Insurer has an easier time in Delaware

Memo to Kenneth R. Melani, chief executive of Highmark Inc., Pennsylvania's largest health insurer:

Rent a shore house in Delaware, make it your happy spot, because it's definitely been more tranquil for you in the First State than it has been in the Keystone State.

These days, it's not even peaceful in Pittsburgh, Highmark's corporate headquarters, where Highmark and the city's most prestigious hospital system are engaged in high-stakes brinkmanship affecting tens of thousands of patients.

How bad is it in Pittsburgh?

The University of Pittsburgh Medical Center, which sells its own health-insurance plan, is threatening to stop accepting Highmark insurance in a dispute over payments for services. And Highmark announced Tuesday that it would spend $475 million, $50 million up front, to bankroll UPMC's rival, the West Penn Allegheny Health System.

Ahhh, but in Delaware . . .

In Delaware, a bill that would remove a major obstacle to Highmark's proposed affiliation with Blue Cross Blue Shield of Delaware sailed through the legislature, passing the Senate unanimously Tuesday and the House, 34-5, Wednesday.

Nothing like that happened in Pennsylvania when Highmark tried to mate with Independence Blue Cross, Philadelphia's largest insurer - a bid that ended in failure in early 2009.

In Pennsylvania, the legislature blocked every move. Leading the charge in the Senate was a former insurance broker, Donald White, chairman of the Banking and Insurance Committee. White made no secret of his distrust of the motives of the state's two biggest Blues. (Highmark is a Blue Cross Blue Shield firm.)

In Delaware, there were three public hearings on the proposed affiliation. The longest lasted 95 minutes, and only eight people testified.

"It was all kind of tepid," said Elliott Jacobson, spokesman for the Delaware Insurance Commission.

In Pennsylvania, there were more than four long days of hearings. Close to 100 people signed up to testify.

"It was passionate, with people of diverse points of view feeling very strongly about the benefits and dangers of the merger," said Lance Haver, who testified as Philadelphia's director of consumer affairs.

In Delaware, Melani was calm, "all spit and polish, the quintessential CEO," said Delaware Blues lobbyist David S. Swayze, who saw Melani at the Wilmington hearing.