Latest / The SEANC View / State Treasurer Brad Briner Breaks Down Recent State Health Plan Wins
Transcript
- 0:11Hello, everyone. Welcome to another edition of the Scenic View podcast.
- 0:15I'm your host, Jonathan Owens. I have the usual crew in here,
- 0:18but we have a special guest.
- 0:20We're very excited to have him. He's been a very busy man since you took office.
- 0:25We have State Treasurer Brad Briner with us today.
- 0:29Very excited to have him in here. He's a very important elected official for
- 0:32state employees and retirees as he oversees the state health plan and the retirement
- 0:38system. Welcome to our lovely podcast studio.
- 0:41It is a pleasure to be here. Thanks for having me, guys. Awesome.
- 0:44We're excited you're here.
- 0:45Thanks. In the last few weeks, you've been on kind of a roll here.
- 0:49You've had some pretty big news coming out. It's been a big roll.
- 0:53On Tuesday, you had a major agreement announced with CVS Caremark,
- 0:57which ended a months-long dispute, I guess? I suspect it's years long. Okay.
- 1:04Yep. And we'll get into that a little more. But last week, you helped broker
- 1:08a deal between Duke and ETA that helps state health plan members continue to
- 1:13see their doctors in network.
- 1:14So we want to get on both of those topics. So let's just jump right in.
- 1:18First question after all that, do you need a vacation?
- 1:22No, but the state health plan team does. They have been crushing it.
- 1:25And I'm so impressed with the leadership there and all the members of that team.
- 1:29They have had, I mean, 25 to 5 has been a tough year in the state health plan. It has not been fun.
- 1:35We needed to reorient that plan. And that's not fun for anyone.
- 1:39And they have been working their butts off to make it all happen.
- 1:42And so I'm just real proud of them, mostly over the last week here.
- 1:46We had a good team over there. We enjoy working with your team.
- 1:49Thank you. You think back, it really has been a hectic year for them.
- 1:53And we've been excited to have Thomas Friedman on the podcast several times
- 1:56and at our convention to talk to members about all the things going on.
- 2:00So let's get into the CVS dispute, I guess, first off. We had Thomas on the
- 2:04podcast in August, and I guess it was kind of bubbling up at that time,
- 2:08and he kind of told us a little bit about it.
- 2:09But can you start by explaining the dispute a little bit and then the agreement? Sure.
- 2:14So I think it's worth taking a big step back. They call them PBMs,
- 2:18pharmaceutical benefit managers. What do they do?
- 2:21Mostly it's software. Mostly it's making sure people pay the right price at
- 2:26the right point of sale and the medication is there and the insurance pays what
- 2:30they're supposed to pay. The members pays what they're supposed to pay.
- 2:32And most importantly, the member gets the prescription they're supposed to get.
- 2:35And that's a reasonably should be a reasonably
- 2:38straightforward business they have made it anything but a straightforward
- 2:41business we don't just pay a price we pay a price and then we get a rebate and
- 2:45they do that so they can hide all sorts of things and it is a very frustrating
- 2:49business to be a customer of but unfortunately given the scale and the breadth
- 2:54of members we have all over the state we have to have someone play that role
- 2:57we couldn't possibly do it ourselves so that's what Caremark does for us.
- 3:00We've had a couple disputes with them over time.
- 3:03The first is that if you go back to last April, April 2024, that is,
- 3:07the weight loss medications, GLP-1s, were taken off formulary.
- 3:11And that's a big deal and something that we're going to work to rectify here
- 3:14in hopefully short order.
- 3:16But that was because of our PBM contract. We did not have a choice between providing
- 3:20them for everybody and providing them for the people who really needed them.
- 3:23It was either everybody or nobody.
- 3:26And so they had to make the choice of nobody because they were running $250
- 3:29million a year on these medications and growing.
- 3:32That was a part of the dispute. Surely we can have a contract that allows us
- 3:35to give people medicines who really need them and not the people who kind of want them. One.
- 3:40Two, when you're dealing with many thousands of claims a day,
- 3:45you're inevitably going to have disputes around specific claims.
- 3:48Maybe it was more than just specific claims.
- 3:50And part of that is just math. It's like, how do you actually run this math equation?
- 3:55And if you read a legal contract, it rarely has math equations in it.
- 3:58So you're interpreting a legal contract.
- 4:00We of course interpret it favorable to us and they of course interpret it favorable to them.
- 4:05So we needed to resolve that. And it's kind of aggregation and componentization
- 4:10of rebates is what that's called.
- 4:11So we got that resolved too.
- 4:14And then there are other pieces where you can't really understand their business
- 4:19model. You can't see everything.
- 4:20And I think we've made material steps forward so that we can actually understand
- 4:24what they're charging and why.
- 4:26I'm confident that we'll still have that discussion, but we made progress in
- 4:30terms of getting more transparency in what they're doing.
- 4:32So those are all the pieces of it. And I think we've resolved most of those.
- 4:36The other one, which is important, is that we now have an ability to direct
- 4:39contract for GLP-1s with the manufacturers.
- 4:42Everything we're trying to do in the state health plan is just trying to get
- 4:46the incentives aligned between our members and the people who are providing for them.
- 4:50If our members are provided for better, we are happy to pay people more.
- 4:54Fundamental principle.
- 4:55And one of the issues we had with Caremark was that we were misaligned in a certain way.
- 5:01So when these large molecule drugs, they're new drugs, come off patent.
- 5:05In the old world of just pills, these are infusions generally,
- 5:09the next day you'd have 10 manufacturers of pills, super easy to do,
- 5:13generic prices would drop, the list price by 90%.
- 5:16When you're making a big, complicated molecule, it's not that simple.
- 5:20Usually, it may come off patent on one day, and there's no generic the next day.
- 5:25It takes a while. Oh, and they've got so many layers of patents.
- 5:28It's such a sophisticated scheme. It is a sophisticated scheme.
- 5:32Like, almost so sophisticated that you respect it, but then you realize what
- 5:37they're doing, and you don't.
- 5:38But, yeah, there's a lot of patent attorneys who've made a fortune doing things
- 5:43that I don't particularly think I'd wake up in the morning feeling good about.
- 5:46But so be it. So this generic problem in large molecules is real.
- 5:51And Caremark decided that there's another business we'd like to be in of developing
- 5:56these so that there is that generic there the next day.
- 5:59That had the ironic effect when they did this the first time,
- 6:02and it was for generic biosimilar for Humira, that they were accelerating generic
- 6:06supply, which because of the nature of our contract.
- 6:09And hat tip to Dale Falwell, who put this contract in place.
- 6:12The state health plan has a very unique contract. But when Caremark was doing
- 6:16this, they were costing themselves money and not lost profits, actual losses.
- 6:21So it was a very ironic situation where they're creating the supply to lower
- 6:25the cost for the state health plan. And not only is that worse for them,
- 6:29it's actually negative for them.
- 6:30So we need to solve that problem. And we solve that problem here, too. Okay.
- 6:35Will members see the fruits of this new agreement in their costs?
- 6:39They will. And implicitly, they already are in some way. So let me get to that.
- 6:44We've been at this for five months. We were close at one point.
- 6:47We were really far away at one point, just like any negotiation.
- 6:50When we were setting premiums in August, we did two things.
- 6:53And I think people heard the first loud and clear, and they're still hearing
- 6:56it again in open enrollment, and that's the premiums you're going to have in the short run.
- 7:00And we recognize people's frustration with that. It gives us no pleasure that
- 7:04the rest of the healthcare system is doing the same thing to everyone else at the same time.
- 7:07But it is a fact of life that the healthcare industry is broken in many ways.
- 7:11But the second thing we said, which is important and is underpinned by this
- 7:15Caremark Agreement, is that in the future, we would advocate for premium growth
- 7:20to be limited to wage growth as long as we possibly can.
- 7:23And under our financial expectations, that is as long as we can see.
- 7:26And I think that's an important promise that we made. And I think we can live
- 7:29up to it in part because of things like Caremark, where those hundreds of millions
- 7:33of dollars that we think we're going to gain through this contract underpin
- 7:36the ability to withstand if there's no wage growth. There might not be wage
- 7:40growth. There hasn't been.
- 7:41There is no budget. Right. But that way, what we're telling state employees
- 7:45is that as a percentage of your paycheck, this is not going to rise in the future.
- 7:50And there is no other industry in this country that can make that claim.
- 7:53And that's a valuable thing, I think, for state employees. And I hope that they
- 7:56receive it that way. But it's not something we've talked about a lot.
- 7:59Now that we have the Caremark deal done, we can feel even better that we can
- 8:02keep that promise. That brings something to mind, though.
- 8:05Suzanne and I have been around here a while. And for most of our careers,
- 8:09there was no premium in the state health plan very intentionally because it's
- 8:12very hard to recruit and retain when you're paying less than private sector wages.
- 8:17We still pay less than private sector wages by at least 14 percent in some sectors. It's much more.
- 8:23But on average, about 14 percent less than private sector. But the benefits are eroding.
- 8:27There did start to be a premium, and then a few times it's increased. It was held for a while.
