Latest / The SEANC View / State Health Plan Shakeup: Atrium Moved Out — What It Means for You

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State Health Plan Shakeup: Atrium Moved Out — What It Means for You · The SEANC View

0:00
Hello, everyone. Welcome to another edition of the Scenic View podcast.
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I'm John Owens, along with Artis Watkins.
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And the best laid plans of mice and men usually go around, from what I think
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that's a saying. I don't know. Heard it somewhere.
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But we did record a whole podcast on Wednesday, and it was great and in the
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can. And then all of a sudden, we have breaking news from the state health plan.
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So we called Thomas Friedman, the executive administrator, and asked if he'd
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come on and explain a little bit about what's going on. And he graciously agreed to do it.
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So he is here in the studio with us. Hey, Thomas. Hello.
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And the news that we're talking about, obviously, is the announcement that Atrium
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will be considered out of network in the plan come January 1st, right?
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Except for a handful of rural hospitals that we're trying to work some stuff
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through with them that based on the agreement we signed in early September,
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based on what Atrium's doing, it doesn't matter network or not network for folks.
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And I think that's something we should spend some time clearing up. Yeah. But yes.
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Okay. So let's review what's going on, Artis. So start all the way back at,
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I guess, the plan's tier structure. So y'all announced, Thomas,
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that the state health plan would have a tier structure moving forward.
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Sometime in the summer, maybe June, was it, that you announced it?
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Yeah, so we voted on the tiering structure in March. And then we rolled out
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the plan design, just that we would do tiers.
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And then we rolled out our tier, kind of the preliminary look at things in June.
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And between June and July, that's when Duke Health came in and said,
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hey, y'all, we're not going to be non-preferred. What is it going to take from
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a discount point of view to get into the access tier? So that has been in place since July.
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Okay. Now, why did y'all make a tiered structure? That's the question a lot of people have.
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And one, I would just start with the traditional model of health insurance isn't working at all.
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When I look about the last few years when we've gone on that traditional structure,
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just to make it through the last two years, we needed an additional $390 million,
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$380 million from the General Assembly. That's money. That's COLA money. That's RAISE money.
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They've got to go above and beyond because prices keep going up.
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And we asked for almost $800 million more from members between premiums and a worse benefit.
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Yeah. A worse benefit that makes healthcare more unaffordable.
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Is leading to our membership getting sicker because we're not investing in their
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health and, you know, the prices of everything are going up.
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So we were asking folks to pay more for a worse benefit that is getting them
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sicker and to make matters worse, prices are going to expect it to go up next
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year faster than any year on record for healthcare costs in the last 17.
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So we said, yeah, this isn't it. This is not a sustainable approach.
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We need providers to compete for state employees' business.
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There are a lot of great things about state employees and members of the state
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health plan, one of them is, and
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I think we all agree, is they're the most dedicated folks to their jobs.
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State employees, corrections officers, stay at their jobs. Teachers stay at
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their jobs. Folks at DOT stay at DOT.
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They're going to be here for the long haul because they're invested in improving
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the state. And our retirees stay on the plan.
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So we said, okay, we have the most people who stick around the longest at their
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jobs and we're paying y'all the highest rates from a commercial perspective.
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And y'all have been on top of that for a long time.
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That's to the hospitals. To the hospitals. That's what you're saying.
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Yeah, we're paying that to the hospitals.
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Yeah. We're not paying the people the highest rates by any stretch of the imagination.
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You know, we're on average $63,000 a year with very little growth.
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I think you all have been on top of that one.
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So we're paying you all hospitals the most. We need you to compete for our business.
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And we're, truth this like a business people, we're going to treat this fairly,
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we want the best discount we can get.
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And in exchange for that, we're going to make it, we want to take the benefit
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back to 2012 to make it more affordable for members to go see you.
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So you're going to be that preferred provider. So you're going to get more members
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coming to you because we have a smart membership group, and I'm going to hit
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on another point of that later, that are price sensitive and good shoppers for care.
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And they're going to stick with you for the long haul. So give us your best discount.
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UNC and Novant, obviously UNC makes a lot of sense. They have a lot of state employees on the plan.
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And then Novant, they jumped in and said, we're going to give you a tremendous
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discount to be your preferred partner.
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And we're going to make up those discounts that we give you by seeing more patients,
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by seeing more state employees, and by having that long-term relationship.
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We're going to make the investment to be the provider for your patients.
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I just want to also say, it was just announced today that Novant had the most
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A from a quality and safety score, leapfrog scores in the state of North Carolina.
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So we're not talking about budget-basement providers for care. Right.
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We're talking about high-quality providers. Yeah, you told our board the last
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time you spoke to the Scenic Board, you were looking at a combination of cost
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and quality. Cost, quality, and access.
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What are you going to do to get more folks in faster?
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So right now, UNC and Novant are building state health plan specific access
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points where they can get white glove treatment to get folks in faster.
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So they're investing not just in their discounts, but building an infrastructure
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specifically for state employees.
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So that was the premise and then you got to be preferred and we knew in rural
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communities across north carolina you think about the eastern part of state
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the far western part of the state there's not two or three health systems in those geographies,
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so we didn't feel right up front just saying you need to give us a discount
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right like they don't have competition they're not get the money back we will
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figure out a way to lower costs there in time,
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but that's not where the big dollars are of our spend is right now so he said
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we're going to treat those folks as the benefit that they have today.
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But because we had to make the benefits so much worse the year before,
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we're going to pay for you some of that preferred savings to reduce the cost
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of specialty care in rural communities.
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Let me ask you one question before you move on, because you said UNC and Novant,
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accepted the challenge, I guess.
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Now, a lot of the questions that we're seeing on social media and whatnot was,
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was Atrium given a chance to be in this tier?
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Everyone was given a chance to be in this tier that could compete, you know.
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I find it very hard to believe, given the number of webinars.
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We talked through the hospital association. We've had multiple board meetings.
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This wasn't a secret. This wasn't trying to pass something on a consent agenda
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at a secret, you know, at a secret meeting.
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We were pretty out in front on what we were doing here. Yeah,
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I think Atrium will tell you they feel completely blindsided that they never got a chance to bid.
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You know, they, I look at Duke Health as a perfect example.
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And called before the board, our last board meeting, you know,
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CEO of the company, it's like, Tom, we're not going to be non-referred for state employees.
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Yeah. I was like, you're just going to have to give us a great deal.
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They said, done. We figured it out in five phone calls.
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So it was set up for the board meeting. I was down in Novant,
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November of 2025. I said, this is the way that things are going.
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I want you, you want to compete hard on this lantern business and win.
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That is how we're going to do this. We're going to start working with these people.
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They didn't want to go any cheaper than they were. They said,
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you know, we got other things, other priorities. I get it. That's fine.
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There's a lot of folks across the state of North Carolina.
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I said, I'm going full steam ahead with the folks that win this.
