Latest / The SEANC View / Inside the State Health Plan's fight for lower costs

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Inside the State Health Plan's fight for lower costs · The SEANC View

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Hello, and welcome to another edition of the Scenic View podcast.
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I'm Jonathan Owens, along with Artis Watkins, Suzanne Beasley, and Samantha Klein.
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The members are restless. Yes, they are. And we have lots to talk about.
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Coming off of last week's great podcast with State Treasurer Brad Briner and
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Thomas Friedman from the State Health Plan. Still lots of questions to answer, so let's get to it.
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Lots of questions still remain about the state health plan's new tier system.
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We posted stories this week about that. There seems to be a PR push from the
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hospitals that are not part of the preferred or access plans or tiers. And so...
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Got everybody lit up. Yeah. The one Facebook post, I think it had about 200 comments.
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So several comments from the same person and several more from another person.
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So people were very interested in this topic. And I think we still have some questions to answer.
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Not that we didn't do a good job of it last week, because we did have the people
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in charge last week. So but let's just try to kind of go through a few questions that we got.
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Because it's complicated. This is a, there's no way to do this simply because
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there's no way to do what we need to do, which is what Falwell wanted to do,
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which is say, here's a ceiling. This is the most we'll pay anybody, period.
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You can't do that. The legislature clearly said, yeah, they said,
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no way. It's, you know, it's being mean to the hospitals. We don't want to do it.
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So Treasurer Briner was left only with the ability to do something a little more complicated.
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But it was that or some pretty dire circumstances.
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Yeah. If he didn't do anything. And right out the gate, because,
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you know, there were some comments about advocacy on behalf of state health plan members.
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But I'm not sure everyone realizes what a huge lobby the hospitals have and
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how much money they have to, you know, try to keep things from happening that
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hurt their bottom line, so to speak.
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Not that they're hurting. Yeah. And I think that people expected us to,
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you know, oppose this vehemently.
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I'm not saying that we don't oppose parts of it, but this is what we've been
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pushing for for 15 years, right? I mean, some form of— Yeah,
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to stop getting ripped off by hospitals has definitely been a huge part.
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It has had to be a huge part of the agenda.
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The bottom line is we cannot get transparency. We can't know.
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No one outside of the health plan and those hospitals, individual hospitals,
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and the third-party administrator can know what the agreement is between the
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third-party administrator that the state health plan hires and the hospitals.
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What we do know is we're paying them a range. And at one point in time,
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that range was anywhere from 80% of Medicare as a reference for reimbursement
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all the way up to more than 800% of Medicare.
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We also know hospitals can operate efficiently and safely and make a profit,
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at somewhere around 200.
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And I guess we've always said that we're tired of them making a profit on our
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backs and counting on the state health plan to pay more to take up.
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They've been very, John, they've been wildly open over the years in,
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state health plan board meetings going way back that the state health plan,
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if it paid less to providers, that would be a tragic thing across the hospital
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systems because that's subsidizing the care of people who are not state employees and retirees.
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Y'all, if you're a state employee or retiree and your state health plan is overpaying
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hospitals to subsidize the care of other people, understand that that means
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there's less money available for raises or COLAs.
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And there's more money coming out of your pocket than needs to come out of your
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pocket. That means more in cost for you.
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Right. You're paying more for other people.
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Period. And we oppose that.
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Very much. We oppose that. However, you have to get to a place where that's
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not happening, and that includes transparency.
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And we're not going to get the transparency. There is a law in place that says
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it's a trade secret exception to the Public Records Act to know what these hospitals
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are getting paid. Exactly.
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So we can't get that. Can't have it. Yeah. One comment that I sent to you was
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someone said they have to report as far as.
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They're thinking about. Yeah. But they're reporting just standard prices and
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they're not reporting what is contracted with the state. Correct.
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And that's probably higher. Right. Much higher. Well, yeah. And you can call
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a hospital and say how much is a colonoscopy at your hospital.
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But you you could call every hospital you want to and find that out.
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You don't necessarily know all the admin fees and everything else that you're
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going to get hit with. And the third-party administrator negotiates all that mess.
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Yeah, this is never, it's never just black and white. Never.
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It's not black and white. And that's on purpose, right? Well, I'm certain. Yeah.
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Well, and people love their hospitals. Yeah. Because hospitals are where we
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give birth to our babies.
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It is where we see loved ones get saved. Yeah. Their lives saved or get treated
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and their pain and suffering alleviated because they've been treated when they need it.
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So, of course, we love hospitals, but we don't love hospitals in terms of the business of hospitals.
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We love the doctors and nurses working in that building and the janitorial staff
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and everyone else that functions to be a part of us getting better.
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But what you're paying is not for those doctors and nurses. That's not who's
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getting rich out. In fact, in most cases, they're woefully underpaid.
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What you're paying for is what we call the C-suite, you know, CEO, CFO, COO.
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There are such deep layers of administration in hospitals in 2026 compared to
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what there was a decade ago, certainly two decades ago.
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Yeah, I thought Treasurer Briner had a point that I had not really ever heard
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before, but he said that they're considered non-profit, but only because they
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are supposed to give away like
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charity care, right? It's not the same non-profit thing that we think of.
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Right. Yeah. People think it really means they're not. So like people hear,
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oh, my hospital is non-profit. They're not getting rich. Like,
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what are you talking about? This is not true, but it's not the same thing.
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Your hospitals, definitely.
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Now, some tiny hospitals are barely getting by.
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They're not getting rich. They're not throwing insane money at individuals.
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But the two hospitals right now, let's just take the ones that are yelling the loudest.
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Yeah, I was going to get to that. Yeah, go ahead. I'm going to shove you into
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it. No, I was just going to say that the big PR push this week was to kind of
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paint Atrium and Wake Med as the victims here.
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Would that be what you would suggest?
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What did you think of the—they came out the gate saying, we had no idea this
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was happening, and we had no input.
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And the treasurer's people obviously had a timeline. They came with some receipts.