- 8:32It is still our belief as an organization, which we've been very open with you
- 8:36about, that if we could have transparency in these contracts.
- 8:39You were just saying on CVS, even the plan didn't have what y'all thought was
- 8:44adequate transparency.
- 8:45Well, we as members get no transparency in it. And we still feel that being
- 8:51that North Carolina's number one costliest place in the country for health care,
- 8:55no doubt we're paying too much for the health care.
- 8:58No question. So just on behalf of our members, because I know they're going
- 9:01to tell me later after this podcast if I don't make this point again,
- 9:04we would argue premiums don't need to go up for them ever until we know what
- 9:09we're paying and we've brought it in line. Yeah.
- 9:11So we can see an aggregate what we're paying.
- 9:14And we see that by member, how much the state is contributing,
- 9:18how much members are contributing.
- 9:19So all of that is available. But I think what you're advocating for is very
- 9:23specific transparency at the procedure level.
- 9:26And so things like Lantern are going to allow us to get there.
- 9:29I think there are competitive issues where, you know, Lantern is a great example
- 9:33of this. We want people to bid against each other.
- 9:35And they will do that as long as they don't have to show their bids to everybody else.
- 9:40Which allows us to reduce cost dramatically. And so the tension for us is always
- 9:44going to be, or it should always be, between saving money and being perfectly transparent.
- 9:49One of the things that I think we have to figure out how we get to,
- 9:54and there's some service disruption issues, which is what you really want to worry about,
- 9:58is we should put a rule in place that says we are never paying anyone more than
- 10:03300% of Medicare, no matter what.
- 10:05Yeah, that would be great. The service disruption issues in the rural areas
- 10:09become very real. And so that's what you have to solve before you can say that.
- 10:14Because if we're putting a facility out of business inadvertently, we need to not do that.
- 10:19We need to be very thoughtful about that and not advocating for any facility to close necessarily.
- 10:24But we've got to create ongoing business models for these folks that are real
- 10:30and that provide access for all 100 counties, which is the other side of this challenge. Right.
- 10:36They're using these procedures not because they're particularly profitable and
- 10:39the rural hospitals are not.
- 10:40It's to subsidize everything else. And where they have huge paramix issues and
- 10:45it's Medicaid, which just lowered its reimbursement rates.
- 10:48Yes. Do you think that's going to affect hospitals pushing back on y'all?
- 10:52Yes. Yeah. A hundred percent. It is a balloon. They're squeezing it on one side.
- 10:57If you're losing it here, you're going to want to get it somewhere else.
- 11:00One of the huge issues we have in this state, generically and specifically, is rural versus urban.
- 11:06And that is very true in hospitals and health systems.
- 11:10We have a lot of rural hospitals that are struggling to get by,
- 11:14and Medicaid has been a lifeline for them. This Rural Healthcare Transformation
- 11:17Fund, the $50 billion that was in H.R.
- 11:201, should help fix some things, but it's not going to fix everything.
- 11:24So there's a lot more to go there. And that's part of our job as a state health
- 11:27plan is to make sure that people have access everywhere, not just the triangle, right?
- 11:31No, and absolutely. I know, you know, we have members, many of whom are in rural
- 11:36areas, and they definitely, they've seen it.
- 11:39They've, in some cases, they've seen their hospitals go away.
- 11:43So, and consolidation's not been so kind to rural areas. It has not.
- 11:48And it's also true in water and sewer, too.
- 11:51I mean, we've got, in the end, we need to do economic development in these areas
- 11:54to create population growth in these areas.
- 11:57That's the real solution to so many of these problems. But that's way outside
- 12:00the scope of the Treasurer's Office.
- 12:03It's one of the only things that's outside of the scope of the Treasurer's Office.
- 12:06Well, I think that this is a good time to talk about Lantern because you can
- 12:10kind of use Lantern's advantages in that area, right?
- 12:13Absolutely. So, we are in the middle of the Lantern process.
- 12:17We have received bids at this point and we are going through and getting best in finals.
- 12:22But the concept is worth spending a minute on. And I know you all probably know
- 12:26this, but just to remind people, the idea is reasonably straightforward.
- 12:31And that is we want high quality providers to compete for your business.
- 12:35And that doesn't happen in health care.
- 12:36And so when we went out to people saying, hey, you need to bid for our business.
- 12:40And oh, by the way, 30% of the facilities in the state, you don't qualify from a quality perspective.
- 12:45Sorry, do better next time and we're happy to have you. But the reactions to
- 12:49what do you mean compete? Why would we do that?
- 12:52We're telling and thankfully we overcame them in many places.
- 12:57So what Landrum will do is once we have those winners, and it's going to be
- 13:01in the five Medicaid regions, so it'll be regional, you will be offered the
- 13:05opportunity if you need an elective surgery or a non-emergency surgery to choose where you go.
- 13:11And right now, if your copay plus coinsurance is going to be $1,000,
- 13:16that's still going to be available to you.
- 13:18But we're going to create a tier where that is now $0.
- 13:21And if you go there, you'll save yourself $1,000. It'll still be high quality. It is your choice.
- 13:26But the effect for the state health plan is good as well, because we should
- 13:29see 20 to 30 percent savings on that procedure by virtue of what we think are
- 13:34expected volumes there.
- 13:35And we can't emphasize that last part enough.
- 13:38These folks aren't on the list because they can't find business otherwise. Right.
- 13:44They're objectively good at what they do. They are. And that's how they got
- 13:47on the list, right? Absolutely.
- 13:48Like I said earlier, 30 percent of the providers in the state didn't qualify to bid.
- 13:53And I suspect when you go into whatever health care provider,
- 13:58they would be embarrassed to tell you that they didn't.
- 13:59And we're not going to tell you who they are. That's not how you host the competition.
- 14:03But this is about high quality. And if you don't believe us,
- 14:06then choose to pay the full $1,000. That's your choice.
- 14:09You're no worse off, but you could be better off. And I think that that should
- 14:13resonate with our members.
- 14:14I hope to be one of the first people in the Lantern program.
- 14:17I need shoulder surgery.
- 14:18Oh, sorry about that. But, I mean, I think it's a really innovative thing.
- 14:22First reaction was for our people, which you just cleared that up.
- 14:26First reaction was, first of all, you're going to tell me who I've got to go
- 14:29to to have surgery and I'm not going to have access to my doctors.
- 14:33And that is not the case at all. That is not the case.
- 14:36And I understand that reaction. I mean, people have been promising fools gold
- 14:39in the healthcare industry forever.
- 14:41And we don't think this is that. What we think is that a large fraction,
- 14:46maybe even a majority of people, will choose to take us up on this. Yeah.
- 14:49And the provider thinks that too. and they're hoping to get a lot more business
- 14:52so their operating room is not idle so they can have eight procedures a day instead of six.
- 14:58And it's a basic business principle of economies of scale.
- 15:01That's how we all win here. And hopefully that will also create access points for off hours too.
- 15:07Why should we be doing surgery at 10 o'clock on a Tuesday? Right.
- 15:11We can do it at 10 o'clock on a Saturday.
- 15:12Yeah. It's better for me as someone who has a Monday to Friday job and it's
- 15:17better for the operating room to be busy on the weekends. Why should it sit vacant?
- 15:21Absolutely. Yeah. So have you seen any patterns in the providers that you do accept?
- 15:28Like, I can see someone saying, well, you're just going to push all your business to Novant or Atrium.
- 15:33Do you have providers from all over the state, like all areas?
- 15:37So we ran these, there's five Medicaid regions. So they divide the state up into those five.
- 15:42And we ran those within those Medicaid regions because it's reasonable to ask
- 15:46people to drive 30 or 50 miles. I don't think it's reasonable to ask them to drive 200, right?
- 15:50So we wanted to make sure that people had access points in all the different parts of the state.
- 15:54And Medicaid and Medicare already do that. So we kind of leveraged their infrastructure
- 15:58to do that so that we could be sure.
- 16:01You will see material volume go to the winning provider of these procedures.
- 16:06But a couple points, it will not be anywhere near all of it.
- 16:10Yeah. So there'll still be some in other places because people prefer their doctor or whatever.
- 16:17And, you know, we'll see how that works. And then there's a lot of procedures that,
- 16:21that we have not bid for. And I'm not sure we can, and we went with the easy ones first.
- 16:25So orthopedics are pretty straightforward. If you need shoulder surgery, you can wait.
- 16:30If you wait a week and, you know, it'll be okay. As we get into other procedures
- 16:34that are more complicated and have more involved follow-ups,
- 16:37it's probably not reasonable to ask people to follow up at a distance very easily.
- 16:41So we've got to work through some complications there. So for the hospital,
- 16:46let's say, who has lost the competition for knee surgeries in whatever region,
- 16:52from a revenue mix perspective, it's like 1% of revenue.
- 16:56It'll matter a little bit, but it won't really matter a lot yet.
- 16:59As we go down and do more and more of this, you're going to carve away at a
- 17:03lot of that if they don't win these competitions.
- 17:06Yeah. You still have things that can't move. Emergency services can't move.
- 17:10Emergency surgeries, et cetera.
- 17:12So there's a huge chunk of a hospital's business that never moves, can't.