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Knock my stocks off if you can.
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I think I got one email from them between November, January,
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maybe one or two emails about, and I said, hey, I'm negotiating this.
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I'm happy to talk to you guys about maternity care right now,
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because we've been trying to do something like that.
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Last I heard from them on things. Meanwhile, I've got UNC, Novant,
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Duke banging down our door like, let's get this done. Let's get this going.
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I don't want to beg for a discount. We are the customer.
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We're the largest customer. We are the largest customer.
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For them to presume that it is my job as the customer to beg them for a deal
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when I have everyone else racing towards us, it's sort of preposterous to me.
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But then they did come in after the fact, right?
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They came in after the fact and said, we're happy to tie, right?
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We're happy to match. What does that mean?
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Offer the same price as that Novant offered. I'm like, y'all, we can't do this.
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They make a discount rate based on getting more volume and being a good partner.
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We lose all credibility with everyone if we say we don't honor our word and
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we're not good partners to people.
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So let's talk about what that means, because you have to administer the entire
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plan for all state employees and non-Medicare retirees in 100 counties and then
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wherever they live, sometimes elsewhere.
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That's your job, and you've got to deal with that. So we've got state employees
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and retirees who are saying—.
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Atrium is my provider. I still want them. I don't really care about all that stuff.
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You said early on something that we need to go back to. The reason that we don't
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have a choice not to care is that if the General Assembly has to keep pumping
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money into this thing because y'all aren't getting a better deal,
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then that money will come from raises.
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It'll come from retiree money. It'll come from maybe the employer contribution
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going into the retirement plan.
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So that's why you would care later down the line if the state health plan paid
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too much because it leaves nothing for the other things you hold sacred.
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And it's awful that employees have been put in this position.
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But to be clear, the state health plan did not put employees and retirees in this position. No.
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And I understand why you would want to blame the state health plan.
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You know, insurance companies don't have a great reputation across the country, you know, writ large.
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But we We are not an insurance company. I'm a state employee.
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We don't get to keep the money.
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There's no profits that go into me getting a timeshare in the Bahamas or anything
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like that. Yeah. Oh, and some people have said, oh, they must be on the take.
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Yeah, we're on the take. We're on the take, too, online. Yeah.
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Because people can't make it make sense that all of these people are very upset,
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with one hospital system and that it's not the hospital system.
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That's right. That might be the problem. it's not the hospital system.
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That didn't answer the call of the clear pricing project it is that it is not
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their fault who has continued to raise prices across the board you know,
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at any point in time they could go to etna they could go to blue cross and say
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hey our rates are too high we want to make them more competitive they don't
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need my sign off for that i can i'm a state employee i don't get to make those decisions for,
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their whole book of business that's not the route they've taken they've waited to hey,
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we didn't compete we didn't win now we're frustrated by it oh they were serious about this.
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Let's try to make this as confusing as possible. And we went back to the table
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with them in good faith after, in July and August, and said,
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hey, let's work something out.
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We understand we want to make healthcare more affordable in rural communities
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where there isn't that competition.
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But y'all, you gotta give us a discount on this stuff, right?
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Like, this is too expensive.
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I can't go back on the rates we're getting from Novant and UNC and some of those more urban markets.
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Let's think about these rural markets and happy to bring those folks into the
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access tier if you can cut prices for those services.
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You know, they didn't cut them as low as Duke did, I'll tell you that much,
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but they were able to cut the rates. We were able to kind of work out something
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for continuity of care for our sickest folks, where we get a little bit of a discount.
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I left that September 12th agreement, September 14th agreement.
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It's like, all right, we're good. Open enrollment's starting in a few weeks.
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Let's get these folks loaded in the access tier so providers can look.
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We'll keep a lot of their primary care docs in the preferred tier.
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We saved a little bit of money. Members are going to save a good amount of money.
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I think we're good. We're building the relationship in a positive direction
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so that as things evolve and go, maybe there's something more to do there at a point in time.
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And then we were entirely blindsided when they rolled out their patient affordability
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program. They didn't tell me.
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Someone from Novant actually reached out to me at 6.10 in the morning,
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let me know that was happening.
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Then our phone kept blowing up, and I was like, hey, this doesn't feel like
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a partnership move to me. And they're like, oh, that's not our intent.
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We kind of look back and realize that they were communicating with community
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colleges during our implementation planning with them that, hey, we're going to do this.
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Here's a quote. Will you save this quote for us in our press release?
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Yeah, we saw those quotes from— And it was like the higher ups.
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Yeah, it wasn't rank and file folks, obviously.
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But they were speaking for their employees. I'm kind of wondering if some of
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them don't regret that, actually.
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You know, I hope so. And we reached out to a few, and a lot of them didn't do it.
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A lot of them just sent us the note and be like, hey, what's the deal here?
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And we're like, you know as much as I do. And you knew before I did.
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So from there, we basically said, hey, you know, you're offering something.
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You know, their point was, hey, we just don't want to lose any patients.
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Right. Well, no one does. No one does. And so I was like, well,
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you don't, state employees are really smart and they're very price sensitive.
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If you offer something so much richer than they're being offered,
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they're going to take it because they're smart people that like,
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and you do have good doctors.
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They're going to take that. And you're leaving us on the hook,
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the state health plan. I've been very clear. We don't have any money. I didn't.
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So let's explain a little bit about what they, I mean, we've done it in other
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podcasts, So on our last podcast, or maybe the one before it,
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we talked about Atrium having put out a statement saying, the one you're talking
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about, that you learned.
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Crack of dawn, they never had told you before they were going to do it.
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And they announced, we're going to do an affordability protection program where
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we're going to allow patients who are state employees to pay us a little bit
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less even than they would if they were. A lot of bit less. Okay.
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Than they were if they were preferred tier patients.
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So it was about half, right? A few of the.
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It's less from a copay perspective and they're going to waive deductibles and
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co-insurance kind of across the board on things too. So it is just a flat number
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and they're going to, you know, they're going to write off the rest.
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Sounds great. Sounds great. Trojan horse. The problem is they're just writing
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off the members portion. They, you know, after in 2027, they're the ones that didn't agree.
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We don't have a contract with them for lower prices across the board.
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So the state health plan, we pick up the difference in that cost on the members
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behalf. So they're steering more members when we've told them we are running
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out of money to a place that has higher total cost of care.
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And they're going to write off that member portion because you're kind of good
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general rule of thumb. Remember when we called the plans the 80-20 plan, the 70-30 plan?
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It meant the member pays about 20% of the cost.
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The state health plan pays about 80% of the cost. So y'all's tax dollars,
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y'all's premiums and dollars, that's what's paying that 80%.
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So they're writing off some portion of that 20 or 30% and sticking that higher
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percentage bill to the rest of the members of the state health plan,
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taxpayers in North Carolina, and that just further compounds out.
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That's what you're saying. that's money for colas.
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That's money for raises. That's money to keep premiums down.