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So they— Yeah, come on. I mean, Treasurer Briner's not going to come with receipts,
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if anybody knows them at all.
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Not going to not come with receipts. And again, as we say often,
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no one gives the health plan more grief than scenic.
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I mean, because we are so mad. We wouldn't even have to have a premium for state
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employees if years ago somebody had had the courage to stand up to what Dale
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Falwell used to call the cartel.
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I don't know if cartel is the best example, but I see why he said it.
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Right? Because what happened was, for years, hospitals just acted like,
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you know, you can't touch it. I mean, okay, yeah.
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You want to pay us less than what you're paying us? We won't see your people.
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So if they're so concerned about patients, what? Like, let's talk about what
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Atrium and WakeMed have.
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Atrium, well, first let me say, the amount of reserves that the state of North
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Carolina has for hurricanes, any other disaster across 100 counties, is $4.2 billion.
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That's what the state has. Atrium by itself has $10 billion in reserves. Billion with a billion.
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And that's just one hospital. They are the biggest.
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And their CEO makes, what, $26 million a year? Right. Yeah. And apparently there's
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quite a few people in the C-suite making multi-millions.
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And they want the state health plan to subsidize care for other people in the state.
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I mean, you can be left with no other conclusion if, I mean,
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I don't know what they want. Here's the deal.
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They would not give a rate, apparently.
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I mean, if they're not a preferred provider, it means they didn't bid with a
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rate that's anything other than way too much. Yeah.
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And this hasn't been a secret that the state health plan, you know,
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was working on the tiered system.
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I mean, that's been publicly discussed. So the timeline, John.
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Might be a good time to throw that timeline out. When did Atrium know?
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Because if you live in the area, and by the way, I can understand,
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if I lived in an area where atrium was pretty much everything. Yeah.
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I would be freaking out right now. That's the part I wanted to talk about.
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That is a lot of our questions. Yeah.
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And we'll get, let's get to that in a second. I'll go over. Okay.
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So the timeline, the state health plan met with Atrium in March of 2025 to explain
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this whole program. So that's more than a year ago.
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They met with all area hospitals in August and September about Lantern.
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Thomas Friedman met with Atrium specifically on November 11th, 2025.
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Lantern contracts were awarded in March of 2026.
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The State Health Plan Board of Trustees approved preferred structure on March 17th, 2026.
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Treasurer Brad Briner met with Atrium CFO and CEO in May and June of 2026.
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And Treasurer Briner even said at the State Health Plan Board of Trustees meeting
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on June 5th, the meeting before the one where this one was announced,
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that nothing is finalized.
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So they had a chance to continue to negotiate So many chances The treasurer's
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office posted that publicly Atrium, I've not seen it anywhere Where they have
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publicly taken issue Said any of that was false.
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By the way, this is If anybody from Atrium is listening Come on the podcast
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If the treasurer's office is lying Please come on here and let's talk about
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it Or Wake Med, too I mean, they're right here We hadn't even gotten to them,
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But they're about to be They're the same thing About to be one and the same, right.
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Now, getting back to the point about rural hospitals, we did have a lot of comments
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about counties where there weren't any preferred or accessed providers.
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And that even showed up at our board meeting this weekend when Thomas Friedman
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came and gave a presentation about this plan.
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Some of the board members had some heartburn about that. And I think we are,
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very concerned about those situations.
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There are a few counties where there are only non-preferred.
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I think Thomas Friedman had said they are working on some possible solutions
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in those areas, but nothing is finalized.
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Well, and something to keep in mind, too, if you have an emergency and you're
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in one of those areas, yeah, your care would be treated under the access tier.
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So don't not go to your hospital and go drive in an hour away or two hours away to another hospital.
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Go to your hospital because your emergency care will be treated as an access
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provider. Because let's remember what preferred doesn't mean you get charged
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a fortune if the provider's not preferred. It means you pay the same as you're paying now.
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Yeah. Preferred means you save thousands of dollars if you need some procedures.
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So to be preferred, you'd have to offer not just good price,
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but Thomas was saying a certain level of quality as determined by national accreditation.
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Organizations that look into
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quality in terms of safety and outcomes and things like that after care.
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So there are some rural areas where there's going to be access.
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Yeah. And so you'll pay the same.
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But, you know, either the hospitals are going to have to step up their game
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in those rural areas in terms of outcomes and quality or offer a better price or a mix.
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And there's no way for us to know the exact situation because,
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again, we don't have transparency of the pricing.
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All we know is some mixture of quality and cost went into this.
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Yeah, I think it's important for us as an organization to establish some concrete
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foundational facts about the program.
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Number one, if you have an emergency, you need to go to the doctor closest to
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you and you will not be charged anymore for that. I mean, the tier system doesn't
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matter at that point, right? Right.
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Access and preferred providers make up, I think, did he say like 90 percent
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of the hospitals in the state?
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Providers, 90 percent of the providers, that includes the doctors.
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And so those levels roughly are equivalent to or cheaper than what you're paying now.
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Right. So 90 percent of the hospitals in the state are around what you're paying right now.
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And, you know, like we said, there are some parts that even we disagree with
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or we're working to alleviate some strain on our members.
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But overall, I think a big thing to point out is that if this tier structure
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hadn't been put in place, premiums would have gone up. I think the estimate was 21 percent. Yeah.
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As opposed to 5 percent, which it did go. Yeah. So.
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And just a reminder about the premium increase. It is not 5 percent of your salary.
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It is 5% of whatever you were paying in a premium already. So we still don't
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like that it had to go up on you, but don't misunderstand and think that that's
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5% of your salary because, yeah, wow, what a hit that would be.
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So it would have been four times larger for everybody on the plan if this tier
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structure had been a benefit. And not just premium increases,
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the out-of-pocket costs. Yeah, the benefits would have been eroded, too.
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And then that would mean also less money for raises because it also would have
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required more money out of the General Assembly.