- 17:16So I'm sorry, I didn't mean to single out Novant or Atrium. I mean,
- 17:20we've done that before. Just trying to think of the big name.
- 17:23But I did hear at the convention someone say that they just,
- 17:26you know, they want me to go all the way to Charlotte to have a surgery.
- 17:29And those are just the ones in the area. But I guess that's something that you hear a lot.
- 17:33I mean, what is, I think, a critical evolution for the health care system in
- 17:38the state, if you fast forward far enough, is kind of the Centers of Excellence piece of this.
- 17:42I think if anyone has a rare condition and pick your condition,
- 17:47there's a place to go in the state.
- 17:49And if you asked a medical professional, they'd say, whether it's Charlotte
- 17:52or the Triangle or wherever, if you have X, go there.
- 17:57That's a strength of that particular place that we've got to leverage,
- 18:00and we've got to send more people there, not less.
- 18:02So I think as people experience the acute parts of the health care system,
- 18:07prepare to travel, but prepare for that to be really good for you.
- 18:10Yeah, I mean, if I could save $1,000, I would drive three hours.
- 18:13Well, and Leonard's got, they'll pay for travel. Yes. Oh, wow.
- 18:18Yeah. In the context of health care costs, travel is so cheap.
- 18:22Yeah. We joke about it. I won't name the county or the provider,
- 18:26but not far from here, there's a county where colonoscopies are about 6x what they should be.
- 18:32Wow. And so we joke, Tom and I, that I'm going to start running an Uber between
- 18:36the two and keeping the difference and be the most profitable Uber around.
- 18:41But those are the crazy inefficiencies we've got to figure out how we iron out
- 18:46without putting that facility in harm's way. So just briefly,
- 18:49I want to go back to Duke and Etna.
- 18:51Can you tell us a little bit about that negotiation and that agreement?
- 18:55And were you able to use the state health plan's largesse to make an impact in it? Yeah.
- 19:01I guess the first thing I want to say is that Duke is a great provider and we
- 19:05need healthy providers and we want them in the system and I'm glad they are.
- 19:09There are a lot of special things that they do that we would be worse off without.
- 19:13But that said, we don't live in a world of unlimited funds.
- 19:19And we can't give everyone everything that they want.
- 19:23That's the uncomfortable reality that we find ourselves in, unfortunately,
- 19:27in a lot of different ways.
- 19:28So these negotiations happen, and there are like three of them going on in the
- 19:32triangle outside this one.
- 19:34They don't usually get this public, and the provider isn't usually so aggressive.
- 19:41That's what we reacted to more than anything, was not only reaching out to our
- 19:45members and sending them multiple letters to scare them, but a radio campaign,
- 19:49which was just not befitting of a high-quality provider like Duke.
- 19:53We've not seen that level before. Never. Yeah.
- 19:57I mean, it could have happened, but we've never seen it. I don't remember one
- 20:01ever that was like that. And so what are you doing and to what end?
- 20:04And the lack of perspective on what the state health plan is going through and
- 20:09the sacrifices we've asked of
- 20:11our members, I guess, triggered us is the right way to say it. I loved it.
- 20:16You were very, very, you were a fighter out there.
- 20:19You know, you kept your diplomat hat on to get it done.
- 20:22But I think it was appropriate when you went so far as to use the word greed,
- 20:26because it was a bad look for Duke when asked about their billions in reserves
- 20:34and or actually that was an investment and then hundreds of millions in profit.
- 20:38And I don't know what in reserves right now for Duke, but to say,
- 20:41well, we'd have to cut into that a little bit if we made less profit off of these state employees.
- 20:47That was, as I think I put on social media, the most tone-deaf thing I've seen
- 20:51in a really long time, and it's state employees needed to see their treasurer
- 20:56stand up for them, and you did.
- 20:58And so we do want to thank you so much. But that is, unfortunately,
- 21:02something we encounter a lot.
- 21:04Like, not even don't cut into our profits, but don't cut into our piles of extra money that we like.
- 21:11But we're cool with y'all not getting a ray. They don't say that out loud, but I mean.
- 21:15I don't even think they thank that artist, by the way. You don't think they're
- 21:18cool with us not getting a ray? No, I don't think they are. I think they are.
- 21:22No, I appreciate that. And while I'm happy to fight, what I'm actually here to do is win.
- 21:28Yeah. And sometimes that means we've got to fight in public.
- 21:32But usually when you fight in public, it's hard to walk things back.
- 21:35Yeah. And so I have a lot of praise for Dr.
- 21:38Owens, Dr. Tom Owens at Duke, who helped them walk this back.
- 21:42And he's the new leader there. And it's important that we win.
- 21:47And I don't need to be out there fighting if I can't deliver.
- 21:50And so I'm happy that our team delivered.
- 21:52And we got a lot of happy people, too. Good. Yeah.
- 21:55Happy they don't have to change doctors. It is also open enrollment right now.
- 21:58Yes. I suspect we have a lot of unhappy people, too.
- 22:01So hopefully we're doing it right by them in other ways.
- 22:05Yeah. And I think a lot of what you've talked about with Lantern as a starting
- 22:09point, as a starting point to what seems to be an overall philosophy under your
- 22:13leadership at the health plan, which is, okay, we have to insert competition.
- 22:17It's very hard sometimes to force the competition.
- 22:21So we're going to think of innovative ways that bring people to the table willingly,
- 22:24both on the side of the providers and the participants in the health plan.
- 22:28So I think that's awesome.
- 22:30But I know you also wanted to make sure we talked about the breast MRIs, the special MRIs.
- 22:36Is it an mri i thought it was a special it is an mri okay yep
- 22:40so it is breast cancer awareness month i'm wearing my
- 22:42pink tie so i want to make sure that we acknowledge that because it's a big
- 22:47deal for a lot of people and it touches a lot of families throughout the state
- 22:50it's roughly half of women have dense breasts and traditional mammography doesn't
- 22:54really do anything other than suggest there might be a problem which isn't overly
- 22:58helpful this has been known for some time.
- 23:02And the next best thing to do is get an MRI, which help you identify whether
- 23:07there's cancer there. We've historically not been willing to pay for that.
- 23:11And most insurers don't pay for that, to be clear. This was raised as an issue
- 23:15during the campaign, and we did some homework.
- 23:19Like, let's look at this from the lens of just how many lives is it safe?
- 23:23And how effective is it in doing so? And once you start to think about it in
- 23:27that term, rather than just an incremental MRI expense, it becomes pretty evident
- 23:31that I think you should cover this, not just for the member.
- 23:35That's, of course, the priority, but also as a matter of long-term finances,
- 23:40it's, as we all know, so much better to prevent than to cure.
- 23:44Ounce of prevention, so to speak. And this is just one more example of that.
- 23:48So August 1st, we changed that, where it is now not only available,
- 23:52but free for our members who need it.
- 23:54And again, hopefully changing lives one at a time, and also doing right by the
- 23:58state health plans finances too.
- 24:00That's huge. That will literally save love. That same advocate had reached out
- 24:03to us during that same period of time.
- 24:06And I think what you just said about most insurers don't cover it.
- 24:10I think you mean in North Carolina, right?
- 24:11Because I was shocked when she said, hey, there's so many states that require
- 24:17insurance companies to cover this.
- 24:19And I thought, really? And looked it up. Yeah. I mean, I was completely ignorant
- 24:23to this issue. Same here. Until she called. Right.
- 24:26And then it seemed like a house on fire, like we've got to do something about
- 24:30this. So thank y'all so much for that.
- 24:32I do think that will save a lot of lives. It's very scary.
- 24:35It is. You know, in addition to trying to make the state health plan solvent,
- 24:39we want to make it better.
- 24:40Yeah. And prevention is a huge part of how you make it better.
- 24:44Keeping people out of the health care system because they don't need it is always
- 24:48the best answer if you can get there.
- 24:50And being proactive with testing, primary care check-ins, and other things like
- 24:55that is how we're going to do that.
- 24:56And it's a huge statement. If the health plan says we want to have this covered,
- 25:00you can drive the market potentially to where our state will look like those
- 25:04states that think this is very important.
- 25:06There is, I mean, there's a huge signaling effect, and we're very aware of what
- 25:11the state health plan does for private insurance.
- 25:13Some people think that their plan just needs to be better than the state health plan.
- 25:16And it's a, state health plan's a pretty good plan, so that's a high standard.
- 25:20And so when we raise the bar, you do see that effect. Well, before we get off
- 25:24health care, I think we'd also be remiss if we didn't ask the question about
- 25:29Aetna, how the changeover is going. We do hear from a lot of members who complain.
- 25:34About the new administrator at Aetna. So can you give us some thoughts on that?
- 25:39Sure. So we process roughly 25,000 claims every day. Wow.
- 25:44And that's Aetna's job, right? It's third-party administrator of claims,
- 25:47and there's an enormous number of them.
- 25:50So while perfection is always the goal, a little realism is that we were missing
- 25:54claims under Blue Cross and we're missing under Aetna, and we're going to endeavor
- 25:58to do better, but I aspire to have a perfect day, let alone a perfect year.
- 26:02We were missing a lot in the beginning of the year.
