Latest / The SEANC View / General Assembly leaves without amending budget; Cooper touts medical debt plan

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General Assembly leaves without amending budget; Cooper touts medical debt plan · The SEANC View

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Music.
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Hello, and welcome to another edition of the Scenic View podcast.
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Jonathan Owens, your communications director, here this week with Artis Watkins,
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the executive director, and Sam Klein, or Sammy or Samantha,
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whatever you want to be called.
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She's going to sit in with us. She usually produces, but she is on the microphone
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today to give us a Gen Z perspective.
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Is that the right generation? Yes. Okay, great.
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You've spoken like a boomer, John. Is that what you want to be called?
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I never can tell. Like, what am I?
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Like, I'm a generation X. You're X. Yeah, we're both X. I was born in 1980.
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We don't count. So, is that right? Yeah. Believe it or not. 81.
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No, I was born in 81. I don't even remember. Have mercy.
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I'm trying to think. That might be millennial. Oh, I'm like on the edge.
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Yeah, you might be younger than X. A zillennial, they call us, I think.
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Right? The zillennials are the people who usually were born,
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like, around where I was born, in like late 90s, almost the year 2000 is the
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cutoff for what people call zillineals.
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Oh, it's just too many. Can't we just be people, all people, right?
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Anyway, but we got a big week this week and it's Independence Day week.
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So that's always fun. And we're giving the people something to ride to the beach,
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to listen to. There you go.
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I hope they are going to the beach. That'd be great. So that may come up in
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our question of the week later on.
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Okay. But so big news this week, and you'll see that Suzanne is not here,
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our government relations director.
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She's having some much needed time out of the office after last week, right?
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The end of the session with the non-budget that came, no budget.
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The non-budget. So it was a it was a hectic week last week.
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What were your thoughts on what happened? Hmm. Well, I still don't think it's
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surprising that the General Assembly left town or, you know,
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at least has taken a hiatus to figure out what they're going to do.
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I did not expect they would probably put any money out there at this stage in the game.
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Yeah. I saw there was a story they called it a kind of a cooling off period.
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Is that you think that's. Yeah. I mean, I still think it's a get closer to the election period.
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Yeah. Yeah. Kind of standard. Maybe a Christmas bonus down the road or something.
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Well, I mean, something has to be done.
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Again, cannot say it enough. The vacancy rate for state employee jobs is off the charts.
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It affects every single person in this state.
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It's probably the biggest problem they have that taxpayers don't know about
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is what they're not getting and that they should be for their taxes.
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And then you got retirees. And people will say to us, why should we care if
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retirees get anything? They're already retired.
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And how does that, that doesn't help us solve the vacancy crisis.
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And my argument is that it may very well, because so many of the people leaving
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are in that critical stage, somewhere between eight to 14 years into their service,
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trying to make up their minds.
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Do I stay for the whole 30 or do I leave? If they think they'll be treated well,
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even in retirement, Yeah, that's reason to stay.
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And we've always said and everyone kind of has this idea that you work in state
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government, you know, for the benefits, not so much for the pay.
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Right. And so 100 percent. Yeah. If those benefits are lessened,
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they're not seeing raises for retirees. What's the point in staying?
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Right. And literally, that was kind of the unwritten contract was,
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I'll make about 14% on average less than I would in the private sector if I work for the state.
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But I know that at the end of the day, I won't get rich doing this,
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but I also won't be left high and dry in my retirement.
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I'll get a little something if inflation goes up.
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I might not get as much as inflation goes up, but I'll get a little something
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so I don't go even further behind. That stopped being the case a long time ago.
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And that's a whole other issue, which goes back several decades now to mistreating the retirement system.
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So just to recap a little bit what we talked about in depth last week,
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the proposals on the table.
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First off, there's already a 3% raise built in for this year,
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and that took effect yesterday, right?
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So we were asking for an amended raise beyond the 3%, and then a bonus as well.
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For retention, not recruitment bonuses. If you can retain, you don't need to recruit.
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And then, of course, we were asking for retirees to receive something to acknowledge
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their costs are going up as well.