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So raises, COLAs, things like that, the money evaporates. I mean,
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I saw some people commenting on our social media that, you know,
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they could just, the General Assembly could just appropriate more money.
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I mean, if they were willing to appropriate more money towards your benefits
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and your pay, they would do it.
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Yeah. I mean, but mind you, the General Assembly has appropriated a ton of money
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towards your health plan.
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And in this past year, we talked about it a few episodes ago,
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Treasurer Briner was thanking the General Assembly because they made an enormous
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contribution towards your health plan.
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And our response at the time, this is before the tiered stuff even came out,
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was there's no way we're going to thank them for that
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because they don't need to be putting that much money into the health plan because
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all they're doing is subsidizing non-state employee, non-state retiree health care.
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With money that could go into your pocket through your pay or your COLA.
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And that's crazy. And then acting like we should be super thankful.
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The money that's going into that health plan wasn't doing anything to keep your
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costs reasonable. In fact, your health plan was on a death spiral. Yeah.
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I mean, it's still in danger. Still in danger. Yeah.
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I don't think that hits home with the plan either. You don't. Yeah.
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Yeah, that, I mean, you could potentially not have a state health plan at all
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if it just spins out, you know, and then, I don't know.
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Maybe at that point the state just gives you money and makes you buy a terrible
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plan on the marketplace.
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Well, Suzanne and I have had, as far back ago as when Democrats were in charge,
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they were saying, look, this is getting so expensive on us that maybe we'll
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just give y'all a stipend.
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Yeah. And you go find your own health care. Yeah, try to do that. today.
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Right. Because, you know, that stipend would not be. Yeah. If you're 25 in perfect
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health. Yeah. You'd be OK for a little bit of time.
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Yeah. I mean, obviously this family or something. But yeah, obviously this.
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You know, is just a symptom of a much broader problem with our health care system.
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You know, obviously there are lots of problems. We're the only industrialized
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country where it's like this, and North Carolina is the most expensive in this country.
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This is nuts. Yeah. It is nuts. But again, I get it. If I lived in an area where
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it was just atrium everywhere and nothing else, I kind of wouldn't care how
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nuts it is. I would just want to know.
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You want to be able to go to your provider. Right. I want to stay with my providers. Your provider,
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can easily fix it. Your provider, like we said, has $10 billion in reserves.
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Your hospital, not your doctor. Your hospital.
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Well, they probably own most of the doctors, I would assume.
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Atrium probably owns most of them.
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But the CEO of that hospital makes $12,500 every hour.
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An hour. So the average state employee before lunch on any given day,
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the CEO of Atrium has made more money than the average state employee would
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make in a year. No, wait, my math is wrong.
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It'd be after lunch. After lunch. Shortly after lunch. But it wouldn't be a complete work day.
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No, wouldn't be a complete work day. And he doesn't hit any home runs or score
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any touchdowns. I don't understand how he gets this much. Exactly. He's not a coach.
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But yeah, so if you wonder why this is the state health plan,
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you know, I saw people thinking that Thomas Friedman, who runs the state health
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plan, people wanted to know his salary.
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OK, well, first of all, look it up, because guess what? All public employee
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salaries, yours as a state employee's and Thomas Friedman's as a state employee's are online.
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Look it up and then compare it to the twelve thousand five hundred dollars an
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hour that the CEO of Atrium makes.
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Thomas Friedman's not y'all's problem, y'all.
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And people were even saying, we're getting paid by the state health plan.
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I know. Which was my favorite response because I was like, trust me,
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the state health plan doesn't have the money to pay us.
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But the hospitals do. John's kind of like putting it out there that,
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hey, if they had the money. Yeah, I mean, you know.
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But the hospitals do have enough to pay us off, right?
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So maybe we change all of it. John is losing his mind.
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Last week, he came out and said, we had, what was it, the most interactive Facebook
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page at all? I don't think after this week, there's no way that's in dispute.
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Agree. Oh, my God. Agree. Yeah.
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But no, we're not open to any bribes. That's what allows us to sit here and say the truth. Yes.
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Yeah. I think people are caught off guard by our stance sometimes because,
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you know, we are telling the truth, just the facts that we're not blue or red.
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You know, and a lot of the comments that I saw was, this is the Republicans'
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fault. Throw them out. Or this is the Democrats' fault.
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Josh Stein. Yep. And we're here trying to tell you our position and,
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you know, the facts as we see them.
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The bottom line, the truth, nationally and in North Carolina,
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there is bipartisan support for allowing that powerful lobby of big health care to,
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keep charging us extraordinary amounts compared to any other country in the
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world. And no, our health outcomes aren't better.
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Yeah. And this is so, yeah, this is not a blue or red issue.
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It's a hospital issue. Yeah. It's a big money issue.
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And we're not getting paid any more by anyone to make these statements,
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you know, and we're not beholden to any party.
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But what our members do expect us to do is call it out.
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Fight for them. And this is the only way to fight for you right now is to continue
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to say somebody has to pop the bubble the hospitals have been living in,
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which is, we'll just say no.
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And I think that's why we've been maybe a little bit more on the side of the
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health plan because they are doing. They are finally doing something, it seems like to us.
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You know, we can give credit where it's due. It took an extraordinary amount
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of work also, y'all, to figure out how to have a system.
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And the people who are mad in many cases, it seemed, are the ones that are in access tier.
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So they're getting the same benefit. They're just not getting a better one.
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Yelling at the health plan, though, if it worked, I would tell you to yell at the health plan.
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Yeah. But for us to still have a health plan, and trust and believe,
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it's just as easy for the General Assembly just to tell all of y'all,
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They're going to put a couple hundred dollars more in your check every month
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and you go handle it yourself. And that will not cover the premium for any plans. Nowhere near.
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But that's, you know, if the health plan were to go bankrupt.
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Which has happened in other states too. Right. And when people have said on
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our social media, then just pay them all the exact same thing. Hey, we tried that.