- 26:05To some degree, that's expected in any transition. Not that you like it,
- 26:09but you can understand it. We have gotten better.
- 26:11I'm not sure that we are to the point that we're better than Blue Cross was last December.
- 26:15Some of that is that is still learning.
- 26:17You have an enormous number of potential claims in the healthcare system.
- 26:21There's the normal ones.
- 26:22You go to see your primary care for your annual physical. That's the most common
- 26:26claim, right? But then you have the very obscure claims that just happen once a year.
- 26:30And so it's only when we run into that claim, we process that claim,
- 26:35we hear from the member, do we actually know that it's different.
- 26:38The other piece of it is, and we're trying to iron these out wherever we find them.
- 26:42So people please make us aware is what I'd call distinction with a lot of different claims.
- 26:46Like as an example, I went to the dermatologist the other day and they charged
- 26:51me an $80 copay, which I was confused by because it's supposed to be $25 And I paid it.
- 26:57And then I got a check, which had my own signature on it. It was kind of cool.
- 27:01For $55 the next week. And so that's $25. That's one way to get to $25.
- 27:07Just charge me $8 and refund me $55.
- 27:08But that's, people don't appreciate that. And so we're working through some
- 27:12of those more customer service pieces of it, too.
- 27:14That is not suggesting that the customer service piece is all that we've got
- 27:18going on here. But we're getting there.
- 27:21They have been a good partner. We have work to do. We know it.
- 27:23Well, I think a lot of the time We've talked about this Edna gets blamed Or you get blamed Right.
- 27:29When, at least on our social media pages, because people are so confused and
- 27:35they're not sure who to be mad at about the cost of their health care.
- 27:40And so. Even we get blamed. Oh, yeah. Oh, goodness. Yes. Yeah.
- 27:44But there's a lot of people that think, well, it's because we switched over
- 27:48from Blue Cross to Aetna.
- 27:49And yet I noticed on LinkedIn, which I've had to pay more attention to because
- 27:54that's where all the health care people are. Yes.
- 27:56They're in a different place than some of the other folks. But that's fascinating.
- 28:00Somebody piped up just yesterday, a physician that said, we're in South Carolina,
- 28:03we've got Blue Cross, same thing.
- 28:06And these are physicians complaining that physicians are not getting treated
- 28:10as well as hospitals, which is, you know, that's another concerning thing because
- 28:14we don't, we really, our members care very much about their doctors.
- 28:18They want to make sure doctors and nurses, workers like they are,
- 28:21are not the ones who are, if we're going to overpay for something,
- 28:25we want the workers to benefit from that and And not just the top levels of
- 28:30admin and the opulent facilities and things like that.
- 28:35They're not all opulent. No, but there are some that are.
- 28:38And that makes no sense. Right. You know what I mean? I agree with you.
- 28:42We really do have a dichotomy in this state, though, between rural and urban in this regard.
- 28:47And, you know, as we talk about fighting the hospitals, quote unquote,
- 28:50those are very different things.
- 28:52Well, yeah. But the governance of groups that fight for them are kind of led
- 28:57by the big guys. Yeah, that's fair.
- 28:59So that's who we have to kind of focus on.
- 29:02But again, I think Aetna and the treasurer's office itself are getting a lot
- 29:06of guff where people really aren't sure where to put this frustration.
- 29:10And one of the big goals that we have for the state health plan over time,
- 29:14and I think we're going to make some progress on this in Q1 of 2026,
- 29:18is making health care easier for people.
- 29:20Yeah. I mean, it's kind of a basic concept that we've lost the thread on.
- 29:25We need to help people navigate.
- 29:28It's this, you know, good luck. You know, figure it out on your own.
- 29:31And maybe for some people that might work.
- 29:34But for most people, we're busy. We've got other things in our life we'd rather
- 29:38deal with than scheduling appointments or reminding ourselves to do X, Y, or Z.
- 29:42We need to be in the business of calling our members, not having them call us.
- 29:45And what does that mean? That's fundamental.
- 29:47It sounds simple, but reaching out to you to help you with, hey,
- 29:52we noticed you haven't had a physical this year.
- 29:54It's like, can we help you find a doctor to do that? How's your schedule?
- 29:58We need to be in that business because again, it goes back to prevention versus
- 30:01cure. If we can keep our members healthy through basic steps, that is great for them.
- 30:06And that is great for everyone as a result. And that is, you have a great team over there.
- 30:11We get lots of questions when folks are having those issues with the claims.
- 30:14And while I don't have access to their information, obviously,
- 30:17you guys are very quick to respond.
- 30:20And your folks, all I have to do is send the information over for this,
- 30:24you know, for said plan member, and they do reach out.
- 30:27So, yeah, guys, don't hesitate to reach out to us. We might not know the answer, but we know somebody.
- 30:33And in turn, I know some people. So, no, we're happy to help.
- 30:37That's what we're here to do. And we won't know unless you reach out. Right.
- 30:40So moving to the retirement system from health care.
- 30:44Obviously, that's a big concern for our members. And obviously,
- 30:47the first thing on their minds is the cost of living adjustment that they're
- 30:51not seeing for the last, what, 10, 12 years, really.
- 30:55You were quoted this week in the NC Newsline saying that some of the changes
- 30:59that you've made and the investment authority that has been created may bring
- 31:04gains enough for a cola in future years.
- 31:07Can you tell us a little bit about those changes?
- 31:09Sure. So there's always a little
- 31:11bit of luck in everything. So let me just acknowledge that up front.
- 31:14We've had a bull market this year. I think it helps to be an investor,
- 31:18but it also helps to understand where the Trump administration is coming from.
- 31:21And april with tariff liberation day
- 31:24and a massive stock market sell-off if you
- 31:27find yourself just ideologically opposed to him and everything he
- 31:30does i think you would have decided to sell
- 31:33your whole portfolio and say the world's ending and it turns out that would
- 31:36have been the wrong instinct so we've had a little bit of luck a little bit
- 31:40of politics honestly but a lot of just basic finance that has gone into what's
- 31:44happened this year we were sitting in a portfolio that had kind of roughly 48%
- 31:49in equities and 52% in bonds.
- 31:51And what you see in most other state pensions in this country,
- 31:55it's 70% stocks, 30% bonds.
- 31:57We're a fiscally conservative state. We're better managed financially than most.
- 32:01And so we don't need to be as aggressive as most people, but that difference in risk was too much.
- 32:07That was adding up to us making 5% a year, and this is over 20 plus years.
- 32:13Versus 6.5%, which is what we need to make the math work. So that one and a
- 32:17half percent compounded every year is why we have a pension deficit.
- 32:20It is that simple. Employees are obviously contributing.
- 32:23The state is contributing. So it is the investment side. So our principal task
- 32:28is to take five and raise it to six and a half.
- 32:31Is seven better than six and a half? Yes, it is. But at some point beyond six
- 32:36and a half, when you start to take too much risk, that's a different problem.
- 32:39We're going to get nowhere near that. But we need to raise 48.52 to something like 60.40. Yes.
- 32:45And that's what we've been doing. That's what we've done this year.
- 32:48The investment authority allows us to not just raise it to 60.40,
- 32:51but to be better in the 60 and better in the 40, which is another way to add value.
- 32:55So we've had, we announced the first half of the year was a record profit number
- 33:00in six months. in pension history.
- 33:02The third quarter was also very good to us. We will publish those numbers soon.
- 33:07But this is only one piece of the puzzle.
- 33:10And the October 30th teasers and elders, meaning we're going to go through all
- 33:14the other pieces of the puzzle.
- 33:16It's called an experience review. It is described to me as actuarial Christmas.
- 33:20So don't let that deter you from coming.
- 33:22Oh, that sounds so fun. Right. Yeah.
- 33:25It's almost as good as the state fair. But what we do is we look at all the
- 33:29other assumptions you want to know the answer to before you talk about cost
- 33:33of living adjustment policy.
- 33:34Here's one. Are people living longer?
- 33:38It's an important component of all this. What is wage growth likely to be in
- 33:42the future based on what it's been in the recent past?
- 33:45Not just for per person, but how many people are on the state employment roles.
- 33:50You want to look at things like that. The other piece that's actually really
- 33:54big, and I think we will change, is what's called our amortization period.
- 33:59So we owe $16 billion at the beginning of the year to the pension system as
- 34:02a state. And how fast do you want to pay that down?
- 34:05You know, you can get 30-year mortgages, you can get 15-year mortgages,
- 34:08you could do it all in one year if you're lucky enough to have that kind of money.
- 34:10We may need to make that decision. We are doing it over 12 years right now.
- 34:14Most states are between 15 and 18. States like California are at 40.
- 34:20I think it's appropriate to be in the middle of this pack on this one,
- 34:2315 to 18 years. that has the effect of lowering how much you have to put in
- 34:27for payment of that deficit over time, plus the excess gains in the investment
- 34:32portfolio you get into that deficit too.
- 34:34So, getting back to the original question, how fast do we get to a COLA conversation?
- 34:39I think it'll be different in teasers versus elders.
- 34:42And without prejudging and telling you everything that we're talking about October
- 34:4630th, teasers is in better shape.
