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June 19, 2003
Only in Government
You don't have to work in government to know medical costs are rising. Hence, it was not unreasonable that the Hawai'i legislature, looking for a way to cuts costs (since it didn't want to raise taxes), recently eliminated one of two medical plans available to state employees.
Up until now, the state had one health plan and the public employee unions had another. It was up to public employees to choose which they wanted but the cost to the employee was the same whichever plan they chose. The unions, having an incentive to provide the best plan for their members as possible, negotiated with providers to do just that. Conversely, the state, not concerned with anything other than cost, negotiated one low on cost and therefore low on benefits.
Not surprisingly, those employees who belonged to unions tended to choose the union plan. But as the cost of health care skyrocketed over the last few years, the state decided it had to do something. That something was to eliminate the union plan.
Whether this was fair or moral or right is not the focus of this essay. Those values would be Good Things to have in government but in these tough economic times perhaps it is too much to expect of our elected officials.
But having made the decision to eliminate the union plan, the department responsible for transferring something like 90,000 people from one plan to another got into gear. Unfortunately, it appears it was "reverse" gear instead of forward.
It appears the planning for the transfer was not up to the task. The period of employees to make the choice (state plan or nothing) was one month long. After that, the department had one month to key-in all the changes before the July 1st deadline. The changes were submitted on a four page form full of data items.
It does not take a psychic to guess that 90,000 such forms would take time to input. It turns out it will take more than one month. It may take as long as two or three. If this occurs, all of the people whose forms have not yet been inputed will, for purpose of eligibility and billing, be shown as not having any medical/dental/optical coverage at all.
This means if I go to the doctor, dentist, or optician they have a choice to make: turn me away or take the chance that I have coverage even though the computer system will say I don't. This is a difficult position to put a provider. Not only because of the immediate economic liability, but even if I do have coverage, government systems being what they are, who is to say the current computer system can handle back-dated invoices? I can imagine all kinds of technical problems that will keep providers from getting paid. Should this happen, my guess is I will end up paying the provider directly and it will be up to me to try to get reimbursement from the state.
Having worked for the state for almost 20 years, the probability of getting reimbursement is about equal to a frozen di-hydrogen monoxide sphere in Hades.
Aloha!
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