I just read this over at Isaac Hunter's Tavern, the blog of local NPR reporter Laura Leslie, and was simply astounded. The state health care plan is in a major shortfall, as discussed elsewhere. So, what should we do to fix the problem? Adam Searing and Adam Linker think we should look at the administrator of the health care plan, of course we aren't allowed to look at them because the details are CONFIDENTIAL.
So, over at Laura Leslie's place we find out that:
House Majority Leader Hugh Holliman is proposing a 30 percent hike in dependent premiums over the next two years – an increase, he points out, that’s in line with what private business is dealing with. That would drive the cost of monthly coverage above $600, which would almost certainly push even more healthy dependents out of the plan and into the retail market where coverage is cheaper.
Before I get into the numbers, let me give you one more quote. Holliman wants to increase the amount that state employees pay for our health care. Because, well, we have it too good.
Just FYI, even at 100% employee coverage, NC still ranks 40th in health expenditure per employee. If you count dependents, NC falls to 49.
WE'RE FREAKIN' 49TH ALREADY! Who you shooting to take out of last place Rep. Holliman? Alaska? South Carolina? Do you really want to be the absolute WORST at something? Are you driven to make North Carolina ABSOLUTELY THE WORST STATE IN THE COUNTRY FOR STATE EMPLOYEES?
Now, Laura Leslie says that this 30% increase will lead to more healthy dependents leaving the plan. You betcha. Consider my dependents gone. Because that $600 is a fairy tale. I already pay $595.52 a MONTH to BCBS for my family health care coverage. Beyond that, I still have to pay $150 per person and $450 in total in deductibles before they begin covering anything. At that point I have to pay an additional 10% in coinsurance for everything up to $1000 per person or $3000 for the entire family.
So, my $7200 in premiums each year do not include the $450 in deductibles and the $1000-$3000 in copayments. PLUS, BCBS only pays what they THINK they should pay, not what the provider actually charges. So, if you go to an occupational therapist that charges $110 for a session and BCBS THINKS it should only cost $85, then those deductibles and copayments only include money inside that $85 range - everything else is on you buddy.
If Rep. Holliman jacks up the rates another 30% I will be looking at nearly $800 a month just to have coverage for my family. Add to that the $350 that you the taxpayer pay for MY coverage and you get $1250 a month to cover the whole family. That is $1250 x 12 months = $15,000 + $450 in deductibles + ~$2000 in coinsurance = $17,450.
Now, tell me again about that special plan that legislators have? How about letting me access that Rep. Holliman? Better yet, how about every legislator voluntarily agree to pay what I have to pay this year? Make it a donation to the state, and tell us how bad you feel for us right after you take a $17,450 hit to your wallet for Blue Cross Blue Shield health care.
I want Medicaid for my family. Have you ever consider it ODD that YOU THE TAXPAYER cover every Medicaid patient at a cost of $5,351/patient and BCBS covers State Workers for $4152/patient? I say it is odd because state employees are a fairly health bunch compared to some of the people on Medicaid.
For instance, Mental Hospital patients age 21 to 65 require $19,375 per service through Medicaid, while those in Nursing Facilities require $24,697 per service through Medicaid, and intermediate care facilities for the mentally retarded require $106,408 per treatment!
So, what you have in Medicaid is a mixed population of fairly unhealthy people which costs the federal, state, and county governments $5,351 per person. Meanwhile, BCBS needs $4,152 per state employee.
Nope, give me Medicaid. See, because Medicaid only pays $3,161 for AFDC ADULTS (Aid to Families with Dependent Children). That's it! That's all! But, what about copays?
And, there are deductibles. I can't find a list of what those deductibles actually are, but since BCBS copays are 7 times that of Medicaid, I'm willing to bet the same holds true for deductibles. No, Representative Holliman, if you really want to do what is right for the people of North Carolina you will open the Medicaid rolls to state employees and use the $4,152 in TAXPAYER money to cover each and every state employee. Then, you will allow state employees to buy into a Medicaid plan at a rate that will cover the health care they use, but will not RIP OFF the employees or the plan. After all, this is taxpayer money we are talking about, doesn't the legislature have a requirement to spend it in a fiscally conservative manner?