Friday, May 29, 2009


I'm typically not one to engage in heated discussion surrounding political or societal matters. Of course, I recognize the absurdness of our political leaders and policymakers. These days, it is especially easy to see as they ineptly react to an economic situation that they laid the path for. But then, as I said, I may hear the latest news... quickly anger, and just as quickly let it wash away.

Well, today happens to be the final enrollment day for our reformed state benefits. Health care copays, premiums, & deductibles are on the rise. Quality coverage is sinking. Anyway, this morning, I opened my inbox to see that my online paystub was available. Payday is always a good day. However, as I viewed my deductions, some voluntary (most were involuntary), I became more frustrated and disillusioned with where we are as a state and country. The amount of tax I donate in addition to the high premium of health care that I pay is starting to impact ME. ME: the person who is thankful for and loves his job. A job that is stable, supportive and enriching. If mediocre health care coverage is still on the rise and is affecting MY family's economy, what is it doing to those that have lost income, lost their benefits, or worst... lost their job(s) entirely? Now is not the time to raise so grave as health care coverage.

Here are the changes (ironically, they called them "highlights") to my health insurance (taken word-for-word from an employee notification):

"Because the legislation for the State Health Plan was just signed into law on April 23, this annual enrollment is being conducted later than normal for a July 1 effective date and with a very short timeframe. Return your completed form AS SOON AS POSSIBLE." Thanks for the rush!

$: Deductibles, copays, and the coinsurance out-of-pocket maximums will increase under both the PPO Basic (70/30) Plan and the PPO Standard (80/20) Plan. They got rid of the coverage option that provided the highest quality of care.

$: Routine vision exams will no longer be covered as of Jan. 1, 2010. Sight probably isn't all that important for my day-to-day work.

$: Preferred brand copay (without a generic available) will increase to $35. Uppercut!

$: Non-preferred brand copay will increase to $55. Kidney blow!

$: Specialty Drug Copays... a coinsurance of 25 percent will be charged for specialty prescription drugs up to $100 for each 30-day supply. So the folks that are really sick are "highlighted" too.

$: On July 1, 2009, there will be an 8.9 percent increase on all coverage tiers (health plans). So for someone with a spouse and 1 child, you'll pay at least an additional grand this year for subpar coverage.

$: On July 1, 2010, there will be another 8.9 percent increase on all coverage tiers (health plans). And you'll pay it again, next year!

In addition to these hikes, NC is one of the few states adopting lifestyle penalties, which they refer to as "Healthy Lifestyles Initiatives."

As they described it:
"In addition to the benefit changes and rates increases outlined in this email, the State Health Plan will implement comprehensive wellness initiatives to support healthy lifestyles, focusing on tobacco use and unhealthy diet/physical inactivity. According to the State Health Plan, these areas are the two leading causes of preventable deaths in North Carolina.

The recent legislation includes a provision for the Plan to ask members to self-report tobacco use and weight status during annual enrollment. The Plan is currently assessing procedures and rules around the tobacco and weight management programs, and will make these available for public comment prior to program implementation."

Basically, individuals that smoke or have a higher than normal "body mass," will have to pay a higher premium. I understand that these workers typically have more health issues with more frequent doctor visits, and thus cost the employer more money. However, policymakers state that this plan was initiated to promote state employees to adopt a healthier lifestyle. Obesity and addiction are complicated behaviors. Behaviors that take years and much support to change. The notion that having a smoker pay a couple hundred dollars a year will get him to quit is absolutely absurd. The fact that it takes time to adopt these positive, yet challenging, behavior changes is a cash cow that insurance companies can milk from, year after year. In addition, it has been shown that tighter household budgets mean families adopt less healthy lifestyles. They consume more inexpensive, fast food. Cigarette and alcohol sales rise in poorer communities. It's quite an unfortunate cycle. It's very depressing that our leaders continue to exploit the growing number of economically disadvantaged families.

And don't get me started on my pay-cut. Oh excuse me, they call it a "Flexible Furlough Reduction." What an unscrupulous world we live in.

For those that are interested in NC public policy,The Progressive Pulse is a solid blog.

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