Editorial: Cooperation not Folwell's confrontation, will control State Health Plan costs

Posted July 12, 2019 5:00 a.m. EDT
Updated July 12, 2019 8:05 a.m. EDT

CBC Editorial: Friday, July 12, 2019; Editorial #8443
The following is the opinion of Capitol Broadcasting Company

Today more than 700,000 North Carolina government workers, retirees, teachers and their dependents are less certain about how much they’ll be paying for health care. They were promised they’d pay less and the State Health Plan would reap big savings.

Unless there is a dramatic change soon, the bungled approach taken by State Treasurer Dale Folwell likely means greater out-of-pocket costs for those who depend on the plan to cover their health expenses.

Folwell said he was going to reduce payments to providers by $300 million to $400 million – and those providers were told to take it or leave it. Absent any dialogue and negotiation, nearly every provider opted to leave it. Now the entire State Health Plan is in jeopardy.

This is not how good employers treat their employees. That’s not how to get control of a health care system that nearly everyone agrees is plagued by high costs that need to be reduced.

If he truly wants to improve the health plan, make it more efficient and less costly, first off Folwell should be North Carolina’s strongest advocate for expanding Medicaid.

That would do more to control health care expenditures by cutting the costs hospitals MUST pay – hundreds of millions of dollars -- to treat patients who can’t afford their bills. Image the impact on medical costs if the federal government covered almost all the expenses, instead of providers, for up to 650,000 citizens who now can’t afford medical care coverage.

Last October Folwell decided, with little discussion or input from those providing the services, that he would end current practice of negotiating with hospitals and other providers on costs. Instead, he’d impose a set of standard rates for services – mostly tied to what the federal Medicare program pays.

His vision wasn’t shared. Just three, relatively small providers signed with the state by the deadline last week. As a result, it is more than likely that those 700,000 who are covered by the state plan will find out-of-network charges, depending on the service or procedure, anywhere from twice to 10 times more than the set fees. Patients are responsible for the difference.

Instead blustering and bungling, Folwell should work with providers sincerely to develop a consensus on fees and rates. Now, there is no discussion or bargaining. The outlook is that patients will pay more and taxpayers won’t save anything.

Ego-driven brinksmanship yields nothing.

Folwell can demand and stonewall all he wants. But it isn’t working to get the coverage those in the State Health Plan need at the reduced costs he’s promised.

If Folwell sincerely believes his job is to work on behalf of those covered by the plan – the teachers and teachers and state workers of North Carolina – he needs to step down from his soap box and work with providers on a deal that reduces costs and serves the state.

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