- 34:47And there's a lot of reasons for that. But I think teasers and elders may go at the same time.
- 34:52But if one goes before the other teasers would go before elders.
- 34:55And I think it's realistic, given what I know today and things change,
- 35:00that we'll be having that conversation in January of 2027 for a June implementation.
- 35:06Okay. Interesting. So, go ahead, Suzanne. I think you had a – I heard you.
- 35:11I heard you have a thought.
- 35:13Well, we do a good job of trying to educate our folks on exactly how the retirement
- 35:18system is built. The quick way to put that is, you know, the employer contribution,
- 35:23the employee contribution and returns.
- 35:26That's what makes the system go. And it should produce its own COLA from that.
- 35:31Returns are the problem. So when our folks hear that there is a return,
- 35:36their first question is, well, are we getting a COLA this year?
- 35:39So we also have to take into account the operations, the employer contribution,
- 35:45stabilization rate, those kind of things. And there has to be enough of an investment
- 35:50return to meet all of those before we have money for a COLA.
- 35:54And just as a reminder, the TSIRS board does not have the power to do cost of
- 35:59living adjustments. Only the legislature does.
- 36:01The local government board does have that power. And so they are different in
- 36:05that regard. And we vote on these things usually in January.
- 36:08So that's when you'd be teeing up to that conversation.
- 36:11But yeah, that's an issue because it's a ton of money for a COLA.
- 36:15So that's going to the legislature and asking them to fully fund a COLA is asking
- 36:21for. You multiply it by what, 10?
- 36:2312. Yeah. 12, you're right, 12. Yeah, just an enormous amount of money.
- 36:28Whereas if we have returns that meet goals, we won't have to do that.
- 36:33And here's where it's really confusing because we've lived through multiple
- 36:37treasurers and a lot of people out there have said, it's Falwell,
- 36:41he wasn't aggressive enough, so we don't have the returns.
- 36:44We didn't get COLAs with more aggressive strategies under treasurers before Falwell either.
- 36:49So we fall back, much like on health care, to what are we paying in fees?
- 36:54We do know what other public systems are paying. We know that ERISA doesn't
- 36:58apply to public pension plans.
- 37:00We know that if we all went out and got a 401k somewhere, we would get documents.
- 37:05We would get official documents. We would get prospectus. We would know what
- 37:09the agreement was. Employees are putting 6% in a month to something they can't see anything about.
- 37:15They're making an investment, and they're unable to see what the terms of that investment are.
- 37:21So, I know where you're coming from. Yeah, I mean, like, you could make a 10%
- 37:25return on something, but if your fees take 4% out of it. Right.
- 37:29So 70 plus percent of our assets have no fee, right?
- 37:34And one thing Treasure Falls does a great job of is building our internal capabilities.
- 37:38So we used to have external people help us with our equity portfolio, as an example.
- 37:43And the vast majority of that now is run through our own trading desk at no fee.
- 37:47We do pay our people something, but you can see that publicly available.
- 37:51So the vast majority of our assets actually have no fee. As we go forward,
- 37:55what I hope to do is bring more assets in-house from an in-house management perspective.
- 38:01There will be more cost in-house as a result of that, but we will reduce costs
- 38:05external so much more than that, that it'll be a good trade.
- 38:08That's great news. That said, we're still going to have areas where we can't do it in-house. Yeah.
- 38:14And we will pay people fees and they, on a dollars basis, they might offend
- 38:19you, but on a net dollars back to us, after we pay those fees,
- 38:22you will like the results.
- 38:24So, you know, I guess fees are part of the equation and they are an important part of the equation.
- 38:29Someone asked me the difference the other day between Treasurer Falwell and
- 38:33my belief about paying fees. And my answer is, I think 80% of the investment
- 38:38management industry doesn't earn its fees.
- 38:41Dale thinks it's 100, though. And that's the difference, right?
- 38:45And so we're going to make exceptions, find people who we think are excellent
- 38:49at what they do, and we're going to bake a fee expectation into what we expect out of them.
- 38:55And net of that, we need to be better off. Well, and this is where your background
- 38:58is such a bonus because what we're hearing from our counterparts around the
- 39:02country is often the folks running the plan honestly may not even know what they're paying.
- 39:08And it's a particular problem in public pensions. You would probably be able
- 39:12to catch those things and know how to surround yourself with people that would catch those things.
- 39:17Yes. But see, it's a huge game of trust. for the employees to hope they've got
- 39:21one of those plans because there are plans out there.
- 39:24Or they have just been robbed. And they've ended up all of a sudden 28% funded and nobody knew why.
- 39:32If you're down that low, I bet you know why.
- 39:34But yes, there are lots of examples. Well, they went hard and aggressive in
- 39:38alternatives in that particular plan. More likely the state legislature didn't
- 39:41fund the pension system. Well, it could be. If you're down that low.
- 39:43It could be a combination.
- 39:44But it is interesting if a plan seems to go so heavily in alternatives.
- 39:48So it's a big swing, right? You either make a home run or. So that's,
- 39:52I think the cause and effect are, in my view,
- 39:55backwards there, where people who find themselves with legislature who's not
- 40:00willing to fund the pension system, and we've had a bipartisan tradition in
- 40:03the state that has been fantastic for a long time, so we're blessed in that way.
- 40:06So people who find themselves in that situation then get desperate.
- 40:10And then they take too much risk.
- 40:13And not that that makes it right, the order of things, but that's how I see
- 40:17it play out where, and I won't pick on any particular state,
- 40:20but I know the people who run the pension system, they have an idea of what they're doing.
- 40:24They're playing the hand they're dealt, and it's a terrible hand.
- 40:28We're not that way in North Carolina, and thank goodness. So we did mention Elders.
- 40:33So bouncing back to that, the folks in Elders, let me take one more step back for the listener.
- 40:38When somebody retires, there is a formula to get your calculation for what you're going to be paid.
- 40:45Elders formula is higher than teasers, than folks who are state employees.
- 40:50So the local employees start out with a formula that's giving them a higher
- 40:54check by, I can't remember how many clicks.
- 40:58Which is one of the reasons why elders is less funded than teasers.
- 41:01Yeah. And that gap is widening.
- 41:03Yeah. So the implication of that is, going back to the COLA conversation,
- 41:08we're in a much better position in the teacher's plan to give a COLA than we
- 41:11will be in the local plan. It's in part because of that.
- 41:14Okay. Except for elders, every one of those, and I can't remember,
- 41:18we're at 1.82 in teasers. And they're at 1.85.
- 41:21Okay. So there, for the last however many years, they've gotten,
- 41:24for three clicks, that would be 1.2% more a year that they're getting.
- 41:30Crediting rate, right. Yeah, it's like they're getting a COLA compared to teasers.
- 41:34Right, but the COLA history, even, the limited that it is, has been better in
- 41:39teasers than the elders for the last decade. Yeah. And this is one of the reasons why.
- 41:44But elders has something closer to the average of the states,
- 41:47because the average of the states is 2.0.
- 41:51Well, according to their website. I'm focused on our state. Yeah.
- 41:54Well, it matters to our folks because to be at 1.82 and to check all the websites
- 42:01around the country and think, what in the world?
- 42:04That's a big difference. That would be somewhere between an 8% and a 9% difference
- 42:08in what they're getting every month. Yeah.
- 42:10No, I get it. I would want to, because I'm a math guy, go through all the math
- 42:15of like you have some pension systems which are not Social Security eligible.
- 42:19Are we counting those in there? because that's a big deal. Yeah,
- 42:22and some of them are, yeah. Right.
- 42:23So I don't know enough to have an educated opinion, but yeah,
- 42:27I get why people will be frustrated by that. That makes sense.
- 42:30And so, you know, trying to get to the end of the story, I know that one of
- 42:35the things you've said publicly recently, and I just wanted to ask you a little bit about it,
- 42:40was that if we could get better returns, that could ease some of the burden
- 42:43on the General Assembly with this very high employer contribution rate.
- 42:47Now, we've seen the time that it was zero. Sure. We've seen the times our funds
- 42:51were escrowed and we had to sue to get them put back, literally,
- 42:55and take it all the way to the Supreme Court.
- 42:57We've seen it all. So we're a little concerned if we start doing well,
- 43:00that that's exactly what would happen.
- 43:02The General Assembly would say we can ease our burden a bit because we've done,
- 43:06they have done a large contribution now for a number of years. Yes.
- 43:11So we're just afraid the retirees are still going to be at the back of the line with a 1.82 formula.
- 43:17And, you know, they don't really care about your asset to liability ratio in
- 43:21terms of, you know, where we stack up compared to anybody else nationwide.
- 43:24They care. Do we see any benefit from this, quote, strong pension system we hear about? Right.
- 43:30And they don't. I understand where you're coming from.
- 43:32You know, the pressures are on three different groups of this,
- 43:36obviously the state employees, the General Assembly and allocating the budget,
- 43:39and then the budget itself as well.
- 43:42And I think it is likely, reasonable, that all three groups need to get part of any excess gains.
- 43:49How that is split up is the General Assembly's purview and will be sausage that
- 43:54will be made at some point, I hope.