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Yeah. So the House's proposal that they passed the week before they left included
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a 1% additional raise for state employees and a 2% one-time bonus for retirees.
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The Senate's version didn't have any of that, no additional raises or bonuses.
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So where do you think they fall, even if they do come back, would it be in between
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those two or will one side win out?
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Oh, I sure hope it's not between those two. I mean, it's not doing a thing to
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address this vacancy crisis that we've got.
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If they do something halfway between the two, they're literally doing nothing
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to address this crisis that we have in terms of vacancies. And it's just the
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strangest thing I've ever seen. I don't understand why people don't get it.
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So we're on a, you know, at a wait-and-see on that, and I guess they'll come back.
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Well, not a wait-and-see, on a work-and-see, because we're working,
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we will be working, members of the House and Senate, nonstop between now and
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whatever point in time they come back and take another look at this.
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So we encourage listeners to do the same.
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Yeah, so there was talk of coming back, I guess, well, they scheduled skeletal
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sessions each of the next month. But Suzanne was talking about maybe September
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they come back and do something right after our convention.
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I'm sure they're planning it
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around it. So stay tuned to the Scenic View podcast for that information.
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But on one of those benefits, the state health plan, last week we had some major
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information that came out about that as well.
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Our representative, well, not our representative, but a representative on the
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board of trustees, Wayne Fish, who is a Scenic past president.
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His time on the board was up, and the governor appointed a deputy director at
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DHHS to fill that position, something that we have serious concerns about.
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Right. I mean, to be clear, the woman who is a deputy director at HHS is,
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if she's anything like the rest of the HHS staff that we know,
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working for Secretary Kinsley, no doubt an incredibly valuable resource for
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information for anything to do with health care. I mean, that's her job.
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The problem is she'd be a great subject matter expert.
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And that's a category. This board was reconstituted by the General Assembly in 2011.
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Senator Tom Apodaca led that charge and we were working with him.
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It was all political people forever on this board who knew nothing about the
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lives of state employees.
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And Senator Apodaca trying to change that. Yeah. And that was right before I
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came to Scenic. But I understand that was kind of grew out of a scandal, right?
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That there was something to do with the bidding process for the...
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Well, there had never been a bidding process on the third party administrator contract.
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And so and neither had that contract been a public document.
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So Senator Apatowka was trying to address kind of all of these issues.
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The health plan was just a mess.
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And one of the things very important to him and to the House and Senate at the
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time was making sure that board was constituted half of subject matter experts,
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whether in health care and finance and all the things you would need.
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And then half in real people who would know how this thing worked.
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And it was great. So you had one active state employee, one retired,
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one active public school teacher, one retired, and then you had the rest of them experts.
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Yeah. And it was, it really was working very well.
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We've had some past presidents of scenic who were on there, Charles Johnson and now Wayne Fish.
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The problem we have now is the two state employees that are on there are both,
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you know, exempt just very high-ranking state officials who might mean very well.
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Don't work alongside and in a job that is low pay, hard to fill positions, things like that.
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So their perspective is completely different. And they make total sense as subject
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matter experts, because again, their day-to-day job is to make policy decisions about health care.
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The only voice your average person had on that board was as an active or retired
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state employee or teacher. Yeah.
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And right now there's not a regular rank and file active state employee and there's not a teacher.
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And there is a subject matter matter expert already that you mentioned.
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Yeah, we've got plenty of subject matter experts on that thing.
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We just don't have any real life rank and file state employees or teachers.
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Yeah. And so scenic members answered the call last week when we pulled out a
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call to action for folks to contact their legislators.
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We weren't able to get something done, but we're still working on that issue as well. Yeah.
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So the appointment came out so late in the game that we weren't able to get that done last week.
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We are not going to stop in terms of apparently we need to clarify the language.
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We know very well what the legislative intent was when Senator Apodaca and the
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House and Senate did this because we were part of it.
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And the intent was definitely to have real people having a voice somewhere about
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their own health care. But that intent apparently is being thwarted.
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We're going to continue to work whenever they come back on this issue,
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and we won't stop until we get it clarified.
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But the other thing is, you know, traditionally, Scenic had been asked,
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do you know of anybody who would be good by so far every administration?
