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“Non-profit” except for those at the top

The Dayton Daily News has broken a story about the executive pay at CareSource. Of course, yours truly is hanging his butt out for trouble- since I’ve actually done some work for Caresource in the past- but, let’s get real here.

“CareSource is entirely funded with taxpayer dollars, receiving money from the state-federal Medicaid program for each client who meets its poverty guidelines and enrolls in the HMO”

Translation: they are government workers posing as a private corporation- and paying top dollar to their CEO. She made 6x what the president of the United States made in 2009- all while pushing paperwork for the government. Understand that CareSource doesn’t actually treat anyone- they just take a scrape for administering the paperwork for treating people.

You’d be outraged if your tax dollars paid a trash collector $100,000- but it’s the American Way to let this “CEO” get paid as a millionaire with our tax dollars. Not only could we eliminate CareSource tomorrow- and put this money directly into health care for everyone, but we could hire people who actually deliver health care instead of process papers.

Unbelievably, the company has been allowed to be a for-profit for a couple of years when it suited them- and back to non-profit when it didn’t:

In 2006, no salaries were reported to the IRS because CareSource’s top executives were compensated through a for-profit arm created to expand the HMO’s business footprint into Michigan. And in 2007, CareSource reported that its top five executives earned a total of $3.2 million from its for-profit arm but did not provide individual compensation totals.

Nonprofits are required to file annually with the Internal Revenue Service. The form — called a 990 — is often the only source the public has on a tax-exempt organization’s financial information.

via CareSource changes how it reports salaries to IRS, showing CEO earned $2.9M. [1].

There is also a question of ethics in having Tom Breitenbach CEO of Premier Health Partners on their board of Directors [2]– since Premier is one of the primary providers of actual health care that CareSource contracts for services.

When people knee-jerk about a government run health system- it’s companies like CareSource that give them justification. Here is a “private company” playing with your tax dollars and paying execs big bucks.

We can afford health care for everyone- if we pay doctors to take care of people instead of paying “administrators” to push papers and approve or disapprove care.

Here is the Dayton Grassroots Daily Show on the subject:


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I worked in hospitals back around 1970.  The hospitals then were largely run by the medical staff, but over the course of a few years the hospital’s administrator increased in power to the point that he was directing conditions of medical care, expanding his fiefdom to include assistant administrators and a CFO (who implemented such ridiculous money-saving programs as requiring employees to return a box of exhausted ball-point pens along with each requisition for a new box).
There’s an interesting book to be written by anyone who wants to quantify the effects of administrative bloat in health care, education, and large corporations.  I’ve noted elsewhere, there are more administrators in higher education now than there are full-time faculty; many university presidents are also becoming millionaires (Gordon Gee, $775K/yr. base salary).  The lavish rewards for those who administer health care (either directly in facilities or indirectly through insurance) are just part of a larger trend to reward “management” that isn’t managing efficiently.

D. Greene

from Wikipedia: “The president earns a $400,000 annual salary, along with a $50,000 annual expense account, a $100,000 non-taxable travel account and $19,000 for entertainment.”

Indeed, while the other things provided for the president cannot really be priced, from that perspective it seems especially obscene. Neurosurgeons who save lives every … See Moreday comparatively make a fraction of her public salary (and that’s not counting all the benefits SHE receives on the side or under the table). Truly frustrating.

I bet she never gets denied when she files a health insurance claim, either, and you can’t put a price on a life, even though we do it every day.

Steve Varner

People are free to make however much money they can. I don’t know anything about what she does or the internal workings of Caresource, but if they think she’s worth that much money, then so be it. She or someone there must be pretty good at what they do if they’ve grown that much recently. They hire area people when others are letting go, and they just built one of the only new towers in the last 15 years Downtown. It’s tough to argue with someone doing so much for the area. I’m guessing this “paper pushing” company can do it a lot cheaper and more efficiently than the government could.


If they’re still using paper than they’re doing it wrong!
In all seriousness though I have worked in the Public and Private sector and from what I have seen nothing is more bureaucratic and ass-backwards than a large corporation.  I’m sure CareSource is only efficient at one thing, funneling money to it’s executives and stockholders.

David Lauri

Bummer about Premier Health Partners not wanting to sponsor B-Cycle.  Perhaps you should ask Pamela Morris if she can spare anything from her multi-million dollar salary.
I find it interesting that although CareSource is the largest Medicaid plan in Ohio, Morris’s pay puts her at “the third lowest among Ohio’s seven major Medicaid plans.”
I guess there are four other Ohio Medicaid CEOs you could be hitting up for B-Cycle sponsorships.



…yours truly is hanging his butt out for trouble…

After you posted your “no thanks” response from Premier, I thought of this:

I say that a man must be certain of his morality for the simple reason that he has to suffer for it.
— G.K. Chesterton


How childish and immature of Tom Breitenbach and Premier. Too bad they basically hold a monopoly on the area hospitals, or I would boycott them.


