In a stunning decision delivered last week with no explanation, California’s Department of Managed Health Care agreed with Blue Shield of California that the nonprofit, which has enjoyed a tax exemption for over 70 years, has no duty to operate for the benefit of the community. Blue Shield can spend the billions of dollars in assets it holds without any regard for what's best for the community, according to the state health plan regulator. The decision came in connection with approval of a $1.2 billion acquisition of another health plan by Blue Shield. I’ll have a lot more to say about this later. But for now, just know that the decision is not the last word.