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That's money to lower taxes. That's just jacking that number up.
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And they say it can't increase. It'd be like, one, that's just madness to say
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that. Like, you don't know our rates with other providers. I'm telling you those are more.
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That's why they're preferred, is because we got a great deal.
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They kept saying it's not our intent to increase the cost of the state health fund.
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So what we've decided to do is take them at their word. If they really don't
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want to raise our costs and they are serious about reducing the cost of state
15:23
employees through this really rich benefit.
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As you and I were talking beforehand, if we offer the same benefit that they're
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proposing to every member of the state health plan, it would raise our costs
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$800 million a year, every year.
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So we said, fine, you're going to offer our member this. I think it's inappropriate
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and it's a contract loophole that you can run this kind of shell game with.
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But if you're going to do that and you're serious about keeping costs low,
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we're going to move your providers to the out-of-network level.
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And I'm going to get to why that's confusing for members in a second,
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but that just means they're going to be writing off more of the expense.
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They're going to still hold the member harmless, but the state health plan isn't
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on the hook for that big, as big amount of money as they're going to charge.
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So tell me if I'm saying this right.
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The reason nothing would change for the member if Atrium meant what they sent out.
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Is that what they sent out said, no matter what is your designation?
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No matter what tier, no matter what tier our providers are in,
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we are only going to charge you this amount of money.
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You know, they've said that unambiguously. They haven't taken it down on their
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website. I checked today.
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That was one of my concerns is they're going to go ahead and take it down.
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But they said, no matter what tier, we're going to charge you this.
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So we are, our members, if you want to, we still prefer you go to our preferred
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providers because this scheme is not going to last forever.
16:43
Yeah. But I don't blame members if they want to save money.
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Absolutely not, yeah. And to me, this aligns the incentive around our member
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saves money, the state health plan saves money, and they're saying that their
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incentive they want to work towards is treating state health plan members.
16:58
Yeah. So up to a point, have at it. My concern is they can tap out of this at
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any time they want. They can just stop doing this and start charging members
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more money. I hope that is not the case.
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If it is, we're going to take care of our members.
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But they've made this promise. that no matter what tier you're in,
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we're only going to charge you this amount of money.
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So why would the state health plan give someone who's been such a bad partner
17:21
over and over and over again even more money?
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If they want to dictate benefits, then they can afford to pay for those benefits
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and honor what they've told state employees.
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And why it's confusing to state employees right now is I talk to all my peers across the country.
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They wouldn't want to be you right now. Out of network, our members have learned
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and have been so disciplined for so long that out-of-network is a bad word.
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It's a four-letter word, right? Yeah. You don't do that.
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We are one of the few plans in the country where over 99% of our spend is in-network
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because we have smart people who go to in-network providers because it has been
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grained in their brains do this over and over and over and over again.
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I'm the envy of everyone. We talk to these audit companies and we're going to
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find all this money in your audit network claims. I'm like, y'all,
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our members don't do that.
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Our members know what they're doing from a network perspective.
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So when they hear out-of-network, their brains have been hardwired back bad.
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And we appreciate them doing that because that has been what we've asked of
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them and they've delivered time after time.
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But what Atrium is doing is unprecedented. So out of network at Atrium does
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not hurt the member of the state health plan.
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They are going to get the same benefit Atrium is promising of them.
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It just saves the state health plan money because it's asking them to do their
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part and actually write off those higher costs that they're charging folks.
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But I do worry that they can cut this out at any point in time. Well, exactly.
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There's no. You know, the irony is they're finally going to see what the impact
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of those high costs they charge everyone because they're going to be the ones
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absorbing them. You know, they talk year after year.
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Oh, costs aren't that high. It's like, well, you're absorbing it now. Yeah.
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Well, and OK, so I'll be honest with you.
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I thought if I were Atrium, honestly, I would have gone out of network on purpose,
19:07
and fulfilled the commitment to the employees and done it for at least a year,
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to show we really mean it.
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We really do care about state employees. So we're going to do this thing that is giving from us.
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I mean, I figure even if it's as expensive as you say, if you got $10 billion
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in reserve sitting around plus, you know, another $40 billion with your parent company.
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You could do it for a year. If you want to say, look, sorry for all the frustration.
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Sorry we didn't get in on time. We really do want to show good faith.
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And at the end of a year, could you possibly think, I know these are probably
19:46
more than one-year commitments, but could you think about letting us back in?
19:51
That would have been a way to do it.
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But I think, I agree, that would have been a way to do it that comes across very authentic.
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The path they chose was to do their kind of announcement right before open enrollment,
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where everyone's kind of paying attention and dialed in.
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And they didn't go out of network because they wanted to have to write off less, right? Yeah.
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And charge the plan more. They wanted to keep their revenue,
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draw in more new patients, and get more revenue at higher. That would be my,
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I can't speak for them, but doing what you described would have been a much
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more altruistic way to do it, right? It's been like, hey, we understand. Yeah.
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I think it would have been a good business expense to show. I mean,
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I think it would have gotten the affection of state employees.
20:34
So let's unpack. You said a whole lot of things right there.
20:36
I want to unpack a few of them because I've been suffering through some of these,
20:41
Facebook comments lately.
20:43
One part you said about $800 million. It would cost the plan $800 million.
20:48
If we gave everyone a benefit this rich. Now, let's talk about where that money would come from.
20:52
It would come from raises, right? Right. It would come from basically from taxpayers.
20:56
Right. You know, given the state of the budget, I think it would mostly just
21:00
come out of members pockets. And retiree money. And retiree money.
21:03
That's where it would come from. You know, there's not an amendment on the ballot
21:07
this year to increase taxes.
21:08
Yeah. No. There's one to cap it. Right. So that money would come from members
21:12
in the existing pool of money if we wanted to offer something that rich. Yeah.
21:17
Because we get a lot of comments that, you know, the legislature should just
21:20
put more money in and pay this. Right. I mean, just make it happen.
21:25
I get frustrated because basically that's saying, let the hospitals charge whatever
21:30
they want, and then the state will pay it. That's right.
21:33
And we've got to be smart consumers. Right. I think you—actually,
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no notes. You can have said it better.
21:38
But, you know, I mean, and then at the same time, we're saying,
21:42
let's cap taxes, and there's always a push for smaller government.
21:46
Well, there's going to be a finite amount of money, and that amount of money is actually dwindling.
21:50
So it would end up coming out.
21:54
Trust me, it's not going to come out of anybody else's pet projects for their district.
21:58
It's going to come out of the other parts of the benefit package for state employees
22:02
and retirees. Or way higher premiums. Right.
22:04
And Treasurer Reiner also has to watch over that entire retirement fund and
22:11
the investments of that and then trying to turn that into a COLA.
22:14
So if you're balancing those two programs that affect state employees and retirees,
22:21
more than anything other than their paycheck—.
22:24
You've got to be conscious of how much it costs the General Assembly to keep those programs going.
