BCBS CA revenue is approximately $25B. The total of above is $25.6M. That's 0.1%.

You may view those salaries as appropriate for leading companies of this size or immoral and outrageous. But either way executive comp is not the big problem with US healthcare costs.

> Why do Cleveland Clinic executives need to be paid $30 million/year?

So they can hire bodyguards?

Considering executive outlays apart from shareholder outlays omits most of the parasitic picture.

"Top healthcare companies spend 95% of profits on shareholders, study finds"

ref: https://www.healthcare-brew.com/stories/2025/02/21/top-healt...

Executives and shareholders are effectively one organism, with execs serving the function of disrupting the host for optimal extraction.

There's no point using this issue to gossip about these people's salaries. Their salaries don't scale, and so don't matter. Scaling costs matter.

This isn’t gossip, it’s publicly disclosed information.

Their salaries don’t scale because they’re grossly overpaid. The fact that ~10 people in an organization get paid enough to be a separate line item in a company of 6,500 employees is insane.

The executive compensation at Blue Shield of California could employ approximately 300 nurses.

> This isn’t gossip, it’s publicly disclosed information.

The gossip part isn't the facts of the matter, it's the deciding how much a business should pay its executives.

Their salaries don't scale because there's only one of each of them. It's nothing to do with them being overpaid. Overpaid isn't an objective word. It's just gossipy nonsense.

> The executive compensation at Blue Shield of California could employ approximately 300 nurses.

I doubt it. Think of all the overhead.

I think this summary is reductive, because it ignores the surprisingly dense layers of middle management in hospitals and clinics that are paid more than the medical professionals (and even that ignores external middle managers like PBMs etc).

I’m actually purposefully ignoring the administrative staff because:

1. They do actual, necessary work, and represent a relatively large and reasonably paid workforce (not grossly overpaid like executvies)

2. They fall under a different budget bucket than executive compensation entirely.

One thing to note: blue shield of California is a non-profit. So no money is going to shareholders.

Blue Shield of California failed the duck test and is no longer exempt from paying California taxes. It’s effectively a fake non-profit.

I think that's highly significant. Keep in mind that that's only one provider in the system. You've also got to pay the executive salaries of your hospital system, your pharmacy chain, your drug company, medical equipment company, etc.

If we figure that every company involved in your $15k/year healthcare cost is paying 0.1-0.5% of their revenue to executive compensation (Cleveland Clinic as a random example pays 0.4% of revenue to the executives, $30 million) then we are talking about a small streaming video subscription worth of cost just which is allocated not on paying a productive group of administrators to keep the lights on, but instead paying excess incentives to an extremely small group of people.

In reality, if CEO compensation was capped to something reasonable like $500,000/year or 10x the pay of the lowest paid employee, there would still be CEOs and the quality of CEOs would not decline because it would still be the highest paid job on the market. Everyone involved in our economy would be just that much richer if the wealth wasn't getting unnecessarily concentrated.

$500,000 is a lot of money, I don't want to minimize that, but it would not be the highest paid job on the market. There's a number of roles in medicine, law, finance, and nowadays software that pay more for fewer managerial duties. There really isn't much room to argue for cutting executive pay without arguing that it's unimportant to get the best people in executive roles.

And that's an argument you can certainly have, but it seems strange to make it a precondition to fixing the healthcare system, when cutting executive pay would resolve only a small fraction of the problem.

And all of those things listed requires far more skill set/experience or education to achieve. You would be hard pressed to identify c-suite skills of any established corporation that can't be found in abundance among lower employees if anybody bothered to look instead of doing the 95% networking and politics games that most c-suite are chosen from.

It would be the highest paid job on the market if the law limited executive pay.

Maybe this idea is sacrilege to the hyper-capitalist brain but it is entirely reasonable to limit personal salary and assets because income inequality has known and proven negative impacts on society.

No one person should make a salary greater than ~$1 million/year nor should they be able to control more than ~$100 million in assets. Prove me wrong on that concept. What possible reason could an individual have to require such excessive wealth?

As far as your second paragraph, your argument is that we can’t fix one piece of a multi-faceted problem without fixing the other pieces, which is logically weak. Paying executives less would make non-zero progress toward cost reduction.

I don't understand what connection you're trying to draw here. Why would we set the rate for a new tax based on the per-subscriber compensation of Blue Shield California's executives?

> Let's charge 49 cents per million dollars of unrealized capital gains per month

Uh, Blue Shield of California is a nonprofit mutual benefit corporation. There are no "unrealized capital gains."

Blue Shield of California failed the duck test and has been paying California taxes for about a decade. It is effectively a fake non-profit.

Yes, it is a taxable nonprofit and to the original claim, nobody gets capital gains from it.

While you’re right on paper, the incentive plan (the PDF I linked further up) discloses that the a good chunk of executive compensation is based on performance metrics that would essentially mimic stock incentives for any other company.

50% of the executive incentive is based on membership targets and operating income.

Blue shield discloses that their CEO pay is about 70x their median employee. This is less than the for-profit organizations’ 250x ratio but that only serves to distort the spectrum of ethics.

We can call these organizations non-profits all day long because they fit our secular corporate law definitions but I’m not sure how a company that pays an employee enough money to own multiple homes with a Ferrari parked at each one would be considered non-profit in the eyes of God. [1]

[1] Not claiming the dude exists but you get the point I am making here.

Ok, performance based compensation would be taxed like ordinary income, right? What's the problem with that?

The original poster proposed "49 cents per million dollars of unrealized capital gains per month" which is invalid not "on paper" but in reality.

That's pretty pathetic pay when we have run of the mill employees(ie non-founders) like Sundar and Satya becoming billionaires from their pay packages.

The fact that we have been conditioned to talk in relative terms like this is sad.

Getting paid $10-30 million a year doesn’t become reasonable just because someone else is making $100 million or $1 billion per year.

That’s like saying I’m not overweight compared to someone who weighs 600 pounds. Doesn’t change the fact that I’m overweight.