- 43:56I mean, I think in theory that sounds like a fair theory.
- 43:59The problem is when things get bad, it's been our experience that we continue
- 44:03to put in 6% and the state takes a holiday.
- 44:06Right. So we can profit share, but we don't risk share. That doesn't seem like a very fair bargain. No.
- 44:13I understand. It's hurtful. Yeah.
- 44:15So we're at 17% in the teacher system now. Yeah. And, you know, a long way from zero.
- 44:20The effect of that is that local employing units are trying to figure out if
- 44:26there's a way to get out of the high-benefit system sometimes.
- 44:29Yeah, of course. Yeah. And so I think that'd be bad for everybody.
- 44:31And so that's another pressure that we have to deal with.
- 44:34Yeah. of how do you make sure that people value this appropriately,
- 44:38want to be in the system, both on the employer and the employee side,
- 44:42of course, particularly.
- 44:43Yeah, there's a lot there. I hope that we create that problem by making the
- 44:47gains that we need to make. Yeah, I like that attitude.
- 44:50Well, we're up for more conversation. I have one more question.
- 44:54I know we're creeping up on time here.
- 44:56Not too long ago, $170 million was, that was great news.
- 45:01Of course, our people got really excited about it. You didn't finish the thought. $170 million what?
- 45:07You just said a long... Oh, there was $170 million hanging out there somewhere
- 45:11and your staff over at the treasurer's office found $170 million.
- 45:16So folks didn't understand, one, where it came from, two, what it can be used on.
- 45:21So we got really excited about the possibility of helping with a COLA or the
- 45:25possibility of helping with those increased premiums.
- 45:28So if you could just touch on where that money came from, how it can be used,
- 45:32what it cannot be used for, that might be helpful.
- 45:35So the $170 million, just to begin with, was never quote-unquote lost in that
- 45:40it shows up in the state's financial statements.
- 45:42It's, I believe, on page 384, though. So it's not exactly front of mind.
- 45:47And it showed up as restricted cash that really was the purview of the treasurer.
- 45:52But it wasn't front of mind for anyone because what it represented was when
- 45:56the state went to make usually a capital project.
- 46:00Let's say you're building a $100 million office building downtown.
- 46:02The state appropriates the $100 million. Maybe they borrow the $100 million.
- 46:06The building gets built. But what if it's less than $100 million?
- 46:11Doesn't happen often admittedly but sometimes
- 46:14it does well that money just sat
- 46:16in escrow and it earned interest we went back 25 years
- 46:19and we still there were deposits into this account
- 46:22before that so this has been going a long time and again it doesn't happen very
- 46:25often but that money you know the general assembly doesn't go looking for because
- 46:28they appropriated 100 million dollars whoever's the beneficiary of the building
- 46:31doesn't go looking for because they didn't need to ask for anymore and so it
- 46:34just sat idle earning cash returns we can do better than cash we should and
- 46:39use this for something productive.
- 46:41So there's only two ways you could use those monies by law.
- 46:45One, you could either reduce the state's debt or two, the General Assembly could reappropriate them.
- 46:50So we made the General Assembly aware of these proceeds and given the state
- 46:55of budget talks, they haven't appropriated a whole lot of things.
- 46:57So they didn't choose to appropriate this. So we're going down the other road
- 47:00now and that's reducing state debt.
- 47:03So we're doing a massive bond refunding plus bond tender this month.
- 47:08Effectively, by the end of all this, we'll have saved the state another 50 to
- 47:13$75 million on top of what we found and reduced state debt, which will allow
- 47:18General Assembly, the voters,
- 47:20to think creatively next time with another couple hundred million dollars about
- 47:25what they want to spend it on. So that's where we are in the process.
- 47:28It gets really deep in the state's financial statements and a little complicated,
- 47:32but in the end, just to put some context on it, this is like opening your kitchen
- 47:37junk drawer and finding 300 bucks.
- 47:39Like relative to an average salary in the state, that's about the amount of money.
- 47:42Pretty big deal. It is a big deal. And, you know, maybe a commentary on the
- 47:46state of the world we live in.
- 47:47We got press inquiries around this. And the first question from all of them was whose fault is this?
- 47:53Yeah. And if I find 300 bucks in my junk drawer, I'm just going to celebrate.
- 47:57That's the first thing I'm going to do.
- 47:58And so that's where we wanted to be on this. I'm never going to answer that
- 48:01question because it's just good news for the state and we can do something better
- 48:05with it. Thank you for that.
- 48:07Do you have anything else you want to talk about? It's open enrollment,
- 48:11and everyone needs to be aware of that.
- 48:13It's important that you update those elections. It's important that you update your beneficiaries.
- 48:17There are a lot of things across my desk, but one of the saddest ones that we
- 48:22get is when, God forbid, something happens, and people have not updated their
- 48:26beneficiaries, and then something happens that they definitely really wouldn't
- 48:29have wanted to happen with their estate.
- 48:31So as you're doing open enrollment, as you're making your elections on health
- 48:34care, update your beneficiaries so that your loved ones are planned for,
- 48:38because that is something that we don't want to have to deal with after the
- 48:41fact. But I don't want to leave it there.
- 48:43Things are going well in the state and going well at the treasurer's office.
- 48:47Please reach out to us if we can do anything better. There's been exactly one
- 48:50perfect person to walk this earth, and it's none of us.
- 48:52So we take criticism, particularly constructive, well, and we'll look for you
- 48:57guys to tell us how we can do our jobs better.
- 48:59Awesome. Well, thank you. We thank you so much for coming in.
- 49:02You guys have been really open with us and sent Thomas over here a few times
- 49:05and we really appreciate it. No, thanks for the partnership.
- 49:08We're all focused on the same things and that's making this state the best state
- 49:11it can possibly be. Awesome.
- 49:13Thank you. Thank you. Okay. We'll take a little break and we'll come back to wrap up the episode.
- 49:23All right well that was a great interview with treasurer brian
- 49:26i think it was his first first time on the podcast yeah first
- 49:29of many hopefully it was a very informative it was cool
- 49:32to have him i really enjoy talking to
- 49:34him yeah he really knows he knows his stuff right absolutely he
- 49:38does and he's not afraid to break it down where we all can digest it
- 49:41and make sense of it yeah so yeah that was a
- 49:44great and for an elected official i mean we've had a lot of elected
- 49:47officials and they're all been really cool but he was cool as
- 49:50a cucumber in the old studio here even he
- 49:52realizes he's got the issues sitting in
- 49:56his lap that are the biggest to state employees honestly and
- 49:59that's not fun but his personality is such that he doesn't let that freak him
- 50:03out he just keeps his focus on the work and trying to make it better you know
- 50:07i was thinking while we were interviewing him that he comes from an investment
- 50:12background and i wonder if he thought he would have to deal with state health
- 50:16plan issues so much. Well, he knew.
- 50:18I mean, that's part of what the treasurer had when he ran for office.
- 50:21But, you know, increasingly, Wall Street's buying up health care.
- 50:25So I'm sure that he already knew probably a whole lot about the industry before he got there.
- 50:31We could have asked him these questions, though, instead of conjecturing.
- 50:34It's kind of fun, though, to try to... Hopefully he's coming back.
- 50:37Yeah, he's got to come back for me to ask. But he's, you know,
- 50:40he's originally from Texas. He's clearly smart.
- 50:44You're going to. The plug for things. Just saying. Just saying.
- 50:47Do you want me to talk about Sanford now? I was going to say now.
- 50:49There it is. It's happened.
- 50:51That's two weeks in a row of really big guests for us. Last week,
- 50:55we went up to Western Carolina University and interviewed the chancellor.
- 51:00Suzanne, you didn't make the trip with us. It was pretty awesome.
- 51:02Yeah, y'all sounded like you had a good time.
- 51:04Except for Sam sent us on a wild goose chase across the university for a T-shirt,
- 51:11but we won't hold that against her. I could have sent you to some of those dorms
- 51:15that are straight up a hill.
- 51:17Not that far. So what he's referring to...
- 51:20We wanted to buy shirts from the student store. We were at the administration building.
- 51:25And Sam said, it's more or less the next building that way.
- 51:31Now, Sam is clearly younger than we are. That's why she's a Gen Z guru.
- 51:36And she's fit. Yeah, I was going to say, we were not probably fit at that age.
- 51:41So John and I go off on this trek thinking, okay, next building down. It was straight up.
- 51:49You might call it a hill. I call it a mountain. It was at least a thousand foot.
- 51:55It was a steep incline. I love how we got like maybe 50 feet from where we were.
- 52:00Oxygen started getting thin.
- 52:03We got maybe 50 feet. And artists said, we should have drove.
- 52:07We should have drove. That's so lazy. To me, it's not that far.
- 52:11And I also didn't say it was the building right next to us. I said it's past those buildings.
- 52:16It's right past them. So essentially next to it. It was.
- 52:20Now, a little bit. So I was looking at pictures of the campus. Beautiful.
- 52:23That is not the most steep hill on that campus. Yeah.
- 52:27That's the thing. That's what I was going to say. So like, we only saw like
- 52:30a very tip of the iceberg of that campus.
- 52:32It's so beautiful there. We saw a very small part of it. Yeah.
