published Sunday, August 24th, 2014

Cook: County's health strategy

Healthcare Emails Welch-Adams
Healthcare Emails Welch-Adams

Somewhere inside the Central Office, there is a multiyear strategy to alter — dramatically — the health insurance plans for all Hamilton County public school teachers and employees.

But teachers haven't seen it.

Principals haven't seen it.

School board members haven't either.

But Ed Adams has.

He's the health care consultant hired by the county schools to help craft changes to the current insurance plan.

According to emails he's written, those changes are coming, and they're going to be big.

"A multiyear strategy to get medical costs under control," he states.

This week, the nine-member school board will take a step in that direction. They will vote to choose one of two options to reduce health care costs: 1) teachers will have to pay $100 more monthly to keep spouses on their insurance or 2) those spouses -- if they work -- will get booted from the county insurance and must sign up for insurance through their own jobs.

The first option can be a real gut punch, especially if you're a teacher making $38,000 a year with a stay-at-home spouse and three kids. Another $100 a month for insurance -- when you're already paying $433 -- may be irrecoverable.

Option two is also jarring. For some families, it would result in a net loss of income. That's right -- option two can be like taking a pay cut.

But as big as these two proposals seem, they are just the opening gambit, the first inning in a larger plan designed by Adams and a small committee -- Superintendent Rick Smith and a few other central office folks -- to redirect insurance costs from the county onto teachers and employees.

"Our recommendations for 2015 are just a start," Adams writes.

In an email to school board members, Adams reveals part of the county's strategy:

• Insuring fewer people in order to contain health care costs, while also shifting costs onto employees.

• So they have a vested interest in making wise health decisions and take personal responsibility for their health," he writes.

(Does that sound paternalistic to you? A bit condescending, as if teachers were golly-gee-clueless about their health?)

• A shift toward more high-deductible health plans.

"Our current strategy is to move in that direction in phases," Adams wrote.

But most of that strategy is kept secret. Adams and his committee studied many, many possible solutions that the county could adopt.

Like discounts for nonsmokers. Or health savings accounts. On-site clinics and pharmacies. Health coaches. Asking insurance carriers to craft new co-payment and deductible schedules. Adjusting dental benefits. Cutting long-term disability insurance.

Yet when it came time for Adams and the committee to make recommendations to the board -- and, by extension, the public -- most of these solutions were left unsaid, with board members having no idea they existed.

"[We] ... chose not to make recommendations on all these options in the first year, for many strategic reasons," Adams wrote.

Strategic reasons? This is not a war. Teachers aren't the enemy. There should be no secret objective to slip in health changes while no one's looking. Teachers and board members shouldn't be treated like last-to-know doormats, only told about insurance changes when the time seems Art-of-War-right to a central office committee.

"I don't particularly like to blindly recommend any multiphase strategy," said Jonathan Welch, District 9 board member, in an email back to Adams. "It's poor policy and poor stewardship to everyone."

Last month, Welch challenged Adams on his recommendations; their question-answer-question email exchange is available online with this column, and if you're at all interested in public education please -- please -- read it.

Because we are facing a come-hell-or-high-water decision in Hamilton County: How will we treat our public school teachers in the future?

They've lost their collective bargaining rights. Standardized testing pressure grows. Funds run dry. We continue to lose good teachers to Georgia, where salaries are higher.

Whether anybody remembers it or not, we entered into a social contract with our teachers: You educate our kids, and we will take good care of you.

Decisions about that care should belong to all of us -- responsible board members, outspoken teachers, concerned citizens -- and not just tiny committees.

Contact David Cook at dcook@timesfreepress.com or 423-757-6329. Follow him on Facebook and Twitter at DavidCookTFP.

about David Cook...

David Cook is the award-winning city columnist for the Times Free Press, working in the same building where he began his post-college career as a sportswriter for the Chattanooga Free Press. Cook, who graduated from Red Bank High, holds a master's degree in Peace and Justice Studies from Prescott College and an English degree from the University of Tennessee at Knoxville. For 12 years, he was a teacher at the middle, high school and university ...

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aae1049 said...

Perhaps it is time for all governments to pay a percentage of salary for benefits, and allow employees to purchase the insurance they wish to have through ACA, or the Obamacare that you supported David. Isn't ACA intended to serve every American, but Congress who has a special plan?