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So it was kind of strange to have this happen out of the blue.
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Again, I'm not taking anything away from the woman who was appointed.
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Again, I feel sure she is more than eminently qualified to speak on health care
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matters. That is her profession.
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But no, she's not rank and file. It matters. It matters to have your voice taken.
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And you said there's not a teacher on the board. There's not.
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Teachers don't have a voice. Right.
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How in the world can you make decisions on policy regarding people's health
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care without their input to say, hey, do you know when you do that?
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Yeah. Here's the effect it has on me and my coworkers.
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It's a huge issue. As we've said multiple times, you could give a 10 percent,
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20 percent raise to state employees.
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But if you make the wrong decisions with the health plan, you take it all back
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in your out-of-pocket maximum, your deductible, your premiums. Your drugs covered.
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Right. Right. Yeah. Your lack of coverage or just having to go into debt to get your medications.
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Speaking of medical debt. Yes. Another topic this week.
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Governor Roy Cooper had a press conference on Monday to announce a rather large
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initiative on medical debt.
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That seems very complicated from my layman's reading of it.
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But can you kind of talk a little bit about what's in the plan?
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Well, a little bit. Because, I mean, this is something that still has moving parts to make it happen.
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And I'm definitely not a subject matter expert on any of this.
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I do know, as many people have read multiple times, one in five North Carolinians
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has medical debt currently in collections.
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Yeah. That's, you know, that's kind of one of our sticking points is that health
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care generally is out of reach. It's overpriced. It's an artificial market.
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And that's not just low income folks. No, one in five North Carolinians.
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I think part of that is, you know, obviously you don't plan to have a huge debt
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come in for a medical procedure or something.
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Right. And it's a unique, a problem that is unique to this country.
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Yeah. You don't have that in other countries. Just like we were talking about
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the weight loss drugs or other prescriptions that are needed by people.
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You don't have this problem in other countries because they don't allow it.
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So that's the setting where Governor Cooper's looking to solve this issue because
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one in five people are drowning in this medical debt that's in collections.
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And we rank, by the way, in 2023, North Carolina ranked 40th in terms of access
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and affordability of health care.
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We have all of these amazing hospitals and institutions of learning for medicine,
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but our access and affordability is horrible.
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So I guess that's what he's trying to solve. And his plan would take funding
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from Medicaid and persuade hospitals to forgive some of this debt.
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I think it's $4 billion in old medical debt, anything since 2014.
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I think, that's on the books. and hospitals have to choose whether they want to participate.
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But in the meantime, the Cooper administration has to get the federal government
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to approve this from a regulatory standpoint.
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So some details here from the DHHS medical debt website that they put together.
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Medicaid enrollees will have
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all outstanding medical debt dating back to January 1st, 2014 relieved.
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So I guess anyone on Medicaid, but then if your income is at least at or below
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350% of the federal poverty level,
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and then it goes into a lot of other caveats, you could see some relief from this plan.
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Now, didn't you say that's about $95,000 a year?
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For a family of four, it's a little over $100,000 a year.
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And I can't remember for not a family of four, I think $57,000,
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something like that. But again, I don't have that in front of me,
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so I'd probably be wrong.
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But I guess what we're all waiting to see is, number one, is this regulatory?
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Does this happen? But number two, is this a long-term fix?
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I mean, it's not a long-term fix if you're still going to have the same problem.
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The problem is the outrageous prices that medical services cost, right?
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Yeah, that's not going away. Anyway, so basically, I guess what I'm struggling
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with a little bit is we have this really, again, this artificial market where.
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Just unregulated market.
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It's just, it's crazy. And so they're charging, they can charge you $300 for
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a Band-Aid if they want, right?
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And so you rack up debt. How does this dissuade hospitals from continuing to
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increase those prices, put more people in a situation where they're in collections?
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I don't see how this dissuades that.
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Or I don't see how it helps prices come down. It doesn't help prices come down in any way.
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And that's the issue. North Carolinians can't afford health care.
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And, by the way, if tax dollars have to pay for this, that's still the people paying more.
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It's not like, oh, okay, it just gets forgiven by the health care fairy.