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Again, we said it earlier, but Dale Falwell, when he was treasurer,
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said, that's what we'll do.
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We'll pay every one of them 200, I think he said, 20 or 50 percent.
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Which would have been enough to operate safely and efficiently and make a pretty good profit.
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And they squalled, the hospital squalled like they were going to go bankrupt.
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Yeah. So there's so much more to advocating and fighting for this issue.
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And we can't be at war with the state health plan and expect to have any conversation
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with them, share information and, you know.
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Yeah. And I think in this case, there's not, I mean, there are some things,
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like I said, that we do have some issues with. But overall, you know.
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There's nothing to go to war with this day of hope plan over.
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It's more the hospitals, right?
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Well, we should probably be specific about what we have issues with.
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It's just the fact that, and the premiums are only going up like $2 to $8 per
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month, depending on what you make.
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We have issues with the fact that it goes up at all because we feel like hospitals
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should have to eat more of that. Because by eating that, that just means less
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outrageous profit. It doesn't mean they're having to cut people or something.
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And then the second thing is the tiered system, where if you make over $65,000,
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you're paying so much more.
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That is just, we're getting into so much of punishing state employees who are
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at what is the average salary in North Carolina.
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Yeah. And acting like they're rich if they make average. I think that's a bad
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message simply because it makes it seem like state employees should be paid
22:54
that much less than the private sector.
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And we have some issues with the rural hospitals not being, or the access in
23:03
rural areas. But I think that pressure has to come from the people in those
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areas to their hospital. Why are you not in it? Why are you not in the plan?
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Yeah. And when the hospitals are, they're clearly telling people, we didn't know.
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In some cases, they're saying, we didn't even know, which is obviously untrue
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based on the timeline. Yeah.
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The treasurer's office put out. But let's say they didn't know,
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okay? Let's just take their word for it. They did not know they were going to be not preferred.
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When it was announced, Duke Health was not accessed here. And they,
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I don't know, within a week, had sat down with the health plan,
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worked it out, and now they're accessed here.
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Some of, well, the life point are still not. Yeah, but Duke Health generally. Yeah, yeah.
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So why didn't every hospital that says wouldn't even know this was going to
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happen? Why didn't they sit down then and offer to not overcharge so they could
23:58
still see these state employees who mean so much to them? You had full opportunity.
24:03
I think that as a PR hack myself, I think that they knew they could run this
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PR campaign. And they knew that the sentiment would be with them because they are a trusted.
24:14
Everyone trusts their hospital, right? As opposed to the state health plan,
24:16
which is the government. Yeah.
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So, I mean, I think they, I mean, I'm not, I wasn't part of the negotiations,
24:22
but they probably didn't expect this to actually happen.
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Like, I know that Falwell fought the good fight for many years about the CPP
24:30
or the clear pricing project, but it never really had any teeth in it.
24:33
No way, they weren't doing it.
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I mean, kudos to Thomas and Treasurer Briner for, you know, standing their ground. I hope it works.
24:43
If it don't, we'll be here to yell about it too, right? Well,
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then they will have to look at something.
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Listen, if these hospitals think, okay, now we've got the business,
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and so next year we're going to jack up those prices back to where they were,
24:55
then you're in a situation where you definitely have to look at more of a situation
25:00
like Treasurer Falwell threw out there where you have to set a ceiling.
25:03
You just have to set a ceiling on it.
25:06
And, you know, Montana did that. Their treasurer, Marilyn Bartlett,
25:10
who's kind of a folk hero in the world of health care now, because they don't
25:15
have near as much access to health care in Montana. You got to drive a good distance.
25:19
So it took tremendous courage and resolve to hold firm, but their health plan
25:25
was literally one of those that was going bankrupt.
25:28
And they went from going bankrupt to, in a three-year time period,
25:32
having a good amount of reserves in that health plan to maintain it for those
25:37
state employees and retirees, only because they stood up to the hospitals and
25:41
they kept their resolve.
25:43
And she said they definitely took a pounding from the public.
25:47
The public didn't understand at first at all.
25:50
And that's okay. It's not people's job to understand. People are trying to just
25:53
do their best to go to work, take care of their family.
25:57
And all they hear is you're taking their health care. Yeah.
26:00
So what are other associations that represent state employees and retirees?
26:05
Or what are they saying? Have you heard anything? I haven't heard anything from
26:09
any other organization. And I know that we've had a lot of teachers on our Facebook
26:12
complaining about, you know, I look at NCAE's website and I don't see anything about it.
26:19
How are they able to just bypass it? You know, it's such a big deal for our members. I don't know.
26:25
I'm not sure what you would say. I guess what I'm saying is we need some allies,
26:31
you know? I mean, everyone should be fighting this fight.
26:35
Yeah, but it's not fun to fight the hospitals. That was just an aside.
26:40
And quite frankly, there are some organizations and groups who are just focused
26:45
on how many members they can get, which that's important.
26:49
You know, there's power in numbers, but, you know, Scenic is actually in the
26:54
fight, fighting for rights and benefits.
26:57
And we know that all these things connect. And we've, if you pay an extraordinary
27:02
amount too much in one place, it means your folks aren't going to get anything anywhere else.
27:08
So we're just trying to make as much money stay in your pocket as we can make.
27:13
And again, you're not going to lose your health care anywhere in this state.
27:18
You can go. It just won't be as cheap as it will be for somebody whose provider,
27:23
happens to be willing to be access or preferred level.
27:27
But that's up to your health care providers where you live.
27:30
And in some places, yeah, in some places there's not many, in some rural areas,
27:34
there's not many state employees in some of the pockets. And that's the thing.
27:38
So, Artis, you were on the radio on Wednesday, WPTF, Afternoon News.
27:44
I really enjoyed your interview. You said a lot of the same things here on the podcast so far.
27:49
But I think that people should go to our Facebook page and listen to that because
27:54
you really spelled out, you know, especially the PR campaign that's back in
28:00
the WakeMed and Atrium side.
