State Health Plan mess gets messier

imagesToday the SHP Blue Ribbon Task Force met to sort out some of the long-term problems with the insurance plan that covers more than 660,000 current and former state employees.

Although much of the meeting was a rehash of statistics we’ve all seen before, I found three bits of information especially enlightening.

First, the SHP is going to conduct random cheek swabs on all state employees to check for smoking status — we knew that. But the SHP administration has always said the random checks would be done at work sites.

Today, for the first time, SHP Executive Director Jack Walker said the random checks will now be done off-site. The SHP will require that randomly chosen state employees drive to an off-site lab or clinic to get a cheek swab before or after work. After all, we wouldn’t want to take up time at work for such fun activities as having a lab tech swirl a cotton-covered stick around in your mouth.

Second, low-wage workers make up a disproportionate share of smoking and obese state employees. Many smokers and obese employees make less than $25,000 per year. That gets to a fundamental unfairness with the wellness initiative — it punishes low-wage workers much more severely than high-wage workers.

If a state employee smokes or is obese the financial penalties are not adjusted according to income. All workers violating the wellness provisions go to a higher cost-sharing insurance plan.

For an employee making $25,000 per year the added out-of-pocket costs in shifting to the less generous plan could be devastating. For Jack Walker, who makes at least $200,000, the added expense is unlikely to hurt much. And for the highest paid state employees, who make more than $1 million per year, the shift in insurance plan is nothing.

Imposing a penalty for smoking is one thing. Crippling family budgets for using tobacco is quite another.

Third, there is a teacher serving on the Blue Ribbon Task Force who spoke eloquently to the burdens faced by low-paid employees. She described her friend who is a teaching assistant paying more than a third of her monthly income to cover her spouse.

She spoke of another teaching assistant who spends so much paying for SHP family coverage that she can’t actually see the doctor — there is no money left at the end of the month for co-pays and co-insurance. She noted several times that we should consider the people who are educating our children as the Task Force makes decisions.

I’m not taking bets on it, but I hope her message sticks in the minds of lawmakers.


  1. TT

    December 2, 2009 at 3:19 pm

    Wow….this SHP policy of testing is a serious invasion of
    privacy. Perhaps someone needs to test the members of this
    “blue ribbon task force”and check to see if they are actually
    pigs dressed up as humans!

  2. TT

    December 2, 2009 at 3:27 pm

    one more comment on this story: The teacher on this “task
    force” is probably sincere in her comments….but this
    is all about invasion of privacy and giving in to the corrupt
    power of insurance companies. The beat goes on….

  3. AdamL

    December 2, 2009 at 3:35 pm

    The Blue Ribbon Task Force isn’t responsible for the random testing … for that we can thank the SHP and the General Assembly. The Task Force is trying to set things right. Let’s hope they do a good job.

  4. m

    December 2, 2009 at 7:21 pm

    Hmm, so some busy employees might have to leave work, put wear and tear on their cars, use their gas and possibly have to rely on fellow employees to cover for them in their absence while they get tested? Bet they will also have to fill out leave slips to account for their time away from work!

  5. Rob

    December 3, 2009 at 8:58 am

    Smokers and the obese are a burden on our health care plan, it’s about time personal responsibility and common sense became a requirement. It’s unfortunate that we have to resort to random testing, but otherwise there would be rampant fraud, that we all end up paying for.

  6. AdamL

    December 3, 2009 at 9:05 am

    Actually, studies show that almost all employees tell the truth using an honor system. Almost every state that has examined the issue has found that random testing is not cost effective. That means you will end up subsidizing the random testing because the plan will not save enough to offset the cost of testing.

    Also, as I note in the post, why should low-income employees be held more responsible than highly paid employees?

  7. pete

    December 3, 2009 at 12:30 pm

    I guess they will soon want to test our levels of alcohol or red meat consumption, our sexual activity, how many hours we sleep or exercise…

  8. Randolph Hilter

    December 3, 2009 at 1:32 pm

    I propose random feats of strength tests, genetic predisposition screenings, family histories checked out, eyesight, hair color, religious and political affiliations, it is all very interesting, very telling of whether certain State Employees are truly worthy of health care. To insure the survival of our beloved SHP do not question or doubt the propriety of of these minor requests. Blind obedience and unquestioning loyalty is what makes us healthy and able to fulfill the our destiny to be a master race of State Employees.

  9. Vivian

    December 3, 2009 at 1:35 pm

    As for money, perhaps people could save more if they weren’t blowing it on tobacco products. They’d be healthier for it in the long run. My mom, who lives in another state, smoked for years and years. She now has emphysema and COPD and is on oxygen 24/7 even though she quit smoking 10 years ago. Wake up people. Tobacco isn’t good for you. It’s unfortunate that the state is resorting to these tactics but I agree with the poster who said that it’s time for folks to take some personal responsibility for their health.

  10. Vic

    December 3, 2009 at 2:28 pm

    Ha, ha! Randolph, i like the “random feats of strength” I can bench press 15 lbs. Will they make me eat protein shakes and forcibly administer steroids?

    Ummm, instead of going after the employees, maybe be insurance companies could require that corporations who sell addictive products foot the bill for the deductibles and the co pays. They are legally producing and selling the products that consumers are now being thrashed for using…Tobacco, Big Agribiz, etc… And people who want to shop at Weaver ST. and Whole Foods can get “safe eater” discounts, like car companies do for safe drivers….

    I’m just sayin’

  11. Adam Linker

    December 3, 2009 at 2:36 pm

    During the task force meeting, Chuck Stone of SEANC asked a reasonable question: If only one member of a family smokes could just that family member have higher cost sharing with hurting the entire family?

    The answer is that our enrollment system is not sophisticated enough to handle that. It just shows that these wellness provisions were not well thought out and the legislature did not take time to understand what is most fair and cost effective.

  12. Something Clever

    December 3, 2009 at 3:05 pm

    Vic – How is it “going after the employees” by making them pay based on the decisions they make? I agree much more with your statement about letting people who eat right and live in a healthy way get a discount as result. The whole idea of cost sharing has a huge drawback – it removes incentive to take care of yourself. That the world was a place where we didn’t have people who need a financial reason to live healthy, but we must deal with what we have.

    Like you said, safe drivers get a discount on auto insurance because they are lower risk. Low risk should give you a discount on health insurance as well.

  13. Randolph Hilter

    December 3, 2009 at 4:15 pm

    How much is it costing to administer these tests? Are the tests flawless? Does a person that doesn’t smoke and tests positive have a hearing? Who hears their cases? How is success measured here? By how many are caught? You have to have real trust in the tester that they are not looking to pad their stats to look good, feel good about that? Think it will be fairly administered and controlled?
    State Employees like myself earn health care, it is not a gift.
    I choose not to smoke, I enjoy a healthy lifestyle that includes hundreds of hours of exercise, but that is my choice. I fear bottom line health insurance corporations being able to make my choices for me and punish me according to their bottom line. It is sickening that our politicians even considered this intrusion of privacy.
    If you are lucky enough to be able bodied, remember, it is only temporary. My uninsured, unemployed friend with MS told me that.

  14. Adam Linker

    December 3, 2009 at 4:22 pm

    The administration will cost about the same as projected savings. No, the tests aren’t flawless. If you fail the cheek swab test you get — tada! — a blood test. That’s your appeal.

    The tests will actually be conducted not by the SHP but by a private company contracting with the SHP.

    True, state employees earn health care. And the more we treat employees like recalcitrant children the harder it will be to recruit good people.

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