22:31
So retirees in particular, rightfully so, have complained a lot that they haven't
22:37
got COLAs in, what, nine years? Yes.
22:39
And even before then, I mean, they are very woefully falling behind.
22:44
Can at least some of that be explained by the cost of the state health plan
22:48
and the cost to legislation?
22:50
Well, again, you have a finite amount of money you can put towards the entire
22:54
package, pay, health care, retirement.
22:58
We cost too much. We are spending too much money. That is unambiguously true
23:02
because we have tackled everything in the past as a revenue problem.
23:05
We need to throw more money at the problem and not tackle the cost of health care.
23:10
Yeah. And the problem with that is, one, it's the wrong thing to do in general,
23:13
but the more you do that, the more prices go up. The more prices go for members,
23:17
the less affordable it is to go to the doctor, the less affordable it is to
23:20
fill your prescription.
23:21
And then those folks get sicker and then health care costs more again.
23:25
So we've created this cycle where we should expect the outcome we're getting.
23:29
Yeah. Well, and I think Treasurer Briner coming in with the background he has,
23:34
he comes from a Wall Street background.
23:37
People think he hates hospitals. I can't imagine he has an opinion about hospitals writ large.
23:46
What I think people who have his financial background hate is waste.
23:50
Yes, they hate waste. Yeah. Hates waste and believes that partnerships should
23:55
benefit everyone within the partnership.
23:57
Yeah. Right? That's how he's been successful is, you know, lines incentives
24:00
amongst partners and treats it like a partnership. You know,
24:05
I think UNC would have very positive things to say about him. Maybe not me.
24:08
Duke, Novant, our independent primary care practices, the ones we've been able
24:13
to partner with, thousands of independent primary care doctors,
24:17
independent specialists, ASCs, three large health systems.
24:21
The treasurer doesn't have a problem partnering with people.
24:24
He has a problem partnering with bad actors who aren't going to honor the deals they make.
24:28
Yeah, state employees and retirees traditionally do not care if their elected
24:34
officials are besties with big corporations. They care if they have the guts
24:39
to stand up to them when it's appropriate.
24:43
So I think that's what we're looking at here. You know, credit to treasurer
24:46
Falwell set the stage that we need to think about this different.
24:49
Oh, he had no fear of any of them? And, you know, maybe he didn't have the aligned
24:54
incentives piece of it, but he wasn't afraid of him. And he was able to point
24:57
at, like, yo, this is a cost problem.
24:59
Right. And we've been able to build on that momentum to start getting people
25:03
to see it as a cost problem and get some of those costs down.
25:08
So, you know, credit to him for setting the stage for that.
25:11
And, you know, I don't think anyone would accuse him of being best friends with
25:13
hospitals. But I think they'd accuse him of understanding it's a cost problem.
25:17
And I think the treasurer does. i think he just has a different approach to
25:20
get those costs done that has proven by our ability to give free surgeries reduce
25:25
cost sharing like i looked in 2011 2012,
25:28
and we're going to keep pushing to make the benefit more affordable with our
25:31
great partners so we can do those investments in health i like i said he doesn't
25:35
get to keep the money i don't get to keep the money it goes back in
25:38
to put money in the retirement fund putting money in raises and we want those
25:41
things to be high for state employees because they deserve it.
25:45
Just specific examples that I've gotten from social media. So one person I think
25:50
is just mistaken in how she's explaining.
25:54
I think she's thinking of last year's or this year's plan as opposed to next year's, right?
25:59
But she says that the moving atrium to out-of-network will make your individual
26:04
deductible go up to $15,000 and out-of-pocket max to $36,000.
26:09
Does that – what is she talking about? Yeah, well, you know what?
26:13
It will make those numbers go up in that range of things. But remember,
26:17
Atrium is saying they're going to pay your deductible. They are saying they're
26:20
going to pay your out-of-pocket maximum.
26:22
So they are going to write that whole thing off on your behalf.
26:25
That's what they said. Regardless of tier, we're going to pay your deductible.
26:28
We're going to pay your coinsurance. We're just going to charge you this copay amount.
26:32
So yes, the out-of-network benefit says this.
26:35
But what Atrium is telling you is don't worry about that. We are going to pay
26:40
your deductible. We're going to pay your coinsurance on your behalf.
26:43
So, what happens if Atrium reneges, though, and... That, you know,
26:47
that's what we're watching every day.
26:49
Because they're not telling us what they're gonna do, they didn't tell us about this program.
26:53
We have to, at some point, take them at their word that they're gonna do this.
26:56
But if they drop out and say, we're not gonna cover your costs anymore,
26:59
I do think it's very consistent with their character of, we promise we're trying
27:04
to do the right thing, and they're not.
27:08
If they don't, if they do drop out, we'll figure out a way. That's why we have
27:12
those hospitals and rural communities in network, so members aren't penalized in that situation.
27:16
We have tons of preferred providers across the Triangle and Triad area that
27:22
provide really high-quality care at a low price for members at richer benefit.
27:27
And that's why we prefer them, right? It's in the name, because they're the
27:30
ones committed to being a long-term partner for our state health plan members.
27:35
And that's what we really, really want. One, we need, if they're going to do
27:39
this and play games with people's costs, they're going to have to be accountable for it.
27:45
Okay, I have a question because of the Atrium-WakeMed merger and how this might relate to that.
27:51
So if Atrium's out of network, will WakeMed become out of network or do you negotiate separately?
27:58
They are still not one company yet, so we're treating them as two separate entities.
28:03
You know, there are some WakeMed providers, some of their primary care folks
28:06
are preferred now. They're going to be preferred next year because of their
28:09
different partnerships they have. A couple of their specialists are preferred.
28:12
The rest of it is non-preferred. But we are not allowed to treat them as one
28:17
entity until they are legally becoming one entity. So WakeMed is not going out of network next year.
28:23
We are trying to figure out different
28:24
things we can do with them from a continuity of care perspective.
28:28
So WakeMed is not going to be going out of network in 2020 unless they choose to.
28:33
Or, I mean, once this merger, however long it takes, it would take a while,
28:37
I guess, for it to become final, final.
28:39
At that point, if Atrium's on a network, WakeMed might be on a network.
28:45
And you bring up a couple interesting things. A judge ruled that Atrium is allowed
28:52
to do this kind of via loophole with their Aetna contract.
28:57
Blue Cross does not have that loophole in their contract for 2028.
29:01
So this is a one-year thing.
29:04
We are going to have to figure out and work with them for something for 2028
29:09
that is going to look – our goal is for it to look like what we thought we had agreed to with them.
29:14
But this is not going to be able to be a multi-year thing. They're not going
29:17
to be able to provide this benefit to members in 2027. That would be a breach
29:21
of their Blue Cross contract in 2028.
29:24
So we have to figure something out for the long term with them.
29:28
You know, we have proposed different things in different structures.