28:03
Yeah, it just hurts my feelings for people, honestly.
28:08
Because they do trust their hospitals and because the doctors and nurses and
28:12
health care providers and those that support them do so many extraordinary things for us.
28:18
Yeah. And we want the best for them. But we've lost focus in this country a
28:23
long time ago, and it's become about marble lobbies and spa-like birthing centers
28:29
instead of paying our health care providers.
28:33
So it hurts my feelings to see hospitals saying these things like we were shocked to learn.
28:39
Okay. Again, if you were shocked, it seems like that shock would have driven
28:44
you to action if, in fact, these state employees mean so much to you.
28:50
And if you're all about your community.
28:52
And, you know, let's just talk about the elephant in the room.
28:55
WakeMed, an atrium, announced on Friday afternoon a few months ago.
29:01
Yeah, we're planning to merge, or Atrium, for Atrium to take over WakeMed,
29:05
however they are doing this, and that the Wake County Board of Commissioners
29:09
was going to have it on their consent agenda, meaning consent agenda means you don't debate it.
29:14
It just kind of, it's there, it gets voted on, it's real quick.
29:18
And this was on a Friday afternoon that it would happen on a Monday, the next Monday.
29:22
So one of the Wake County Commissioners said, I've gotten a lot of feedback
29:26
on this, that shoving this through on a consent agenda with all but no announcement
29:31
to the public is not cool.
29:33
So let's put this off. They put it off for 90 days.
29:37
And we're coming up on that. So the question is, does WakeMed,
29:42
and it's $1 billion in reserves, and Atrium, and they're $10 billion in reserves.
29:49
Does Atrium still want WakeMed if WakeMed is not accessed or preferred?
29:54
They were maybe reconsidering it or something.
29:57
But literally, that was one of the things that came out. Yeah,
30:00
it may even affect this murder.
30:02
Is that supposed to matter to a state employee? But, you know,
30:04
if it doesn't happen, then another hospital system will probably take them over.
30:09
Maybe UNC Health and then maybe UNC Health is not preferred the next time.
30:14
You know, maybe they have such a market.
30:16
That's the thing you have to watch. I mean, this will be a really bear of a
30:20
job for the health plan moving forward is to make sure because consolidation stinks. It's awful.
30:27
So whenever any hospital system, I don't care who they are, they start buying up everybody.
30:32
Everything's going to get way more expensive than it should be.
30:35
Yeah, always results in.
30:36
So it's going to be hard for them to make sure the folks that become the golden
30:40
child this year in terms of preferred provider don't decide next year. They're jacking it up.
30:46
But again, if it gets to that point, that's when everybody has to be ready to
30:51
demand that what Montana had the guts to do, that we do it. But I do think Treasurer
30:57
Briner had to try something else first.
31:00
Yeah. And if the hospitals show they can be good faith brokers in this, then fine.
31:05
I think that he saw the success of the Lantern plan. Yeah. And I think that,
31:09
you know, like we talked about last week, it's kind of a little bit of an extension
31:12
of the Lantern program to the entire system.
31:15
But remember, Treasurer Briner comes from, he dealt with Wall Street for decades. So...
31:21
If hospitals thought that's a guy that's going to blink. Yeah. Yeah.
31:24
Oh, there's just so much we could talk about. But, and like Atrium is so big
31:29
that it can fight this fight, right?
31:31
I mean. Yes. Yeah. They are owned by an even larger behemoth. And they know.
31:36
Advocate health. And they know that they own hospitals in rural areas where people need them.
31:42
And so those people will complain about this. Well, because the messaging's
31:47
not clear coming from the hospitals about the fact that people can still go
31:51
there when they have an emergency.
31:52
And by the way, if that emergency means that you need to stay at that hospital
31:55
and be treated, you're treated for the whole time through without being penalized
32:01
in any way. And if that's ever not the case, give us a call and we will fight
32:04
that for you. Because Thomas Friedman's been very clear.
32:07
We want you to go get treatment. Yeah.
32:09
But if you have an elective procedure and you'd prefer to have it to Atrium,
32:14
I mean, it's my understanding there's Novant facilities in a lot of that area, too.
32:17
So you're going to maybe have to drive a few more miles to a Novant place if
32:22
you want, if you want the cost of your procedure to be significantly lower.
32:27
So it may be a little more in gas to save a lot more on the procedure or go
32:31
to Atrium. Yeah. You can still go to them. Yeah.
32:34
You just pay more for it. Yeah. So let's just wrap it up with some top line
32:39
facts, as I was mentioning earlier.
32:41
If you have an emergency, go to your hospital closest to you.
32:45
The tier system doesn't matter at that point. Right. Premiums are increasing
32:48
5%, which we are opposed to, but it could be 21% if this tier structure wasn't introduced.
32:55
Your argument should be with the hospitals that are electing not to help you
33:01
save money, right? Yeah.
33:03
Anything else that we... I had some questions about out-of-state coverage,
33:07
and you are covered at the access level wherever you live if you're a state employee.
33:13
I had a spouse of a Medicare-eligible retired state employee.
33:16
She was retired, too, that lives in Florida.
33:19
So she can see her providers in Florida. Use the state health plan here from North Carolina.
33:24
It's at an access tier rate. Yeah. That's good to know. Yeah.
33:29
That is good to know. All right. So the only other news story I had this week
33:34
was Colin Campbell at the WUNC wrote a story about when the raises and bonuses would be paid out.
33:41
And we had a lot of comments on that story, too, rightfully so.
33:45
And you spoke, and Artis, you spoke to him about this story.
33:49
You pointed out that it may be political, you know, it may be an attempt to
33:54
curry favor right before an election.
33:57
Just seems convenient. Yeah. Artis Watkins said if it was the raise and you
34:02
weren't implementing it until October, you would save one quarter's worth of
34:05
money of the raise. But when it's just the one time bonus, there's no savings. So there's no reason.
34:12
Yeah. I mean, because a raise is recurring and it goes, it's divvied out all
34:18
year, we have had situations where the legislature delayed the raise.
