Wow! Angela Braly ranked by Forbes ahead of Hillary Clinton and Queen Elizabeth on its list of powerful women. No. 16 in the country! This is heady stuff, indeed. It is good for Indianapolis to have such a prominent national figure in our midst. Known for her " public policy expertise", she is called a " hardheaded negotiator and workaholic", who is " not about to roll over for the likes of Michael Moore". I think it is legitimate to ask if she will use this extraordinary power in the service of better public policy or larger profits?

Reading the complete Forbes article perhaps offers some clues. An advocate of the " if-it-ain't-broke..." argument, she told the head of the Yale-New Haven Hospital, " In China, they roll you out of the hospital if you run out of cash." Is China is the standard by which we should measure our health care system? No one I am aware of points to China as a model. Braly insists that " health care reform be done by the private sector, and in measured steps." Of course, she would. She leads the country's largest health care benefits company whose earnings have grown 55% per year since 2000 to $ 3 billion in 2006, a company so attractive that Warren Buffett just bought 4 million shares. What else happened in that time frame? Employment- based insurance fell from approximately 70% of the work force to just under 60%, and the number of uninsured rose to 47 million, according to just released U.S. Census figures. Oh yes, also during that period WellPoint's premiums prices grew at 2.5 times the rate of inflation.

Despite the abject failure of market-driven managed care and incrementalism over the past decade, Braly insists that there must be some form of market- driven managed care. Hello, Angela... It has failed miserably as a mechanism to control costs or reduce the number of un- and undersinsured. Of course, it has worked brilliantly for the bottom line of insurance giants such as WellPoint.

Ms. Braly boasts of new innovative insurance products like Tonik for the young uninsured and high deductible/HSA plans to empower the consumer, but her own sales chief says there is no plan to change emphasis from traditional corporate accounts to consumer directed plans. Why? The sales chief, Mr. Watts, says " such a move would hurt profit margins." Her own finance chief, Mr. DeVeydt, concedes that " price increases account for half of earnings growth each year."

And finally, the article points out WellPoint's $ 2 million campaign against the Schwarzenegger plan in California which would require insurers to offer coverage to all regardless of health status. It is the only major insurer to do so.

None of this is surprising. WellPoint's CEO is obligated to its shareholders, so there is virtually no chance that its earnings will be jeopardized in the interest of better national public policy. After all, health care in the U.S. is big business, not a matter of public policy. According to Forbes, Ms. Braly's employment contract calls for $2.4 million in salary and 410,000 stock options. At current prices, that is more than $32 million. It seems that her lofty position among the nation's female power elite is more likely due to this statistic than do any demonstrable committment to improving the nation's health care environment.

Anyone interested in real health care reform should read the Forbes article. If you find something which makes you sanguine about the future of American health care, please let me know.

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