Ironic that a company that you would think would like to project a “caring for the citizens” facade declined an opportunity that could be (on one hand) considered helping the healthcare of the citizens.

jay madewell

good work, david- keep fighting the good fight.

i agree, that there would be plently of money for healthcare for everyone if things were run efficiently.

eat the rich.

Greg Hunter

How childish and immature of Tom Breitenbach and Premier.

Yes maybe he can check himself into the Mayo Clinic to understand that he has NPD.    Poor little Tommy as we should all feel sorry for him as its causes are clearly not his fault.

Some evidence links the cause to a dysfunctional childhood, such as excessive pampering, extremely high expectations, abuse or neglect. Other evidence points to genetics or psychobiology — the connection between the brain and behavior and thinking.

Of course a large corporation that benefits from people not walking, riding or being in shape would look for any excuse NOT to fund and initiative that would limit the future supply of patients.  The truth always hurts and poor little Tommy is no different than most of the CEOs in America.  They all feel like they are doing God’s Work.  Unbelievable, but there are plenty “supposed good people” that support these people by working for them and turning a blind eye because they are supported and loved by the community.  I remember a country that thought like that at one time….


I find it funny that one of their ‘competitive advantages’ is

…a thorough understanding of Medicaid, Medicare, and the associated regulatory environments…
CareSource, Health Plans

A competitive advantage created solely through the enormous complexity of the government regulations (if they weren’t complex and unwieldy then understanding them wouldn’t be a significant barrier to entry).  These are the market distorting effects that get free-marketeers riled up.
The creation of little cottage industries like these when big gov does big things is a drag on our economy.  Instead of being employed in creating wealth, CareSource folks are employed in understanding our increasingly complex entitlement services regulatory environment.  That’ll help us be more competitive in the global marketplace! What? You mean there’s no export market for Medicaid regulatory expertise?


Let’s hear what the Regions Leader’s President and Chief Executive Officer  Mary Boosalis is raking in.
This in a year where even the annual employee holiday dinner was cancelled after more than 30 years. A once a year freakin’ free holiday meal in the cafeteria. The little “bonus” GONE.
BUT, guess who eats free in the MVH cafeteria every week? The Oakwood and Beavercreek football teams, courtesy of the sports medicine center. I sleep so much better at night knowing those poor kids get free meals. I’m sure the Boosalis twins don’t even notice the signage when they look for mom in the bleachers when they play in Miami Valley Hospital Stadium in Beavercreek.

Ohio Medicaid

It’s a shame but that’s the way it is.

David Lauri

Some interesting news via a photo on CareSource’s Facebook page.  It seems that CareSource, which as David Esrati notes above can afford to pay its CEO an annual salary of $2.9 million, was very generous last week to <a href=”http://www.arcohio.org/” title=”Learn more about AIDS Resource Center Ohio on its website”>ARC Ohio</a>, donating $12,500.
Very generous, that is, if you consider a donation that amounts to 0.43% of $2.9 million as being very generous.  Or if you consider a donation that doesn’t begin to cover the salary of a HIV counselor as being very generous. Or if you consider a donation that might cover the cost of HIV drugs for one person for a year as being very generous.
Thanks, CareSource!

Bubba Jones

Even if the donation wasn’t “very generous”, it’s still $12,500 more than they HAD to give!

Lisa Anderson

This enrages me.  Caresource just signed my death certificate by refusing to buy me medical equipment needed. And they put in writing that they know this!  I have a rare disease and can not absorb oral meds that I take many times a day to stay alive. Need an insulin pump to deliver corticosteroids subcutaneously.  My doctor states without this I will die soon.  Yes, Caresourse says they understand this, but because Ohio law states medicaid will only purchase insulin pumps for type 1 diabetics with a specific A1C range AND who have proof they have used a pump with positive results for 3 months (who pays for that during the 3 months?).  Appealed up to state hearing: denied. Tried getting approval under compassionate care policy: denied due to above stated statute and advised this policy only applies to medication, not medical equipment.  Tried under off label use policy: denied due to state statute and because off label use policy only applies to medication not medication delivery system. Pump is $8k and supplies about $700 for 3 months.  Of course, given this is a medicaid policy, Caresource would not even be paying 1/3 the stated cost. Got hauled out of Ohio JFS office at State Hearing in an ambulance and taken to hospital due to adrenal crisis.  Had about 35 trips to ER, hospital stays, and crises at home over last 14 months due to adrenal crises.  Doc says everytime this happens I have a 40-50% chance of death. Wouldn’t it have been cheaper to approve me for the medical equipment needed? Caresource didn’t seem to have trouble taking tax dollars, the ones I paid over 40 years of working full time.  Maybe I should have had policy about that…