34:23
And that way they could give a bigger raise because they saved one quarter's worth of money. Yeah.
34:28
But moving forward, you would still have had that amount of raise added to your salary.
34:33
But with one-time money, there's no savings in waiting.
34:36
Yeah. And we're not talking. So the raise part, the state controller's office
34:40
reached out to us and told us they couldn't, I guess, press the buttons in time
34:45
to make it happen for July.
34:46
And that's why it's delayed to August. But you're still getting paid the new rate from July 1 on.
34:52
So your August check will be not saying much, but they will be it will be larger
34:56
than a normal check will be like the September check, maybe lower than the August
35:01
check. But the bonuses are a different story, it seems like.
35:05
Yes. Yeah. So another bit of news out of Scenic World is that we did launch
35:10
our new website this week, scenic.org.
35:13
I mean, it's very up-to-date and modern-looking.
35:17
Right now, the overall function of it may be similar to the old website,
35:23
and that's just for continuity's sake. But we will be adding more features as time goes on.
35:30
And it would do have a login feature to a member portal, which is a big deal
35:34
for a lot of members who have complained that they had no way to access their
35:37
accounts and see what they're paying and things like that. I mean,
35:40
they had to call here to do that.
35:43
Now they can access all of that online. I feel like we're up to 2000, maybe 10 now.
35:50
We're crawling into the... We were like 1997, and now we're up to like 2010.
35:55
You can see what you're paying and things.
35:57
So check it out, scenic.org. First time that you use the login feature,
36:01
you will have to create an account.
36:04
If you have any problems, send us an email, webmaster at scenic.org.
36:08
And yeah, I hope you like it. A lot of cool things on there.
36:11
And we're hoping to release a mobile app in the fall, so built on this website. Very cool.
36:19
Very cool. Check it out. Sammy, what's up with the Gen Zs these days?
36:24
So since we talked a lot about health care and the state health plan today,
36:28
I found some information about Gen Z's approach to health care. Cool.
36:33
Starting with some of the priorities of Gen Z when it comes to health care are more holistic, right?
36:38
And that can be reflected in what they are looking for when it comes to benefits from an employer.
36:43
The main benefits that they are prioritizing when it comes to looking at employers,
36:48
are retirement savings, mental health services,
36:52
maternal care, and something a little different that Gen Z is starting to look
36:56
for when it comes to benefits from employers is child care services.
37:01
Because we do want to have families one day and even just support or some sort
37:06
of benefits, stipends of making child care a little bit more affordable is something
37:12
that Gen Z's are really looking for. You should be.
37:16
Truly. Child care is very expensive. Always. But it's been that way.
37:20
Yeah. Forever, you know, to where oftentimes one spouse is working just to cover
37:25
the child care. Yeah. Yeah.
37:28
So when it comes to how Gen Zs are consuming health care, though,
37:32
they're consuming more in person than online.
37:35
They actually, while we do not prefer full in office work necessarily,
37:40
Gen Zs are much more likely to prefer hybrid and remote work scenarios.
37:44
They do prefer in person as a way of communicating with their doctors.
37:50
Yeah, I think there's always going to be that. You know, you always want to go to the doctor.
37:56
What about, does it say anything about, like, mental health services? Yes.
38:01
So when it comes to talking about mental health services, that is more than
38:06
63% of Gen Zs are looking for mental health services whenever it comes to one
38:13
of the benefits that they want from an employer.
38:15
And some of this includes not just therapy and psychiatric services,
38:21
but also nutritional services.
38:23
Yeah, but it doesn't say whether they prefer in-person or telemed when it comes
38:28
to mental health. Not necessarily.
38:30
Because I could see that would be something you'd be okay with talking to someone,
38:35
over Zoom or virtual. Yeah, I would think most people would probably prefer.
38:40
You still want to go in-person? No, I think. Yeah, I doubt it.
38:43
Because we have Teladoc as something we offer here, and people love Teladoc.
38:50
Yeah. And they love it because they can contact somebody anytime they want. Yeah.
38:55
A lot of testimonies about how great that program is. You should check that
38:59
out, by the way, on our new Scenic website.
39:03
With this, employers have also been trying to evaluate how to drive healthcare
39:08
utilization with Gen Zs, because a lot of Gen Zs do say that there are things
39:12
keeping them from going to see a doctor.
39:14
And based on a study that I found, some of the barriers are nearly 45% say that
39:20
cost is the thing that is stopping them the most.
39:24
That's what we're screaming about. 43% said embarrassment slash lack of trust.
39:31
40% said time.
39:33
And 28% said inconvenience. And I feel like we have had discussions before of
39:40
researching and figuring out where to go for certain medical things.
39:44
And that can be an issue among some.
39:47
But for Gen Zs, there is only 25% of Gen Zs that say they don't know where to
39:52
go. And that's the reason that they don't access it.
39:56
But the main thing is cost.
39:59
And affordability. And with that, it also has cost of health care,
40:05
talking about what Gen Zs are willing to pay for when it comes to health care.
40:11
Now, nearly 27% say that they would not pay for primary care.
40:16
Nearly 26% say that they will not pay for mental health.
40:21
But the crazy thing is nearly 31% say that they will not pay for functional medicine.
40:26
What is functional medicine? Basically, whenever it comes to actual care and
40:32
saying I need certain prescriptions, certain things like that,
40:36
they would rather not pay out of pocket for those kinds of things.
40:40
I wonder if it's that they want or that they can't.
40:43
I think it is a combination of, because in this, it also says,
40:47
despite support from family, because a lot of Gen Z's still are on their parents'
40:51
health care, this generation is already hammered by medical debt.
40:55
And 25% of Gen Z's have reported skipping rent or mortgage payments because
41:01
of medical debt obligations.
41:03
Wow. And a major challenge is inadequate insurance.
41:07
68% of Gen Zs with insurance said their medical debt was a result of their plan
41:11
not covering the services that they need or received.