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It's taxpayers paying for it. Sam hasn't. Sam, why don't you weigh in on this?
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I mean, medical prices are absolutely crazy. whenever I first moved to Raleigh
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and I got my job here, I had a brief lapse where I had no medical insurance
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because my parents' medical insurance, it expires as soon as you turn 21 or you graduate college.
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Right. So I had three months where I had no medical insurance.
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I thought everything's going to be fine. I'm going to be okay.
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I have no history of health problems.
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I'll just wait three months until my new insurance kicks in,
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start going to normal doctor's appointments, keep on track with my health.
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Two weeks after my medical insurance was gone, I had a severe year medical emergency
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where I ended up in urgent care.
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No way to pay for it. Was terrified.
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And I was lucky enough to have my parents help me. And I could have ended up
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with medical bills at collections because prices are just outrageous.
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And I couldn't afford it at that time because I had just taken out a loan to
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move to Raleigh. I had just started my job here.
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So I wasn't set up for anything yet. I had just graduated college.
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Well, I love the younger perspective you can bring to these conversations.
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And so do you and your friends ever talk about health care? Does it come up as a topic?
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Whenever me and my friends talk about health care.
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Crazy because we get excited about having health care because so many of us,
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whenever we first started jobs out of college, there wasn't a lot of health care options for us.
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And a lot of jobs nowadays also don't have health care included in their jobs.
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So whenever my friends would say, oh, I got a new job, I finally have health care.
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We get so excited. A lot. Yeah, I guess a lot of kids are, well not kids,
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but younger adults are doing kind of the gig economy type jobs that aren't.
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Yeah, a lot of the new age jobs kind of are where I graduated.
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A lot of us graduated right around COVID.
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There was no jobs at that time, except for going to retail or going into fast
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food, different options like that.
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And a lot of those, they wouldn't put you on schedules for 40 hours a week because
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they didn't want to have to give you the benefits.
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Because they can't afford them as employers. lawyers. No. So you'd be working
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35 hours a week, but still not getting insurance.
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And you're worried constantly, I'm going to get sick and I'm not going to have any insurance.
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Right. But do they know? Do you think they know where the problem really is coming from?
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That the prices are so out of control? Or do you think the employers are just being stingy?
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I don't think a lot of us know because I never really knew that the prices were
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the issue until I started working here.
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Because I think that it was just everyone who worked in those things were people
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saying, oh, they just don't want to give me the benefits.
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Right. That the employers were just being greedy. Just don't want to give us
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the hours so they don't have to give us the benefits. Yeah.
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So, I mean, I think there's no reason the average person has to know why things
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are so expensive. But we do have some facts.
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I know the treasurer's office shared a few months ago, sometime back in the
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winter, a report that was authored with researchers from not just the health
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plan, but Johns Hopkins, School of Public Health, Rice's, Baker Institute for Public Policy.
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And it was about executive compensation at hospitals. And what was striking
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is that at one hospital in North Carolina, CEO pay went up 473% over a five-year period.
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473%. But the registered nurses there, theirs went up 16%. And that's a field
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that's very much in demand, registered nurses. Right. So the costs of health
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care don't seem to be finding themselves.
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In fact, physicians, overall family medicine physician wages rose 22 percent from 2010 to 2019.
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Registered nurses only rose 14.8 during that same period of time.
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But here's the salaries of the biggest hospital CEO paychecks in North Carolina.
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$11.1 million a year. $9.8 million. $8.2 million.
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Not bad. $8 million. I mean, this is... Not bad if you can make it.
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I mean... Right. That was the biggest checks that anybody took home as a CEO.
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Anecdotally, we have a huge hospital right here near our office,
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and you see a lot of really nice cars coming out.
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But my thing is, I want you paying the doctors and the nurses and the techs.
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And please, you know, pay these folks.
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They are they're saving our lives and caring for us.
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And at the end of the day, this is where we are as a nation. Like, are we?
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The problem is and how this relates to state employees is that's why you have
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to have regular people voices in health care wherever you can get them.
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And the fact of the matter is you're not going to get them on a board in the
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boardroom of a hospital.
