Within the industry - and from existing and former staff members - there are questions over the management "churn" that has taken place since Mr Bowie started a wave of restructuring nearly five years ago.
Mr Bowie, widely credited as a "big-picture man", has concentrated on developing the vision and the big strategic shifts Southern Cross needed to make to grapple with a rapidly changing health sector.
To implement Southern Cross' strategy, he eased out a raft of managers he had inherited from the 25-year rein of his predecessor, Peter Smith.
Out the door went hospitals manager Lois Kritos, general manager David Turner and sales chief Maxelyn Tudman. Of the seven-person executive team Mr Bowie inherited, only group marketing manager Paul Retgien is still there seven years later.
This is par for the course in much of corporate New Zealand. But the subsequent rate of churn has confused outside players. Many senior sales managers were made redundant and with them disappeared some close relationships that had strengthened Southern Cross' insurance book.
The basic business was split into healthcare delivery and healthcare finance divisions headed by new general managers Dr Lesley McTurk (hospitals) and Robin Milne (finance). Mr Milne has also moved on and so, too, has George Jepson, the chief operating officer appointed in late 2000 to oversee the detailed business.
A look through Southern Cross' last five annual reports is surprising for the extent of the musical chairs game.
But the big shift in culture has not been matched with a general uplift in operating performance, as credit rating agency Standard & Poor's notes.
The industry is now questioning whether Southern Cross needs to refocus on its basic business: processing health insurance claims efficiently.
Questions are also emerging over Southern Cross' governance, particularly whether chairman Hylton LeGrice, a cultivated consulting surgeon, has a sufficiently strong personality to monitor and coach his chief executive.
Mr LeGrice and Mr Bowie have a very close relationship.
Mr Bowie says they talk, "sometimes up to three times a day", as they try to keep on top of the public relations disaster.
Some ill-chosen words by Mr LeGrice have not helped the situation - a "glitch" that was not of concern to the board.
Mr LeGrice may have been trying to keep the issue focused as an operational problem, but it has deepened perceptions that Southern Cross has become arrogant.
It is the second time Mr LeGrice has been in the hot seat in the past year.
As an independent director of the Montana Group, he spent many hours last year defending the interests of minority shareholders as Britain's Allied Domecq and Lion Nathan battled for control of the country's premier wine producer.
Last October, as members gathered for the annual meeting of the "not-for- profit" Southern Cross, there were concerns over rising premiums and a fall in service levels.
It was a heated affair. But Mr LeGrice and director Jeff Todd - a well-respected Auckland consulting accountant and former national head of Price Waterhouse New Zealand, were elected without any difficulties. So, too, was trustee Bryan Kensington, who has extensive experience as a company chairman and director.
But there are suggestions that the board will face challenges at this year's agm. Businessman Robert Gapes, a former IBM man, has been mentioned as a potential candidate for a seat on Southern Cross' board.
Mr Gapes would not confirm his intentions to the Herald. But the Environment Court commissioner is reliably understood to be among the well-connected names who would like to bring stronger governance to Southern Cross.
Mr Bowie has a strong personality. Deeply analytical, he has driven rapid organisational change from behind his senior managers for seven years. He is not seen by staff as a people person - that role has been left to his managers.
It has been a big task for any executive. But Mr Bowie felt no qualms in taking on the challenge.
In April 1995, longtime chief executive Peter Smith advised the board he intended to retire the following year.
After 25 years as head of New Zealand's largest medical insurer, he felt it was time to move on: Southern Cross had been run on the "smell of an oily rag" for too long, and a major reappraisal was needed of its place in the new health sector environment as the changes wrought by the Health Funding Authority took centre stage.
Mr Smith left behind a membership that was growing for the first time in five years - the total stood at 876,464 in June 1995. Average claims turnaround was three to five days and many staff had been with the organisation for years.
But sentiment did not disguise the fact that a significant internal restructuring was needed. Mr Smith had a good idea what needed to be done, but felt it was better that task be carried out by a new chief executive.
Mr Bowie had wanted to come back to New Zealand from Europe to raise his young family and to run a company. But he ended up running a not-for-profit healthcare co-operative.
It was his ability to lead change and apply a customer focus that brought Southern Cross and Mr Bowie together, he said at the time.
It was a big step down for him: Southern Cross' turnover was then $300 million compared with DHL's $3.5 billion.
"I drive the business hard, I work hard, I set high standards and fundamentally my strength is in the creation of 'what' and getting good people around me to implement it," he told the National Business Review.
"I want these people to stretch themselves to achieve the 'what'."
His strategy included the expansion of Southern Cross into further private hospitals and the integration of the industry with the move to form affiliated service providers.
Getting medical specialists' costs down was a priority in times of rapid medical price inflation which last year reached between 7 per cent and 8 per cent, with surgical costs even higher as the price of technically advanced procedures escalated and the low dollar pushed up the cost of imported supplies.
But the price of Mr Bowie's strategy has been a huge increase in underlying business expenses. He admits the increase in expenses - running at 12 per cent - is "nothing to write home about".
He said they should get back to historic levels as the investment in new technology paid off, systems were bedded down and overhead ratios were reduced.
"By any measure, 12 cents in the dollar is a very good figure if you look at cost ratios in general insurance which are generally in the 20s," he said.
"The most recent Australian experience in our business has seen ratios at 14 to 16 per cent.
"We have to keep pushing that lever. Part of the reason for the investment in the new Diamond computer system was so we can get savings."
Industry critics say Southern Cross should have learned its lessons over computer problems by now.
In its 1999 annual report, the insurer had to apologise over claims-processing delays"which to members used to rapid turnaround have been unacceptable".
The report says: "For this we apologise. Those problems are on the way to being resolved ... We must anticipate and prevent problems in the future as we change our businesses."
Costly strategies to establish Fusion, a workplace insurer, against advice from the Labour Party that it would pull the plug on a competitive environment for accident compensation, have been cited by former managers as foolhardy.
So too, the expense of bringing in consultants Kaiser Permanente, partnerships with Marlborough Transitional Health Trust and various technology investments that have since been abandoned.
"These have flowed through to increased premiums," said one former manager. "We used to pride ourselves in keeping costs under control."
Processing time for claims has tripled since the Bowie regime began and there have been concerns from Aetna members that Southern Cross' problems may spill over to affect them now that their insurer has been swallowed by its bigger competitor.
Reducing the cost of administering claims is also a focus for Southern Cross.
"It is still a very paper-based system because of the fragmentation of a billing system, the focus on primary care cover and lots of small receipts floating around," Mr %Bowie says. "Over time electronic commerce will enable us to further the efficiencies."
%Southern Cross is perplexed that surgical claims are running much higher for January than previous years. The insurer will not disclose current figures - providing details for late 2000.
"If you look at the last five years we have seen generally in January-March a drop-off in claims. We didn't see it last year, we haven't seen it this year," says Mr Bowie.
"Within that context there is a segment which we do see every year and which we will see because the hospitals shut and we haven't seen it yet. But that will give us relief in terms of processing surgical claims."
Mr Bowie is hopeful that the industry decline that has seen many members stop paying premiums has now bottomed out at about 33 to 34 per cent.
"The market is tough for everybody - lots of pressures on discretionary spend and the young consider themselves as invincible, so that is a tough segment for everybody and I don't think anybody is doing all they would like to with that segment.
"We are not seeing cancellations of our senior members - we are doing everything we can to hang in there."
But one thing is clear: unless Southern Cross' operational performance improves, the rising cost of premiums will continue to put pressure on its members' ability to keep up payments.
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