state health benefit plan georgia

state health benefit plan georgia - Our state is struggling, as are countless governments across the society, with rapidly rising healthcare costs for its employees. As we have seen in Georgia, boss are taking a lead role in negotiating with insurers the best transactions for their governments, with expense containment being a top priority.


As recent events have indicated, state employees are locked out of the policymaking and monetary decision process. In Georgia the nearly 600,000 state employees and their families have no representation on the board of the Department of Community Health( DCH) which prepares plan for the State Health Care Benefit Plan( SHBP ). During the most recent crisis, when United Health Care was selected to administer the SHBP, DCH board members themselves claimed to have no knowledge of the plans and negotiations that preceded the move to United Health Care.

While the superintendent and its personnel have made the key decisions with limited or no input from the DCH board and absolutely no input from the 600,000 enveloped state employees and their families, recent policy decisions have resulted in higher fees, higher deductibles and higher out of pocket costs for these employees and their families. Many of them report weakened aspect of service and a decline in the accessibility of health care providers.

The recent change in the SHBP, which began January 1, 2006- designed to save the organizations of the system nearly $60 million yearly- is for UHC to become the plan administrator. Providers around Georgia, very conscious of UHC's cost containment priority around the nation, were reluctant to sign on board the UHC network, thus leaving large portions of the state without providers.

Both places- both providers and UHC- appeared to be using the resulting disapproval from state the workers and their families to drive peace negotiations in their spare. While some providers have recruited with UHC during the past few weeks, many more are continuing to negotiate, maintaining out for the most favorable layout and leaving many thousands of state employees and their families in limbo, waiting to see if their physician or infirmary attaches the network or not.

The current system, with decision and policymaking in the sides of a very few, and virtual privacy smothering those monetary and policy decisions, establishes needless disorder, indignation and puts state employees and their families in a constant statu of reacting to the latest real or perceived "outrage" wreaked, perhaps unwittingly, by a superintendent and an busines who claim to be providing an employee benefit and service.

While accepting the very real crisis in health care, PAGE belief the entire process needs to be "opened up" so that SHBP policy decisions are more transparent, the economics of a state health care design more open to public understanding and explain, and we are starting make policy decisions on the basis of input- not just from the "bean counters"- but input from the hundreds of thousands of insured state employees and their families.

Cost is certainly a lawful priority for policymakers to consider, but if expensed is the sole thought, then issues of quality and access are secondary at best, if not rejected fully and state works as well as the general public are all poorly served.

To that culminate, PAGE proposes the following steps be taken:

- Pattern of a fifteen representative State Health Benefit Plan Advisory Committee composed of educators and state employees who are covered by the plan. The group will fill quarterly and will be involved in all SHBP policymaking activities, including but not is restricted to, plan administration, design motif, design changes, qualitative its further consideration of design work, scope of services that are, networks, etc. These working groups will recommend design changes to the superintendent, members of the legislative council and the DCH.


- Appointment of a Executive Study Committee on the State Healthcare Benefit Plan, with members to be referred by the Governor, the Speaker, the Senate President, PAGE, GREA, GAE, GSBA, GSSA, and GAEL. The committee will be charged with maintaining a series of public cross across the state to hear from citizens, providers and others on their own views of the status of the current design and their suggestions for plan improvements with regard to access, aspect of service and design expenses. The committee will fill quarterly through 2006 and publish a final is present in December 2006 with findings and recommendations to be acted upon during the course of its 2007 session of the General Assembly.


- The superintendent and the Department of Community Health will contract with a Georgia school of our policies for a state by state cross-examine and analysis of inventive state healthcare plans across the society with particular attention paid to expense, access and aspect. This investigate will be conducted during 2006 and the school will form quarterly reports and presentations of their findings at each of the Legislative Study Committee cross. A final report with summary recommendations will be made by the contractor to the superintendent and members of the legislative council in December 2006.

Everyone involved in the SHBP situation must realize that healthcare nationally is in an economic crisis. That crisis does not stop at the state wrinkle. But accepting the immensity of their own problems should not prevent good faith assaults at solving the larger, long-term, structural problems within the system. In the coming daytimes, PAGE will be working with the superintendent, parliamentary masters and others to inaugurate putting in place safeguards and processes such as we list above. supplying a organisation of state health care benefits to several hundred thousand employees and their families in today's financial and health care home is a daunting chore , no question. But "its by" doable and it does not "ve got to be" done as it has been this year. Surely we can all do better than this.