41:15
Well, good appropriate topic for the Gen Z Minute this week.
41:19
Interesting. It is interesting. But overall, Gen Z does want to prioritize their
41:24
health and invest money into it, but they need to be able to access services
41:28
with clear pricing transparency.
41:31
Yeah. So does everyone. I think a lot of those issues, everyone has.
41:34
Everybody's done. Everybody's just done with the system. It's true.
41:38
I mean, like, people keep saying something needs to be done.
41:41
Well, yeah. Yeah. But, I mean, unless the industry can decide it's not going
41:48
to abuse people the way it has been in terms of cost, I think you'll see in her lifetime for sure.
41:56
They're going to ditch this model. Oh, yeah. We are already at the point where
42:01
Gen Z is basically on their own DIY health care system of how they care for
42:05
their own mental and physical health. Yeah, that's even scarier.
42:09
So I hear what you're saying, Artis, and, you know, I would not disagree with socialized medicine.
42:16
And it's kind of the same thing, I guess. But I would think that before we get
42:20
to that point, we could heavily regulate.
42:22
That's what I'm saying. Unless they're going to not fight that. I don't know.
42:28
There doesn't seem to be a middle ground that the big health care conglomerates
42:32
have been willing to reach with people.
42:35
And the point I'm making is that her generation is going to say,
42:39
because they're going to be in power at some point, and they're going to say,
42:43
We're not doing it. We're just not going to. There's so much about what's been
42:48
accepted or done by the generations before them that they have absolutely rejected.
42:53
Yeah. So they're going to get there and say, we already can't buy homes. Yeah.
42:58
But we're going to get our colonoscopy. Yeah. You know, Gen Z might save us all.
43:03
I mean, I just don't think they're going to. I don't think they're going to
43:06
tolerate being the only industrialized nation where we pay this kind of money for our health care.
43:11
So before we get to the question of the week, I have something to bring up to you, artists.
43:17
I sent it to the group chat earlier this week, but someone has taken your state
43:22
job, the state job that you were born for.
43:26
What is it? Caring for the puffins at the NC Zoo. I couldn't believe it.
43:30
I didn't even know we have puffins at our zoo. I know.
43:34
So the NC Zoo has been doing some awesome videos on social media about their
43:39
keepers and what they do.
43:40
And it's really cool. I really enjoy, have enjoyed them. But a state employee
43:45
named Lauren is in charge of the Rocky Coast area.
43:49
I don't know if she's in charge of it, but that's where she works.
43:51
And she cares for the polar bears, the seabirds, and the Arctic fox and other,
43:59
animals. The Arctic fox was pretty cool.
44:02
Lauren is so lucky. Yeah. So we have to get Lauren on the podcast.
44:05
Maybe we'll make a trip to the zoo. I like it. I want to do it.
44:09
Yes, let's go. I didn't even know they had them We could do video podcasts that
44:15
week And maybe they'd let you pet a puffin Oh man.
44:19
I pet a puffin Lauren You guys can't see Artis' face right now I'd be so excited
44:25
The sheer excitement on her face Lauren might have competition for her job They are so cute,
44:32
They have a new director at the zoo, and he's been doing a lot of videos and
44:36
things. It's pretty cool. So a good time for us to visit.
44:38
Yeah. You know, and that just points out, the zoo has so much that we just don't even know about.
44:44
Y'all definitely go to the zoo. John is a great, you are the best advocate for
44:49
the zoo. You talk about him a lot. I grew up like 10 minutes from it,
44:52
and we went there all the time. We'll have listeners. All my friends work there.
44:56
So all my friends work there, and we snuck in the back gate and went through
44:59
the zoo. Oh, my gosh, John.
45:02
So it was pretty fun. That was 40 years ago.
45:05
Or 30 years ago. You're lucky a tiger didn't grab you or something.
45:08
I've been through the back gate of the zoo, but it was with the zoo staff.
45:13
Yeah. Well, I was, too. You don't know what that gate's leading to.
45:17
I was given permission. I was at a scenic event, and they said,
45:20
do you want to go through the zoo?
45:21
Oh, and they're opening the Asian exhibit soon because the budget passed, right?
45:26
So they can hire people for that.
45:29
What a treasure we have. Yeah, see if the zoo will let us come out.
45:33
I would love it so much. And then I'll drive y'all back by our pottery shop.
45:37
We want to see the pottery shop.
45:39
He'll make us buy some pottery. I got in the plug this week.
45:41
You did? Listen, I want to say something else about puffins before we leave. Okay.
45:44
I saw this thing, and it's so cool. In Iceland, in some town there,
45:50
where 20% of the world's puffins are born in that town.
45:55
And it's kind of like on Bald Head Island where everybody will lead the sea
46:00
turtles that are born to the shore so that they don't get confused by lights of town.
46:04
And they're drawn to the moon. So you take a flashlight and kind of help them to the sea.
46:09
Volunteers have to do that. Well, people go to this town in Iceland during this
46:14
certain two-week period because these puffins sometimes get confused by lights
46:18
from town, and they'll fly towards town, and then cats will get them and stuff like that.
46:23
So volunteers come from all over the world, and they join with the people from
46:28
that village, and they help the puffins.
46:31
And here's how they do it, y'all. They take the puffins, they gather them up,
46:35
and then the next morning, each Each person has a puffin and they kind of chunk
46:40
them off a cliff, like up into the air.
46:44
And the puffin naturally will fly. Yeah.
46:46
I found what that's called, actually. It's called puffling patrol.
46:51
Oh, wow. Can you imagine?
46:53
See, and I'm sitting here thinking that puffins don't fly, that they're like
46:56
penguins. They definitely fly. They fly. It's speedy.
46:59
This says that they rescue the young, disoriented puffins that wander into town
47:03
during their first flight from the cliffs to the sea.
47:05
So maybe we should take over Iceland. No, it was Greenland. No,
47:09
stop. John, he's lost it today.
