North Dakota Scandal Raises Concerns About Health Co-op Route

For the North Dakota insurance sales reps, March may have been the ideal time to enjoy the swim-up bar at a resort on Grand Cayman Island. But back on the northern Plains, where temperatures were below zero, policyholders at Blue Cross Blue Shield of North Dakota were less delighted when they learned about the trip for 66 staff members and guests. Word of the $238,000 Caribbean retreat broke last winter, compounded by news of other perks: $15 million in executive bonuses over five years, $400,000 for charter flights and $35,000 for a vice president’s retirement party. And when the ensuing uproar cost Michael Unhjem his job as chief executive, his landing was softened by a $2.5 million severance payment. The golden parachute had been added to his contract after his 2006 drunken-driving arrest, a state audit pointed out.In an era in which stories of corporate excess have become common, the drama of North Dakota’s dominant insurer resonated deeply here, largely because the state’s nonprofit Blue Cross Blue Shield is essentially a cooperative, owned by policyholders. It is an arrangement close to the model promoted by powerful lawmakers as an alternative to the “public option” that would put the federal government in the insurance business. The legislation that the Senate Finance Committee will probably approve Tuesday calls for the creation of health insurance cooperatives in all 50 states and the District.A liberal group here argues that the North Dakota scandal illustrates the danger of assuming that the cooperative model would assure virtuous behavior, especially in an industry awash in money. “Call it cooperative, call it mutual, call it private insurance,” said Don Morrison, executive director of NDpeople.org. “If what we want is to have quality health care at a price people can afford, it’s not coming from the culture of private insurance. If this is a model, let’s get real.”As an existing company, the Blues would not be allowed into the ranks of new co-ops envisioned by