29:31
They've proposed different things in different structures.
29:34
I would just tell you that I can't imagine the trust getting lower between either
29:37
party. I'm not even clear what that would look like.
29:40
But my job is not my feelings. My job is to get the right thing done for teachers
29:45
and state employees. So we would hope they would honor what they put in place for 2027 and beyond.
29:50
And if they won't we are going to have to figure out something for 2028 because
29:54
blue cross is not going to let them do this scheme aetna doesn't think this
29:57
scheme is the right thing to do either to be perfectly clear they've blindsided
30:00
aetna as well and aetna has been a tremendous partner through this kind of step in the process,
30:05
but this is a one-year max thing where they're going to be allowed to do this
30:08
from an out-of-network perspective so we have to figure out a long-term answer and.
30:15
The long-term answer is not for them to be in the preferred year in 2028.
30:19
They've already undercut our preferred partners and undermined those relationships.
30:23
Those are the relationships we're going to continue to invest in.
30:26
But we need to figure something out for as many atrium providers as we can so
30:31
they can continue to see people. And if it costs more, it might cost our members more.
30:36
But this is a one-year out-of-network situation.
30:39
And I'm just so sorry to all our members because this, y'all are put in the
30:42
middle of something that is not your doing, not your fault.
30:45
And it's not your doctor's fault at Atrium either. You know,
30:47
your PCP isn't scheming in the back room of, and making websites about things.
30:52
They're trying to be a good doctor and they have good doctors there and I get
30:55
it. I'd be frustrated if I was them. I'd be frustrated if I was,
30:58
I'm frustrated. But this, this is something we are going to have to come to
31:01
resolution to for 2028. I am hopeful they're going to honor their commitment in 2027.
31:06
At the same time, I still want our members to use those preferred providers
31:09
because they're going to be our long-term partners, and we want to hug that.
31:11
But I don't fault a member for wanting to save money, particularly when it saves
31:15
the state health plan money as well. I get it.
31:16
Well, some people say, well, I've been getting my oncology care at Atrium,
31:19
so I get that. Well, you know, for those folks with the oncology care,
31:23
part of our agreement with Atrium was you can keep those patients at a little
31:29
bit richer benefit today from specialty care.
31:31
They would give us a discount. That was part of the agreement is those sick
31:34
folks on transplant lists, going through cancer, kids in the NICU.
31:39
That was part of that September agreement, was you can keep treating those folks
31:42
at the benefit that they have today, just give us a little bit of a discount to do that.
31:47
So that was the agreement. We agree that those folks shouldn't have to change,
31:50
and they should be able to save a little bit of money too.
31:53
And that was the agreement we had for those folks.
31:56
My intent is to honor that agreement, but if they're just going to charge members
32:00
so much less, those folks should take that deal.
32:03
So we had an agreement with them for those really sick folks to cover it at
32:06
the benefit members have in 2026 with a reduced specialty copay,
32:12
with a reduced allowed a month that's going to the state health points. We had that agreement.
32:16
I hope they honor that agreement. I think there needs to be some sort of debate,
32:21
some sort of town hall in Charlotte.
32:24
And you and Gene Woods can't get up there and...
32:27
Debate it out in front of people. He is much more charismatic than I am.
32:31
Maybe I'll say Brad. But yes, I'd be happy to. Gene Woods is very good at his job.
32:35
But his job is not my job. His ethics are not my ethics as a company.
32:38
And I'm not going to say anything bad about anyone.
32:40
We want to work with these people. We want to have a relationship.
32:45
But the facts remains, we just see the world differently from an ethics point
32:48
of view. I don't believe the treasurer doesn't believe in purchasing hospitals via consent agenda.
32:54
Doesn't believe in saying you're going to fund all these things,
32:56
but it's only some part of it.
32:57
When we make a partnership with someone, that is the partnership.
33:00
We don't sign our names to things we don't believe in.
33:03
And they just see the world differently. And I don't want to get in an arguing
33:07
match with folks. We have the facts on our side, and we're going to look out
33:10
for our members and do the right things for our members. And that's going to be the focus.
33:15
And I hope they do the right thing and honor what the commitment they've made.
33:18
Because the judge said they can do it. We want them to honor that commitment.
33:22
But I also want people to know you have preferred providers that want to work with you.
33:27
That sprinted towards giving you a better deal, not just for 27,
33:32
but for 28, 29, and 30. And we're going to continue to grow that preferred network
33:35
because y'all are paying too much for healthcare.
33:38
Yeah. And we got to do a better job of making them pay less for healthcare.
33:42
Well, if there's any fig developments coming in the next little bit,
33:47
we'll try to see if we can either get you back or have you let us know what
33:52
we can tell folks on this podcast. And try to tell us like Tuesday so we don't record all of it.
33:57
Yeah, you never know what happens. Oh, I know. Loretta tells me the best time
34:01
to drop news is on a Friday, so. Oh, yeah.
34:04
Bad news, particularly. Well, thanks for coming by, and listeners,
34:07
stay on for the rest of the podcast, which is, I think. It's all over the map
34:13
today. Lots of great things, especially our interview with Nathan Foster.
34:16
From the North Carolina Justice Center. About the WakeMed atrium merger.
34:26
Hello, everyone. Welcome to another edition of the Scenic View podcast.
34:29
I'm Jonathan Owens, along with Artis Watkins and Samantha Klein.
34:33
We've got a little bit of everything this week. We got some things for retirees,
34:37
a little update on the atrium state health plan crisis, if you will,
34:43
the atrium-wake-med merger, maybe some other things. So stick around.
34:58
Okay, so we are recording on Wednesday, but this will be posted on Friday,
35:04
and by that time, early voting will have begun, because it starts tomorrow, right, on Thursday?
35:10
Yes, when this is aired, we'll have one day in the can of early voting.
35:15
That's kind of a new thing, it seems like. In the last few elections,
35:19
people have been watching the early vote returns.
35:22
It seems like every day you get a new update. And remember two years ago,
35:27
they kind of flipped because Republicans used to vote more on election day than
35:32
they did during early voting. And it was kind of this.
35:36
Slip. Yeah. Where there was a lot of early voting among registered Republicans.
35:41
So it's interesting. Who knows?
35:43
It's just so much more convenient. It really is.
35:46
I don't understand the whole partisan divide over early voting.
35:50
I think we should have a whole weekend where you can just go vote,
35:54
you know, or make it a holiday. Well, yeah, make it a holiday from work for
35:57
everybody. But you can't do that, especially with our folks.
36:00
They've got to staff those prisons. They've got to. That's true, yeah.
36:03
And by the way, speaking of prisons, this week is a very serious week. Yeah. Somber week.
36:08
It's the ninth anniversary of the murders at Pasquotank Correctional,
36:13
where four correctional personnel lost their life in a riot.
36:17
Yeah, that was a terrible time.
