When it comes to insurance, Eric Carter says Kansas has gone to hell in a handbasket.

“Despite what (Kansas Insurance Commissioner Sandy) Praeger tells you, Kansas is an awful place to do business,” he said.

He called Praeger’s office a “bureaucratic morass” that’s stifled much-needed competition, sent premiums through the roof and slept through the last four legislative sessions.

“Her legislative agenda has been nothing,” said Carter, a conservative Republican state representative from Overland Park. He’s challenging Praeger in the Aug. 1 GOP primary.

Praeger, a former Lawrence mayor and a state senator from 1992 to 2000, said her opponent is playing fast and loose with the facts.

“Kansas is ranked fourth in the nation in the number of (insurance) companies’ headquarters outside the state doing business inside the state,” Praeger said. “That’s 1,600 companies. That tells me we have a very good business climate in the state.

“He says we take forever to get (companies’) paperwork done, but the National Association of Insurance Commissioners rates departments on the speed in which they process filings,” she said. “The national average is 31 days; ours is 21 days.”

The insurance commissioner is elected to a four-year term and supervises all transactions related to insurance companies in Kansas, including mergers, business conduct and the products they sell. The insurance department has a $22 million budget and employees nearly 150 people.

The winner of the GOP primary will face Democrat Bonnie Sharp, a state representative from Kansas City, Kan.

Opposite views

Other Praeger-Carter differences:

l Carter cited reports that he said showed health insurance premiums in Kansas had increased 10 percent a year for the last three years in part.

“Not true,” Praeger said. “We’ve seen a stabilization in premiums, and what increases we have seen are an indication of health care costs going up. That’s not a problem you solve with insurance – that would mean (companies) either paying fewer claims or offering fewer benefits. I’m not sure those are options Kansans want.”

l Carter insisted that Blue Cross Blue Shield of Kansas controls 67 percent of the state’s health-insurance market.

“When one company is that big, it means there’s not enough competition,” he said.

Praeger said Blue Cross Blue Shield of Kansas is, in fact, the state’s largest health insurer. But its market share, she said, is 38 percent.

“It’s true they’re the largest,” she said. “But people like Blue Cross – their overhead is lower than the other companies’, their premiums are lower and they pay claims promptly.”

l Carter blasted Praeger for helping pass a 2001 bill that required health insurers to cover mental and physical illnesses equally.

“Mental health parity is now the No. 1 driver of health care costs,” Carter said. “It’s a mandate, and mandates are what drive up costs.”

Praeger, who played a key role in getting the bill passed in the Senate, disagreed.

“We did an analysis of mental health parity’s effect on the state employees’ health insurance and the additional cost was between 1 and 2 percent,” Praeger said. “It is not a big cost driver, and there are all kinds of indicators that show being treated for mental illness – depression, for example – reduces costs in other areas.”

If elected, Carter said he would push for a bill to rescind mental health parity in Kansas.

“I may not be able to undo the damage,” he said.

Few head-to-head meetings

Carter chided Praeger for avoiding him on the campaign trail, noting she often sent Assistant Commissioner Bob Tomlinson or aide Cindy Hermes in her stead.

“I haven’t shared a podium with the commissioner in a month and a half,” he said late Thursday.

Carter accused Praeger of using state employees – Tomlinson and Hermes – to lessen her campaign expenses.

“You watch,” he said, “when the (campaign) expense reports come out (today), they won’t show a penny for their time or mileage. The taxpayers are paying them.”

“Again, not true,” Praeger said, noting that Hermes is serving as her campaign manager and has taken a leave of absence from the department.

State law, she said, allows incumbents to send staff members to their place.

“We’ve been very careful in keeping track of what are campaign-related expenses and what are not,” Praeger said. “It’ll all be in the report.”

She denied avoiding Carter. “He assumes I’m avoiding him if I’m not where he is,” she said, “when, really, I’m either campaigning somewhere else or I’m being insurance commissioner.”

Praeger said she missed a pair of joint appearances with Carter because she thought it was more important to meet with representatives of a health insurance company that wanted to do business in Kansas. Another time, she needed to review the details of Aviva, the world’s fifth largest insurance group, buying the AmerUs Group.

Topeka-based American Investors Life Insurance Co. is a subsidiary of AmerUs Group.

“One of the things we’re dealing with here is I have a job and (Carter) doesn’t,” Praeger said.

Carter is an attorney. He said he tends to represent health care providers.

The brain surgery incident

Last week The Pitch, a Kansas City-based alternative weekly newspaper, reported that during a recent forum Carter shared that he had been made aware of a brain operation at the University of Kansas Medical Center that lasted 60 hours, after which the patient spent a month and a half in the hospital’s intensive care unit. He said the surgery cost taxpayers an estimated $600,000 to $750,000.

According to The Pitch, Carter noted that when the patient was ready to be discharged, “they put him on a a plane and flew him back to Mexico.”

A spokesman for the medical center later doubted there had been a 60-hour operation, costing more than $600,000. He declined comment on the patient’s nationality, citing privacy restrictions.

Asked if he exaggerated the length and cost of the surgery, Carter replied: “No, I have a relative who’s there at the Med Center.”