- 52:35I'd like to go back and tour it.
- 52:37I spent my whole morning pretty much walking around that campus whenever I got
- 52:40there. So I was a little sweaty when we recorded the podcast.
- 52:42Do you feel like a lot has changed in the last few years or?
- 52:45Not a lot. But, I mean, the new dorms
- 52:48buildings that are right next to the administration building are there.
- 52:53They were, I think they were almost completed whenever I graduated.
- 52:58Because I remember that's where my dorm building used to be.
- 53:01And I got to watch that get knocked down.
- 53:04Yeah. Because they sent us out an email saying when they were going to be knocked
- 53:08down. And those had been there a long time.
- 53:10Like, my mom lived in the dorm building next to mine. That was also knocked
- 53:14down. And so we knew when it was getting torn down because the school sent out
- 53:18an email saying, hey, we're exploding two dorm buildings today if you guys want to go watch.
- 53:24I mean, it's a great interest to people. And so it was a really cool thing because
- 53:27there were so many students who had lived there and we all just pulled up in
- 53:31trucks and cars and sat on the bed of trucks and sat on our cars and just watched
- 53:36it happen because there were so many of us that had our freshman year lived there.
- 53:41You shared a moment. It is funny how when you first go back to your school after
- 53:46three or four years, I guess you're in this position.
- 53:48It doesn't change that much, but it starts to change a little bit.
- 53:51And now, like, it's been, what, 20 years since I graduated? Oh, yeah.
- 53:54Totally different. And Carolina is totally different. They're just buildings
- 53:57I've never... Football is the same.
- 54:00Not a good thing. Right. Yeah.
- 54:03Oh, let's not even talk about it. It's been an exciting week in Chapel Hill. We're a little bitter.
- 54:09Even my mom has said, she told me she was like, it hasn't changed too much since she had been there.
- 54:14And she dropped me off exactly 30 years after she had graduated.
- 54:19And so when she dropped me off, she was like, yeah, there's a couple new buildings.
- 54:24But, well, Chancellor Brown, Chancellor Kelly Brown at Western,
- 54:27when we interviewed her last week, said, And Western, it's not their goal to
- 54:32try to let's become huge or let's become this or that, that they want to be
- 54:35awesome at being what they are.
- 54:38And I think she said not chase every shiny thing.
- 54:42And that is how that campus strikes me, though, even just looking at it.
- 54:47It's always nicer than the last time I saw it. They're always upkeeping things
- 54:52and renovating things appropriately, but they're not doing, like,
- 54:56huge expansions that really alter that character.
- 55:00And that character of the campus and of the university is really unique. It's cozy.
- 55:05And people love it. Cozy. They love it. We had a great time in the mountain there.
- 55:10We went to the golf tournament the day before. It was a lot of fun.
- 55:13So this week on the Gen Z moment, Sam, we gave her a little break because she's
- 55:18a little bit under the weather, although you probably can't tell it from this.
- 55:22But so we gave her a little bit of a break. But I did find this article from
- 55:27The New York Times that says that Gen Z is actually great at saving for retirement.
- 55:32And I thought I'd bring it up because I know when I was their age,
- 55:37just starting out, I did not care about retirement one bit.
- 55:41And like. Well, it was so far away. Yeah. This says that 20% of Gen Zers are
- 55:47already saving for retirement and they're contributing to 401k plans at higher
- 55:52rates than their predecessors.
- 55:54Well, good. That's excellent. It also says that they do a lot of almost like
- 55:59micro-investing, I guess is what they call it, through like Robinhood and things like that.
- 56:03Oh, yeah. And I guess I don't know if you really count that as retirement savings
- 56:07because it's almost like speculation.
- 56:09It's almost you can access those funds.
- 56:12I don't know. But they do cite that as well. Do you find that you are thinking
- 56:15about retirement more, Sam?
- 56:18Really? Well, a lot of my generation has the fear that we're not going to be able to retire ever.
- 56:24So I think that's where the earlier investments come in.
- 56:28I'm on the fence about Robin Hood. I did a lot of research on that when I was
- 56:32in college in a marketing course. We had to write a paper about it,
- 56:36whether it was good or bad.
- 56:37And so I'm still not sure about that, even after that research.
- 56:42Mixed feelings. Yeah. I think that kind of ties in with our discussion with
- 56:46Treasurer Briner, too, that, you know, obviously the retirement plan,
- 56:50and he was talking about individual investors and things. I don't know. I don't know that.
- 56:55I don't know. Well, I mean, I think it matters in terms of, and we're going
- 56:58to be talking to OSHR Director Stacey Meyer soon, but I think all of this matters
- 57:03in terms of what state employment has to offer or public employment has to offer to young people.
- 57:10What used to be a draw for young people who were more risk averse,
- 57:14wanting something more stable, was public service because you had good benefits.
- 57:19You wouldn't get rich on your salary, but you would be okay.
- 57:24And you would have a good retirement plan and a good health plan.
- 57:28And so we did express in our interview with Treasurer Briner that we've seen
- 57:31those things kind of diminished a bit, the retirement plan and the state health
- 57:36plan in more recent years.
- 57:38But the salaries didn't change to be what the private sector salaries are.
- 57:41So it's that's kind of an ongoing problem that we're going to have to face.
- 57:45The chickens are coming home to roost.
- 57:47Yeah, I use I mean, I've started using this thing called acorns.
- 57:53I don't know if you've heard that. It kind of takes like really small parts
- 57:56of—anytime you buy something, it'll take like two cents out and invest it.
- 58:00I don't know. I haven't seen huge returns or anything on it, but— Not on two cents.
- 58:07But, you know, I guess that's maybe one thing that Gen Z is using as well.
- 58:11We should have a—what are we?
- 58:13Gen X or Gen— I mean, you're a millennial. Suzanne and I are X,
- 58:17but you'd have to be a millennial. Okay. On the older end.
- 58:20Yeah. Yeah. You were the first year of millennials. Okay. I think we've talked about this before.
- 58:25So before we move on from Gen Z, we got to talk about the big news from the week.
- 58:31Taylor Swift's new album came out. And what are your initial reactions, Sam?
- 58:36I love it. I stayed up till 2 o'clock in the morning. I listened to it twice
- 58:41through the night that it came out.
- 58:43I have a bad habit of just staying up really, really late when an album releases.
- 58:48It's so good. It's so good. There's been some backlash to it,
- 58:52right? There are some people who don't like it.
- 58:54They think it's not lyrically deep enough after she just released something
- 58:58like the Tortured Poets Department, which I think is kind of reflective of her life.
- 59:02She's happy and just living life joyfully.
- 59:04Let her live life joyfully and create happy, fun pop music. Nothing will mess
- 59:08with a songwriter like happiness. Yeah. Healthy amount of snark in it.
- 59:12And I am always here for snark. There's plenty of snark. I love it. I like Spicy Taylor.
- 59:17Yeah, Spicy Taylor. My reactions, I've had to listen to it several times.
- 59:23I've not been as excited about it. I mean, my wife and my daughter are very
- 59:27excited about it. My wife is really in love with it this time,
- 59:30which she's not a huge fan.
- 59:31I think maybe it's like geared towards an older person than the younger folks
- 59:36this time. But I don't know. I've liked some of the songs.
- 59:39There's a lot of samples on it, though. And I guess she's recognized that.
- 59:44I mean, in her album, she's said this song is from an interpolation of the Jackson 5 or whatever.
- 59:50But you can really pick out a lot of the samples.
- 59:53I'm kind of on the fence on whether she maybe used AI a lot to produce this
- 59:58album or not. What do you think, Sam? No.
- 1:00:01No? No. This is just how Max Martin and I can't think of his other name.
- 1:00:08This is how the albums that she produces with those two that she produced it with come out.
- 1:00:14Reputation, 1989. They're very poppy albums.
- 1:00:18And that's just the way that those producers work.
- 1:00:21It's not like Jack Antonoff. He's much more mellow. I mean, clearly it's not.
- 1:00:28Oh, yeah. Jack Antonoff is a huge producer as well. He helped her produce a
- 1:00:32lot on the Tortured Poets Department.
- 1:00:35He also has been producing a lot with Sabrina Carpenter. He produces a lot with huge names.
- 1:00:40I do like the Opalite song, and I do like The Life of the Showgirl with Sabrina Carpenter.
- 1:00:46The rest, eh, I mean, they're all right. I like Canceled.
- 1:00:50I like my friends Canceled. I like Actually Romantic and Opalite.
- 1:00:55Those are my two favorites.
- 1:00:56What about you, artist? I don't know any of which you speak,
- 1:01:00but I have great respect for her talent, for sure.
- 1:01:04Look, I've been worried about Dolly all week, okay? Amen. I know that she came
- 1:01:07out and was like, I'm okay. Yeah. Did you see the video? Yeah, I'm still worried.
- 1:01:11Oh, really? Yeah, something's wonky there. Love Dolly Parton.
- 1:01:14You think she's got some ailment? I mean, I don't know what's going on, but something's off.
- 1:01:19I don't want to put that out there. Yeah, I don't want to put that in the universe.