August 24, 2014 at 1:04 a.m.
zulalily said...

What David Cook seems to ignore is how much health care and insurance premiums have risen since Obamacare took effect. As a couple who aren't old enough for Medicare but have retired from jobs that don't have health insurance in retirement, our premiums went up 25% this year and our co-pays and out-of-pocket expenses are over $10,000 a year. With premiums and out-of-pocket costs, we will pay over $20,000 for healthcare this year and we do not qualify for a subsidy. Teachers, according to an article in this newspaper within the past couple of days just are barely short of having a "Cadillac plan" that requires almost an unheard of small amount out of their own pockets. As a taxpayer, I see no reason why the county should be paying premiums for working spouses. I agree with commenter "aae1049" that it is time to give a flat amount to each teacher and let them purchase their own insurance. That is the most equitable way to handle the situation. Times are changing and I don't like the insurance deal I am getting, but I spent years as a public school teacher before changing careers and I was the only one in my family covered by my health plan. Teachers need to understand that if they don't like the new deal on healthcare, then they should vote republican!

August 24, 2014 at 11:03 a.m.
aae1049 said...

I have been learning more about this great idea to further socialize health insurance, as the Dems supported. However like David, they seem to talk out of both sides of their mouth. Let's put government workers on ACA.

With private insurance ruined by ACA, the reality is that public employees and government needs to get out of the benefit business, and trying to maintain an unsustainable standard. We know as an estimate that all benefits of local and state governments are equal to about 30 to 40 percent of their gross salaries, this would include leave benefits, health insurance, public contributions to retirement plans,.... Instead of trying to maintain specific plans, it would be better for the taxpayers to simply provide the 30 percent or more directly to the public employee, and let them purchase the benefits they wish to have, rather than the taxpayers selecting specific programs. It causes too much conflict and distraction. So, here is your percentage for benefits, go buy what ya want. It is also safer for the employee to control their own pension funds. I mean who would you rather have managing your pension funds, 1) Andy Berke, County Commission or Gov. Haslam, or 2) you and your savvy brokers.

August 24, 2014 at 1:03 p.m.
GameOn said...

Teachers deserve every benefit they get. Twenty years ago, the job required far less work outside of the classroom. 10 to 15 hours total for the week would cover it. Today, the job is quite different and you can forget the old stand by line ..."they have summers off". I am married to a veteran teacher and I can assure you that she has no life of leisure. She works a minimum of 4 to 5 hours every evening at least four nights a week, 8 to 10 hours on Saturday, and another 6 to 8 on Sunday. This past summer, she spent around 30 to 35 hours per week working on school materials for the coming year. She has a love for learning, a love for teaching, and a love for mentoring children.

The job of a teacher is mentally and physically exhausting. Teachers have the daily stress of educating, disciplining, and keeping up with 20 students a day. Plus, our teachers are no longer are allowed to sit down in the classroom. They are required to be moving around the classroom at all times. A few years ago, my wife wore a pedometer to work and she walked 8.5 miles in the classroom for the day. Most teachers don't even get a bathroom break until class is dismissed for the day. Our teachers will need good insurance for the replacement joints, bladder tucks, and blood pressure medications in their future.

Before you envy the salary and benefits of a teacher divide it by 70 hours instead of 40. Just another great example in our society of professional people being paid unprofessional wages. It just goes to show how screwed up our country really is. We care more about football than education. Don't believe it, look up the highest paid state employees in the United States.

I would strongly advise any student considering a career in education to find anther career and anyone thinking about marrying a teacher needs to think twice. I feel like I'm single most of the year.

But teachers have summers off.... In the words of Joe Biden... BFD!

August 24, 2014 at 11:19 p.m.

aae1049 wrote: " . . . it would be better for the taxpayers to simply provide the 30 percent or more directly to the public employee, and let them purchase the benefits they wish to have . . ."

That would perhaps provide some solace to the already underpaid teachers of Hamilton County. However, there is no evidence to suggest such a plan is in the works. Additionally, the flaw with this logic is that by creating millions of individual consumers of insurance products, the power of large organizations to bargain for lower rates will likely encourage insurance costs to continue to rise. Perhaps we should also give a stipend to those on Medicare and Medicaid and send them off to fend for themselves.

August 28, 2014 at 6:23 a.m.
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