36:19
That was a devastating time. And that was six months after Megan Callahan lost
36:23
her life at the hands of an inmate at Bertique Correctional.
36:27
So those correctional facilities are very physically close to each other geographically,
36:34
and to lose five lives in that small area of the state in six months was a very brutal time.
36:42
Those employees were Justin Smith. He was 35. He was a correctional officer.
36:47
Veronica Darden, correctional enterprise manager. She was 50.
36:52
Wendy Shannon, 49, a correctional officer. And Jeffrey Howe,
36:56
a maintenance mechanic at the prison.
36:59
I'll never forget that. See, that's some of those things where people don't
37:03
think about the fact that it's not just the correctional officers who are put
37:07
in danger there. Anybody in the walls.
37:10
And they're still facing the same dangers, right? And the tremendous irony of
37:15
that is that a couple of them, my memory is, they had come back.
37:20
They were veterans, military veterans. I know at least one of them had gone
37:26
into combat as a military veteran, came back, okay, and then lost their life
37:31
in a North Carolina prison.
37:32
So that kind of kick-started a lot of reforms with regard to the prison system
37:37
that had been really important.
37:39
Yeah. And, but we're by no means did we make the kind of progress in nine years
37:45
that we should as a state.
37:46
If anything, it's worse because there's still less. In some ways, yes.
37:50
The vacancy crisis for certain got worse. Yeah.
37:53
It's moving in the right direction now a little bit, but, you know, we got to get it there.
37:57
Yeah. So I won't name their names, but it's looking at the entry here about the event.
38:03
And three of the four people who were convicted of the murders,
38:08
three of them were sentenced to death, and one is four consecutive life sentences without parole.
38:13
Yeah. So to all our folks working within the walls of prisons,
38:17
you know, we're always thinking about you. But this week, you know,
38:20
we're especially thinking about y'all.
38:22
Stay safe. Hard, hard segue here for me.
38:26
But looking back at last week's episode, tomorrow, Thursday,
38:31
October 15th is also the start of the state fair. Woo!
38:35
Yeah, a happy thing. Yeah. So we have, I really enjoyed talking to the Commissioner
38:41
Troxler last week. Oh, he's the best.
38:44
We got to get him in studio or we need to go out and interview him.
38:47
I think it'd be more interesting to see the ag department.
38:51
Him and his environment at the fair, he's quite, quite something out there.
38:56
What if we just sent me out to the state fair one day with a microphone and
39:02
a recording device and I'll just follow him around?
39:06
I don't know about following him, but I had actually thought of doing that with
39:09
one of the employees who's worked there a long time.
39:12
And I thought about mentioning it to you, but I didn't know how you would feel
39:15
about it. It's the state fair. I know. Maybe we should do that.
39:19
I have a contact there who's worked in the fair for more than 30 years.
39:23
It's the happiest thing that happens in state government all year.
39:27
So maybe that'll come up in the next few weeks. We'll have a video about that.
39:31
That'd be awesome. Are you all planning to go to the fair this year?
39:35
I want to, but I just need to find time in my calendar slash figure out my transportation there.
39:42
Because you talk about a bear. Traffic is insane to get to the fair.
39:46
Not only that, but it's also insane to park or paying to park.
39:51
Even if you just want to park close, like some people would rent out parking lots and stuff.
39:56
They charge outrageous prices to park there because they know it's there for convenience.
40:00
Yeah, my daughter had her birthday was Sunday and we had planned to do something
40:05
on Sunday, but then we had the huge range, right? So we had to do something indoors.
40:10
But my suggestion to her was like, let's just postpone it to next week and go to the fair.
40:16
She wasn't buying it because she already had plans with her friends that she
40:19
wanted. She wanted to see her friends more than. And her boyfriend.
40:22
Yeah, yeah. I'll talk about that.
40:25
Meanwhile, my birthday was like four weeks ago, and I still haven't gotten to
40:29
celebrate with my parents. Oh, so maybe you can go to the fair with them.
40:33
But then Sunday, we wound up going to Fayetteville to an escape room,
40:37
and we drove through a part of the town that had been hit by a tornado. That's the day, right?
40:43
So, yeah, that was not fun. That was your neck of the woods there, Samith.
40:49
How did your parents fare? Did they have any? My parents are good.
40:52
They definitely got the warning. But apparently my dad's sitting out there on
40:55
the porch watching the storms and stuff as they blow by.
40:59
Yeah. Because I also got a warning in my neighborhood, my area near Durham,
41:04
Briar Creek. It was hard to not get a warning in North Carolina on Sunday.
41:07
Yeah. It was crazy. It was bad. I hid myself in my bathroom for about an hour.
41:12
Because, I mean. Tis the season. Yeah. As someone who grew up in Tennessee where
41:16
there was a lot more tornadoes, I remember a lot more tornado drills and stuff when I lived there.
41:22
Watch, not super concerned on a tornado watch. Warning means it's been spotted.
41:28
You need to take cover. Yeah, that's a little space out there. Yeah.
41:32
So here at Scenic, it has been just a really busy week, I guess,
41:35
everything. And here at Scenic, we've even been busy. We had a press conference
41:39
today. This is, we don't really do a lot of press conferences,
41:43
but we, you know, once or twice a year maybe.
41:45
But this was a we had all of our friends come over from the other groups associated
41:50
with the Atrium Wake Med merger fight.
41:53
And we had a press conference calling on Attorney General Jeff Jackson to hold
41:58
some public hearings on the proposal and to, you know, hear our side of the
42:03
issue. And I thought it went really well.
42:05
We have Nathan Foster from the
42:07
NC Justice Center was kind enough to stick around for a brief interview.
42:12
So we'll have that at the end of this episode. So we'll get more into that topic then.
42:17
We did say we had a retiree issue to talk about.
42:21
I thought you would find it fascinating about AI. I like that your mind directly
42:27
went to me about all things.
42:29
Yeah, but I would never have thought
42:31
AI could help people know what their retirement contracts look like.
42:34
So our old friend Ted Seidel, who helped us a lot on the pension forensic accounting,
42:40
audit that we did a few years ago, he's now gone on to bigger and better things.
42:45
I think he's like a celebrity now, right? Oh, he's a big deal here.
42:49
But he has an article today about how people are using AI to expose state pension secrets.
42:56
So that's something you want me to get into, right? You want me to start digging
43:00
in with Claude? Sure. I always would love to know what's in every contract that affects our members.
43:06
But I think that that's a fascinating, again, never would have expected AI would
43:11
be part of any kind of transparency we might get in the pension world.
43:16
Not just in North Carolina, but all around the nation. This is such a problem.
43:19
Public pensions are kept under total secrecy in terms of their investments.
43:25
It would be fascinating to learn what all these public pensions are invested
43:29
in. Oh, I'm about to dig into this.
43:30
Another plug for Pension Fight Club. Go watch that documentary.
43:34
That's right. Go watch Pension Fight Club.
