampton on Sep 5, 09 8:13 AM
lulu belle you forgot to mention that the civil services (police, coast guard ect) that you claim are free are actually paid for by taxes. It is not free and I pay my fare share. Judging from your opinions I take it you are not a business owner. The GVT constantly rapes the private sector to pay for its services. Some good some bad
By razza5350 (1906), East Hampton on Sep 5, 09 9:37 AM
Well, razza5350, you certainly like to pick and choose your government services don't you? Please note that this article is about a non-government, small business owner in Sag Harbor who is not receiving Blue Cross/Blue Shield coverage at any hopital in Suffolk County because he holds an Empire policy. Therefore, your assumption about what is working in the private sector is unjustified. Empire covers government employees as well as private businesses. If you do not think other insurers are ...more
By lulubelle1956 (24), Westhampton Beach on Sep 5, 09 10:19 AM
1 member liked this comment
Razaa, why is it inappropriate to use police, coast guard, public schools, highway works projects, etc. as an example. They are social services provided to you by your government, paid for with taxpayer dollars. A public option would be the exact same thing. Just like medicare, the VA and more.

Lulu is right, you are cherry picking points that make your argument and dismissing those that disprove it. You want to talk about the government "invading" the private sector, that's fine. ...more
By dagdavid (646), southampton on Sep 5, 09 1:12 PM
I take it you both are either liberal democrats or are not in the private sector. Both of these people seem to want to save the world regardless of cost. I predict the public option will die in the senate when coller heads will prevail .Bottom line is Medicare and SS will be bankrupt before I reach that age or we will be back to Jimmy Carter days of 70% top tax rate to pay for all of this crap.
FYI I cant take anything lulu says seriuosly after quoting barney frank
By razza5350 (1906), East Hampton on Sep 5, 09 2:14 PM
1 member liked this comment
I am a liberal and a small business owner and I do not believe you can put a monetary value on a human life.
By dagdavid (646), southampton on Sep 5, 09 6:12 PM
dagdavid, how much of your income have you spent on paying for other folks' healthcare...out of the goodness of your hear. exactly. $0.00. Why try to create a system where the gov't takes our loot in the form of taxes and then re-distributes it. there seem like enough folks are for ahem,''healthcare reform''...why don't you all put your money where your mouth is and start coughing up money and paying for these folks you care so much about. perhaps we would like a choice about how to spend our ...more
By thetruthhurts (21), southampton on Sep 6, 09 7:05 AM
Dag, Personally I do not believe in GVT dependency and I loath big GVT BUT I do respect your answer. It is the only one that makes sense to me. As a small business owner medical coverage is tough for you. You may want to look in Oxford or HIP sole proprieter plans, Healthy NY (if you can qualify) or Blue Cross Tradition Plus (that is if these guys work out a deal). Premiums range from 100-400 a month.
By razza5350 (1906), East Hampton on Sep 6, 09 7:24 AM
Razza, thank you for elevating the debate to a respectful tone. Many posters can only stomp their feet and shout insults, contributing nothing beyond rage and fear to what is an extremely important debate. No one can deny that our current health care costs are simply unsustainable. To me the issue is not about big government or socialism and other distractions, the issue is how can we accept the fact that we live in a country where we allow people to die for lack of accessible health care.

We ...more
By dagdavid (646), southampton on Sep 6, 09 10:01 AM
WASHINGTON, Sept 10 (Reuters) - The number of people living in the United States without health insurance rose to 46.3 million in 2008 from 45.7 million a year earlier, a U.S. Census Bureau official said on Thursday.
By peoplefirst (787), Southampton on Sep 10, 09 12:44 PM
mysteriously that number has dropped to 30 million per Obama's speech.
By razza5350 (1906), East Hampton on Sep 12, 09 8:54 PM
gurney's, new year's eve, celebration, montauk