- 1:01:22But Dolly and Willie are in the world together.
- 1:01:25Speaking of really amazing songwriters. You know, they're both in that category.
- 1:01:29What is Willie now? Like 90-something?
- 1:01:32170. He's going to be fine. He and Keith Richards will be here when everyone else is gone. 92. 92.
- 1:01:38Bill Daniels is 98. Who's that?
- 1:01:41Did you never watch Boy Meets World? Oh, that guy. Mr. Feeney.
- 1:01:45Yeah, okay. He's going to be on Dancing with the Stars next week. At 98.
- 1:01:50Danielle Fishel, who played Topanga, is on Dancing with the Stars.
- 1:01:53And that is who she is bringing out for dedication night, is Bill Daniels.
- 1:01:59And I'm so excited for that. God, I'm old. I need to go get Botox like today.
- 1:02:03So just for our listeners, you know, this is the portion of the podcast that
- 1:02:07you can turn off if you don't want to hear all this. But you know what?
- 1:02:11I like to listen to it because I want to try to stay informed. Young.
- 1:02:16Well, no, no. Just informed. I don't believe in trying to stay young,
- 1:02:20whatever that means. I mean, you know, you want to enjoy life.
- 1:02:23But I want to be interested in what younger people have to say and what they're
- 1:02:27interested in. Because, again, y'all are our future.
- 1:02:31That's right. Y'all, oh, thank you. You said y'all. Yeah, well, yeah. I love that.
- 1:02:36Well, John, yeah, you got a whole lot more time to go, bud. But after our very
- 1:02:41informative interview, this is a good part of levity. It's decompression,
- 1:02:45yeah. A little decompression.
- 1:02:47So overall, where do you rank the new Taylor Swift and the pantheon of...
- 1:02:53I was about to say, there's 12 albums to go through there, and that doesn't
- 1:02:56even include Taylor's versions.
- 1:02:58So is it too early to rank? Yeah. Yeah. What's the big single?
- 1:03:02Opalite? The first single that she did was The Fate of Ophelia.
- 1:03:06We don't know what the second single is going to be.
- 1:03:09It's usually when she chooses singles, it's usually based off of fans and what
- 1:03:14they're saying their favorite songs are.
- 1:03:16It's not always because the last album was I Can Do It With A Broken Heart was
- 1:03:22the second single when everyone was in love with the smallest man who ever lived
- 1:03:28because everyone found a way to relate to that, I feel like.
- 1:03:32So I have a feeling it could be Opalite, but it also could be the life of a
- 1:03:35showgirl so that we could get a music video with Sabrina.
- 1:03:39Well, yeah, I can see that. I did see that there's a video for Opalite, though.
- 1:03:44So maybe that's it. There's not a video for Opalite. There's a lyric video for
- 1:03:47Opalite. Okay, I want Taylor Swift to pay for some kind of sponsorship. This is, at this point.
- 1:03:53What's funny is she probably would. If she knew about us, she probably would.
- 1:03:56Well, at this point. If she knew about us is the key there. Anyway.
- 1:04:00All right, you ready to go to the question of the week? Yes,
- 1:04:03Scenic Swifties, let's do it. Yes, because they haven't had enough of us. John's work here.
- 1:04:11So Sam picked the question this week because I'm just totally out of ideas.
- 1:04:16But it is October, and that means spooky time, right?
- 1:04:20So what is your favorite Halloween or spooky movie?
- 1:04:24You know that makes us want to say, what's your favorite scary movie?
- 1:04:29Scream. From Scream. That actually might be mine, Scream. I don't love scary
- 1:04:34movies. I don't either. I'm not a scary movies person.
- 1:04:37Yeah, like, I think it's because. Halloween doesn't equal always scary movies.
- 1:04:41No, it doesn't, because Practical Magic, boom.
- 1:04:44That's my favorite right there, Practical Magic.
- 1:04:47Is that the one with Sarah Jessica Parker? No, that's the one with...
- 1:04:50Sandra Bullock and Nicole Kidman. Oh, yeah. They're making a second one. I know.
- 1:04:56More Midnight Margaritas. Yes.
- 1:04:58So, yeah, I was very traumatized when I was young because my brother was 10
- 1:05:03years older than me, and he loved scary movies and, like, scaring people at
- 1:05:07Halloween and just being a crazy teenager at Halloween.
- 1:05:11And so I was five years old, and he made me watch Child's Play. I was terrified.
- 1:05:16And my mom- That's not good. My mom did not like that. But yeah.
- 1:05:20So since then, I haven't really loved Halloween. But I guess maybe Scary Movie.
- 1:05:24I was a teenager then, and that was a big deal at that time.
- 1:05:28So is it Scream, or is it Scary Movie? Because Scary Movie is a parody of Scream.
- 1:05:33No, Scream. Scream, definitely.
- 1:05:34Although Scary Movie is funny, though. Yeah. Yeah, so-
- 1:05:38I'll just lump them all together. Okay, Artis, what's your favorite scary movie?
- 1:05:42I mean, I love Halloween, the movie Halloween.
- 1:05:46Jamie Lee Curtis is also a national institution. Yeah, she is.
- 1:05:51But the movie that's scary, that slasher films like Halloween are entertaining
- 1:05:55to me, but they're not scary to me.
- 1:05:57Things where something could really, really happen, those scare me.
- 1:06:02There was a movie called The Stepfather.
- 1:06:03Oh, yeah. And they remade it years later, but when we were in high school,
- 1:06:07Suzanne, so this was way, way ages ago,
- 1:06:10they made this movie, and this guy would marry a lady who already had children,
- 1:06:17and he wanted the perfect family, and of course, nobody can be the perfect family,
- 1:06:21so when they weren't able to be,
- 1:06:23he would get rid of them and then move to a new place and do the same thing.
- 1:06:26Like, that guy ended up being on a TV show called Lost later.
- 1:06:31But he was such a good actor. And he scared me to death because he was so,
- 1:06:37the character looked so unassuming and friendly.
- 1:06:41And, you know, it just made you look at everybody different after that.
- 1:06:45But it was a truly scary movie to me.
- 1:06:47I think that my generation had a film similar to that with Blair Witch Project.
- 1:06:53Oh, yeah, yeah, yeah. And everyone thought it was real at the beginning.
- 1:06:55And like we went and saw it like
- 1:06:57the weekend it came out and everybody's like, oh, my God, it was real.
- 1:07:00Like it really happened. It was free. And then like a week later,
- 1:07:03you're like you hear that it's not it was not real. But I'll watch any of those.
- 1:07:07See, the things that scare me are very different. Like I will watch any scary
- 1:07:12movie, Blair Witch Project, all of those things.
- 1:07:15A movie that I remember from really, really young, I was maybe seven or eight.
- 1:07:20I had nightmares for two weeks afterwards. And I didn't even watch the whole
- 1:07:24thing because I told my parents I'm going to bed before it even finished.
- 1:07:28The bucket list. What? I haven't seen that. Yeah.
- 1:07:31Scary? For seven, eight-year-old Sammy that's thinking about dying and having
- 1:07:36a bucket list and having to check things off. You way overthought this. Yeah.
- 1:07:41Way. So realistic things is what terrified me because I started to dread the
- 1:07:45future and started thinking about those things.
- 1:07:46I have a lot of anxiety and always have since I was really little.
- 1:07:49So. We're working things out on this podcast.
- 1:07:51We are. It's been therapy day. I gotta look up the bucket list.
- 1:07:54Okay, then if you want to see something happy and not a horror movie,
- 1:07:58Halloween Baking Championship.
- 1:08:00Ooh, yes. Love it. That's always fun. Are you talking about the Morgan Freeman, Jack Nicholson?
- 1:08:05Oh, I love that movie.
- 1:08:07Yeah, that scared me as a child. Okay.
- 1:08:11That scared me as a child. It's a buddy comedy.
- 1:08:14It was not a comedy for me. Yeah. Alright, we'll have to delve deeper into that once we're off air.
- 1:08:20Unless I'm accidentally combining movies because there were multiple movies
- 1:08:24that my parents would watch and they'd be like, it's a hopeful story.
- 1:08:27And I'm like, no, people are dying.
- 1:08:29Oh, so you were, as a kid, you were just obsessed with the death part. Oh, yeah.
- 1:08:34My mom, she worked in the ICU and I would have to sit there and say happy birthday
- 1:08:37to someone in this world and cover my ears anytime she came home with like a sad story.
- 1:08:41I would just be like, la la la la la la la la. Happy birthday to someone in
- 1:08:44this world. La la la la la la. Stop talking about it, please.
- 1:08:48Oh. Well, that's a good way to get away the end of podcasts.
- 1:08:52Happy birthday to someone in this world. I actually like it.
- 1:08:56Hey, I still say it to this day. It's somebody's birthday. What is today?
- 1:08:59The 9th. So if October 9th is your birthday, happy birthday.
- 1:09:02Happy birthday. My daughter's birthday is the 11th.
- 1:09:05October 11th. This is our most ADHD episode. We are all over the place.
- 1:09:10Her birthday is 10, 11, 12.
- 1:09:12Oh, that's cool. That was fun. All right. Have a great week, everyone. Bye.