43:36
Oh, I might contact Ted and get into this. Yeah, see? See what we can dig up. See?
43:42
You guys can't see it, but John is currently looking into it. The wheels are turning.
43:47
Oh, he's got a little how-to.
43:50
See, our retirees have wanted that for a long time. They want transparency because,
43:56
when you're told repeatedly as a retiree, you can't have a COLA because we don't
44:00
have enough gains in the system. Our investments aren't making enough gains.
44:04
One of your first questions is going to be, why not? Yeah, why not?
44:08
I mean, because they'll look at they've got a mutual fund somewhere.
44:11
They can tell, why am I doing well, but the retirement system's not like this doesn't make sense.
44:17
And part of that can be fees.
44:20
And sometimes there's layers of fees that we're paying. But, you know, we can't know.
44:26
So retirees, that's their money. Six percent of their check every month went
44:29
into that for their whole life.
44:31
They want to know. Yeah. Well, not their whole life. Not since birth.
44:35
Their whole working life. Their whole career. Somebody would have pointed that
44:39
out. So I want to make sure we correct it.
44:41
Okay. Well, let's get to the interview with, well, it's not really an interview.
44:45
It's just kind of a hang. We'll call it like a hang.
44:47
Yeah. So Nathan stopped by after the press conference and he had a few minutes.
44:52
And we hashed it out about the whole issue. So if you're interested,
44:57
stick around. I think it's a really good discussion. He knows a whole lot about
45:01
healthcare in general. So glad we had him on and you have a great week.
45:11
Hello, everyone. We're here today with Nathan Foster from the NC Justice Center,
45:16
a recurring guest of the podcast.
45:18
Welcome, Nathan. We're coming into the studio right after our press conference
45:22
on the Atrium-Wake-Med merger situation and the letter.
45:27
We've partnered with other groups to send to Attorney General Jeff Jackson pertaining to the merger.
45:34
And we just want to discuss a little bit about this whole situation.
45:38
You can watch the whole press conference on our Facebook page.
45:42
And I thought it was a pretty good press conference. What did you think,
45:44
Nathan? Yeah, absolutely.
45:46
I mean, it was great to be able to speak and explain why the attorney general
45:52
really needs to play a role here. Yeah.
45:55
So let's explain a little bit about why we sent the letter and, you know, go from there.
46:00
The Wake County commissioners voted a few weeks ago to move ahead with the merger.
46:06
But now it goes to, one of the places it goes to is the attorney general's desk, right?
46:12
Correct, yeah. For further approval. Is it approval or is it?
46:17
Well, that's a question that one of the members of the media asked.
46:20
Are you asking him to say, you know, to block this? Are you asking him to help
46:25
change this and make it a better deal? What do you want?
46:29
And I think anything's on the table, but the most likely thing the groups would
46:35
like to see is, This deal that was done without proper procedure,
46:40
very little public input at all.
46:42
We'd like to see them set this deal aside, start over.
46:46
Actually do some proper vetting of this whole situation, and most importantly,
46:51
have some sort of community meetings, town halls, whatever you want to call them, where.
46:58
Attorney General Jackson's team can hear from the public.
47:02
Yeah, I mean, I think that one thing that is relevant to the Attorney General
47:07
is it seems like there was no public bidding process.
47:10
This deal was made behind closed doors. They didn't consider other offers.
47:14
They didn't consider other hospitals to have this kind of relationship with.
47:19
And whether that raises any concerns about whether it was done in a valid way,
47:24
I think is a really important question.
47:25
And, you know, we just don't have access to that information because they've
47:29
been so secretive about this process. And one thing that the attorney general
47:31
can do is really shine a light on this secretive process.
47:36
The other thing, obviously, is prices. This is going to merge and create an
47:41
even bigger system that will be the largest system in Charlotte,
47:45
the largest system in Raleigh, the largest system in Winston-Salem,
47:49
getting to the point where they can charge what they want and nobody can tell them anything.
47:53
And that's a monopoly concern. That's an anti-competitive concern.
47:56
And the attorney general also has a responsibility to protect North Carolina
48:01
consumers and North Carolina patients from our prices going up.
48:05
And so that's another aspect that they really should be intervening in.
48:08
Yeah. So, I mean, they already almost have that now with the triad area and
48:14
the Charlotte area. I guess it's the last jewel in their glove,
48:19
their infinity stone glove, right?
48:23
Yeah, at some point, you would think that an elected official would,
48:27
you know, stand up for their constituents and, you know, say this is at least
48:32
needs some more scrutiny, right?
48:34
Well, we were thrilled, speaking of someone standing up for their constituents,
48:38
we were thrilled that Commissioner Tara Waters was in attendance today just
48:43
to see what was going on because she and Commissioner Vicki Adamson.
48:47
So strongly stood up for folks.
48:50
I mean, it can't be overstated how hard it is to stand up to these huge corporations.
48:57
Even if from the outside, it seems like that kind of decision is obvious to a lot of people.
49:01
I'm sure that when you're in the room and over and over again having these closed-door
49:05
meetings with these CEOs and these lawyers, it's really hard to say no to them.
49:08
And so I give Commissioner Waters and Commissioner Adamson a lot of credit for that. Yeah.
49:14
There's also a Federal Trade Commission side of this issue, right?
49:18
So what's going on with that?
49:21
Yeah, the Federal Trade Commission has a responsibility to protect Americans
49:26
from corporations making monopolies, raising our prices.
49:30
And I think that it's clear that that is what is happening in this case.
49:35
You had the CEOs of the hospital saying they want prices to go up because they
49:40
will have more leverage.
49:41
The challenge with the FTC is this is something that's called a cross-market
49:45
hospital merger because Atrium and Wakemet are technically in different markets.
49:49
And historically, there's been less challenges to cross-market mergers.
49:54
And it's been a huge problem because the cross-market mergers still raise prices
49:58
and they've been happening and prices have been going up and nobody's been stopping it.
50:01
And so the question is whether the FTC decides this is a cross-market merger
50:06
that we're going to challenge. And I think certainly there's a strong case to
50:10
be made, but I am not an FTC lawyer, so I don't know exactly what they're thinking right now.
50:15
So has this moved beyond the commissioners at this point? I mean, are they?
50:20
Well, on the one hand, the commissioners did vote without all of the material
50:24
terms of a contract before them. They voted for the contract.
50:29
That is done. Could they technically? I guess somebody who voted with the prevailing
50:35
side could try to recall the motion. I don't know.
50:38
I think that where the commissioners stand on this now is there's going to be
50:43
work that is after the fact.
50:45
And it seems like they almost tried to rush some of that. And one of those is
50:48
to fill the three slots for the Wake Med board.
50:52
They flashed something up online yesterday so people could apply to be considered for that board.
50:59
And then a little while later it was removed.
51:03
A lot of us did wonder, were they trying to rush that through before the election?