47:12
I mean, we can have all the puffins. But can you imagine being part of the puffling
47:15
patrol? Nice. That would be so much fun.
47:18
Okay, well, so my question of the week this week. John's Wacky Week.
47:28
And you have an out from this conversation. But what is something in North Carolina
47:32
or specifically maybe the triangle that maybe is off the radar,
47:37
but people would have a good time doing?
47:39
And I say this because people are broke, but they still want to take vacations.
47:43
It can be North Carolina and therefore you can say like the zoo. So that can be your out.
47:47
But I have one that I really want to do. I want to go to Dick's Park and see
47:52
all these birds that are showing up. Have you seen this? No.
47:55
Yeah. Yeah, on Instagram, there's like crazy birds there, like colorful birds
48:00
and things. Yeah. That have just flown in?
48:02
It's like a bird watcher's paradise all of a sudden. Oh, yeah.
48:05
And John's the bird watcher. Yeah, big into birds. That's super cool.
48:08
Yeah, so Dick's Park, birds. That's what I want to do. I may do that one day.
48:12
I'll plug the mountains. Okay.
48:14
Got something. So the first Hunger Games movie was primarily filmed in North Carolina.
48:19
And there are three different spots in the western North Carolina area that
48:22
you can go to that are filming locations.
48:25
So one of them is Henry River Mill Village, and that's where District 12 is.
48:30
The arena was DuPont State Recreational Forest.
48:34
And some of the additional regional stuff is in like Pisgah National Forest. Very cool.
48:41
So, yeah, I think I spoke to a member from out there who lived close to the,
48:47
Henry whatever mill town.
48:49
Yeah, at convention, I think. And I can't remember who it was.
48:52
But, yeah, I remember that story. And also the other is the state park.
48:56
DuPont State Recreation. So we have state employees there, too. Yes.
48:59
Anything cool? Well, we were talking about the sea turtles just a minute ago,
49:04
and I know the locals at Topsail Beach don't love the summertime,
49:08
but, you know, there's the sea turtle facility down there.
49:12
And just this morning I saw where, you know, folks are gathered at dawn.
49:17
I love that. Got it roped off so you can watch the sea turtles make their way
49:21
to the oceans. We go to Holden Beach and they have a big sea turtle presence,
49:26
too. They have the same thing.
49:28
And I saw a video of a man who found the sea turtle on the other side of the road. Oh, wow.
49:34
Going the other way towards the waterway.
49:38
And so he, like, picked him up and took him back to the ocean.
49:41
It was very sweet. Turn around. Turn around.
49:44
So, yeah, the turtles, the sea turtles are a big deal. Yeah,
49:47
that's cool. What about you, Artis? I'd like to do that, too. Yeah.
49:50
To me, it's always, always, always going to be the Museum of Natural Sciences,
49:54
just because I think that's amazing that we have that.
49:57
And that there's so much for the Littles. Yeah.
50:01
Or any of us, actually. I still enjoy going through there. Yeah.
50:04
It's a neat place. Suzanne, we used to walk over there. We did.
50:07
When we were at the legislature during breaks. Now, the history museum is under renovation, right?
50:13
For another full year, I think. Okay. Yeah. But the natural science.
50:17
And it needed it. Yeah. It's open.
50:19
Is that the one with the dinosaur? The natural science? The acro.
50:22
Yeah. I think we just plugged every part of the state.
50:26
Yeah. We did. We covered it from end to end. But that museum,
50:29
and the fact that we have a museum like that, that is, it's free.
50:34
Oh, I saw something about, you know, Sue is the T-Rex in Chicago.
50:38
At the Field Museum in Chicago.
50:40
And you can now smell what her breath would be like. Oh, ew.
50:44
Why would we? Yeah, you like press a button and the smell comes out. Okay. Yeah.
50:48
So maybe we do that at the North Carolina.
50:51
So fun fact, Sue almost came to our museum.
50:54
Betsy Bennett was a director at the time, and she was really just a super visionary
51:00
person and very nice and cool person. But Betsy said, let's get Sue.
51:05
And that's when they were redoing the Science Museum. And she said,
51:08
that would just be cool to have that as a feature. And everybody's like,
51:11
yeah, we would never be able to get Sue.
51:14
We slightly missed that bid to the Field Museum that had so many more resources.
51:19
But she had marshaled enough support from people who supported the museum that she came real close.
51:25
But that acro, in many ways, that acrocanthosaurus that's from Atoka,
51:29
Oklahoma, is apparently a pretty doggone amazing specimen.
51:34
It's right up there. Yeah, it's pretty awesome. And it's very similar to a D-rex, right? Yeah.
51:42
And while you're visiting the Museum of Natural Sciences, you could cross the
51:45
street and visit your legislature.
51:49
Talk about, speaking of dinosaurs.
51:53
I don't know, you know, because of what we do. I just personally think everybody
51:55
should make a trip to the General Assembly and see where it's done.
51:59
I think more people need to know that that's accessible.
52:02
Because I have so many of my friends that are like, oh, no, I need to make an
52:06
appointment to go in there.
52:08
You can walk straight into the building. I love seeing other states' legislatures
52:12
as well. I think it's cool to go into them. Yeah.
52:15
So are they there when they're not in session? Or in L.A. at least?
52:19
In some offices. Yeah. Yeah, generally it's not fully staffed when they're not
52:23
in session. But some of the local legislators will go in to do some work.
52:27
Yeah, there's somebody around. But it's even an interesting place when they're not in session.
52:32
If you're coming to Raleigh, you could probably contact us and we could maybe check in.
52:36
And the Capitol? Another really, it's more interesting to go in the Capitol than you would think.
52:42
And the governor has his offices in the Capitol, right? Or is that still a thing?
52:46
I don't know. I think he still has some in there. Yeah, I think there is. I think there is, too.
52:50
Very cool. So, informative episode this week. If you're still listening to us,
52:55
thanks for sticking around, and we hope you have a great week.