51:07
Because there is one incumbent, Sophia Jackson, who voted to allow this takeover
51:14
of Atrium, of WakeMed, who does have an opponent, John Adcock.
51:19
And in fact, we're saying our CNIC's political action committee,
51:24
we call it MPAC, has endorsed John Adcock in that race against Sophia Jackson here in Wake County.
51:31
The AFL-CIO had endorsed Sophia Jackson, the Triangle Labor Council,
51:35
had endorsed Sophia Jackson and rescinded that endorsement. They did not endorse
51:40
anyone else, to be clear, but they rescinded her endorsement.
51:44
So that's the only reason some of us, I think, we were all kind of wondering
51:47
yesterday, Nathan, what was the reason for the almost push for that?
51:53
I don't know why that happened. But, yeah, as you said, the commissioners voted
51:58
away most of their power. There's still some role for the commissioners in appointing
52:03
some of the board members.
52:06
And that matters because the board gets to be in the room where decisions are made.
52:11
And so at least there can be some transparency of how these decisions are being
52:14
made for the community if the right board members are there,
52:18
even if nobody can actually stop A-Trim from doing what it wants to do.
52:22
You can at least see what's happening as it's happening.
52:25
Yeah, the Wake County Commission now can appoint three of the board members
52:30
as this transition is taking place, and they seem to have tried to rush it through
52:35
and do it, I guess, before the election happens and before the new board comes in.
52:39
But then they took the post down. I'm very confused, and I'm not sure exactly
52:44
what's going on with that.
52:46
Speaking of the impact endorsements, we also endorsed three other commission candidates. Right.
52:52
In one of the sets of races for
52:56
the Wake County Commission, there are four candidates and you choose two.
53:00
And the two that Impact has endorsed are Christine Kushner, who used to be Wake County School Board.
53:06
And Mona Singh, who has just been awesome about the fact that we need more transparency
53:12
and we need to do the right thing by patients and by public workers.
53:16
And then we also endorsed Vicki Adamson, who we mentioned earlier,
53:19
who does not have an opponent, but definitely deserved an endorsement because
53:25
of the way she fought for all of her constituents, including,
53:28
city, county and state employees and retirees.
53:31
And just going back to one point that you mentioned in the press conference,
53:35
Nathan, and I think it raised a lot of eyebrows from what I could tell.
53:40
We actually had a lot of reporters show up, so that was good.
53:43
You said that they asked if we had spoken to the attorney general, and you said.
53:52
That the commission hasn't even delivered the documents to the attorney general. Is that correct?
53:57
Yeah, so the hospitals, once they dot all the I's and cross the T's,
54:02
they have to tell the attorney general, hey, we're doing this deal,
54:06
we're transferring control.
54:08
And then that starts the attorney general's process. And I can say that we asked
54:13
the attorney general earlier this week and they hadn't received those documents
54:16
yet. So the review process hasn't started yet. What do you think the holdup is?
54:21
Would it have anything to do with the election, you think?
54:24
I'm not sure if it has to do with the election, but I mean, it's clear that,
54:27
this was rushed through so quickly and there were so many last minute changes.
54:30
I would not be surprised if they haven't dotted all the I's and crossed all the T's.
54:34
And that could be on some really important stuff like whether these price controls
54:39
mean anything or not, among other things. And I think it just goes to show how
54:42
much the commissioners rushed the deal, that they sort of signed away their power. Yeah.
54:48
Took themselves out of the picture in terms of having any leverage before the
54:51
deal has even really been been finalized in a complete way. Yeah.
54:55
And the pure public relations skeptic in me is saying maybe they're thinking
54:59
it'll die down at some point and they can.
55:02
Oh, it's not. It's not going to die down. Obviously, this is going to keep happening.
55:05
Obviously, we'll keep holding press conferences to keep it in the forefront. Right.
55:11
So where do we go from here? I guess I guess along those same lines where.
55:16
Yeah, well, I mean, this coalition of groups who represent workers in the community,
55:20
and the whole state in terms of state employees and retirees,
55:25
we're going to stay together and continue exploring every avenue.
55:30
Because I do think Nathan's right, and John, your skeptical PR side is right,
55:35
that whenever something big happens, there is the hope that it'll just die down
55:40
and everybody will just kind of live with it.
55:42
It is imperative if we're ever going to stop being the number one most expensive
55:46
place for health care in the country, North Carolinians are going to have to
55:50
make sure that we don't let these things go.
55:53
And then we keep them in front of policymakers at every level of government.
55:57
So we'll also be coming into the General Assembly session in January,
56:02
pushing hard for the kind of reform Senator Bergen already tried to get through
56:06
last year regarding the way hospitals can behave.
56:11
Well, before we go, I just want to give a quick shout out to all the groups
56:14
who signed on to the letter. And you can read the letter on our website.
56:17
We're going to post it for everyone.
56:19
To Attorney General Jeff Jackson, the Patients Union, who they were here today,
56:26
the State Employees Association of North Carolina. Shout out to y'all.
56:32
NC Justice Center.
56:35
That's Nathan's folks. The Raleigh Apex NAACP, the Men of Southeast Raleigh,
56:42
the Triangle Center Labor Council, the NC Poor People's Campaign,
56:46
and the Communication Workers of America of North Carolina.
56:49
I think it's Triangle Central Labor Council. Triangle Central Labor Council. Okay.
56:54
But, yeah, we made some new friends. Look at us. We got some friends now, Artis. Yeah.
56:59
We're already talking, Nathan and Artis, we're already talking about some future,
57:04
projects that we can get together. Absolutely.
57:07
Yeah. Because the one thing that the press keeps asking, what,
57:11
you know, what is it about these costs that has us so interested in this?
57:16
And so just as a reminder to state employees or retirees who are listening,
57:20
the General Assembly spent $4 billion, $4 billion with a B, over the last two
57:26
years on your health plan.
57:28
That's not because you're sicker than other people and you overuse your health care.
57:35
It's because you're overcharged for your health care. Thomas Friedman from the
57:39
plan confirmed that on this podcast. You are overcharged for your care.
57:44
Now, you might think, why should I care? State health plan's paying it.
57:48
If those state health plan bills are so high, the General Assembly has to put
57:52
$4 billion over two years in to pay them towards your health care.
57:56
There will come a time they're not willing to do that they don't have it and
58:00
also they're not paying you any raises or retiree colas in the meantime,
58:06
and they're probably cutting some state services yeah because the way they look at it,
58:13
is this health plan is costing us so much money but that's part of what we're
58:17
paying the workers so if if you think we're being a little too hard on the hospitals.
58:23
Just understand that money's coming out of your pocket.
58:27
Yeah. One way or another, if you're overcharged. So it's got to stop or you'll
58:32
never get anything again.
58:35
Yeah. Yeah. These costs have got to come down. Have to. Yeah.
58:39
Well, thank you so much for coming in, Nathan. And we look forward to partnering
58:42
in the future. Absolutely. Thank you all. Thank you.