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But the state health plan board was always meant to be different.
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So I wish Governor Cooper luck in terms of doing something about the medical debt.
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But yeah, speaking of state treasurer, he did release a statement because he's
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been on this issue for a long time. Years.
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Yeah. And his statement was basically, you know, welcome to the discussion.
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Governor Cooper. Welcome to the party. Yeah.
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He is pushing the medical debt weapon is a de-weaponization act.
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Can you tell us a little bit about that?
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That would basically put parameters in place to keep people from unreasonable
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interest rates and unfair tactics and debt collection, all the things that have
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put these one in five North Carolinians in debt collection.
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So, you know, I think one of the things about Treasurer Falwell is he's always
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understood how all of these things connect, how the state health plan was such
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a big constituency and health care in general in this state need to go hand in hand.
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And he calls out issues around the state health plan that are issues for everybody
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trying to afford their health care.
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But he has been calling, like you said, for years on health.
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People to step up. Yeah. So obviously we have, we still have a lot of questions about this issue.
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We need to, we like our personal invites to folks. Maybe we should invite some DHHS officials.
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Well, maybe Secretary Kinsley and Treasurer Falwell, because they're both great
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guys and they both have been on this podcast.
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Maybe they would come on here. Friends of the Scenic View podcast.
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Governor Cooper could come on if he'd like, right?
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Well, sure. Yeah. I just I was saying Governor Cooper's always welcome.
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I was saying DHHS is administrating this program.
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So I think everybody agrees on one thing. This medical debt that's hurting North
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Carolina families so much is out of control.
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And we know as advocates for state employees and retirees that our health plan is facing dire straits.
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We just want to make sure we lend our voice to whatever efforts are going to
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be taken, that they ultimately drive costs down.
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It's interesting that, you know, our health plan is facing some turmoil.
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All kinds of, you know, families are facing all this debt.
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And the other side is doing pretty well. Maybe it's ironic or not ironic, right?
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It's an incredibly powerful industry.
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So another thing that happened last week, just kind of taking the world by storm.
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But my question is sam why didn't you
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watch this presidential debate so before
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i even i knew it was happening and i was on the phone with my mom that evening
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and she was like i'm gonna have a glass of wine and watch it because this is
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gonna be interesting and i was like well it was probably and i also just knew
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with my generation i would see everything on tiktok that there was to see yeah and i did,
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There was a lot shared.
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The jokes about how they were arguing about golfing half the time,
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calling each other losers.
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Even some of my hardcore Trump friends were like, is this the best we can do?
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Two men arguing about golf, you know? Yeah. So is this a common theme you see
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with your friends in this generation?
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Yeah, it's a really common theme. Even my friends who said they were going to
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watch it had to turn it off like 15 minutes in.
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They were like, I am getting a headache from listening to these two men bicker.
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I can't watch this anymore. more at what point
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will my generation artists are we in the
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same generation i'm x okay well we're
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we're close you may be in the same generation like i
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said i don't know i don't know i think you are a millennial maybe anyway
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whatever well we're our even even your generation then because older than sam
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you haven't had a presidential kid well i guess was back was obama he's older
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than you though he's not in your generation is he i don't know anyway at what
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point there's there's There's more of us than them, right?
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So at what point do we step up, you know, and throw a candidate?
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Us and them being, oh, generational. Like the 78-year-old people running for president.
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Even the third-party candidate is 70.
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I don't have any problem with somebody being 78 years old. Again,
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I cannot emphasize enough.
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I sat in Senator Sanders' office, and that was the sharpest politician I've
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ever sat and had a conversation with.
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Period. Age, irrespective of age or anything else. Yeah, I wonder how old he is.
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He's in his 80s, I believe. Wow. Yeah, so we're obviously probably not qualified
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to talk about the mental fortitude of either candidate at this time,
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right? We're not getting into that. Nope.
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Unfortunately, none of my generation can run yet. We are not old enough.
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That's right. That is a weird requirement, the 35-year-old.
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I wonder, even in 1776, you would think that 35 was a pretty high age, right?
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People didn't live but to like 50. Well, I mean, I think their goal was to get
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people who were, you know, the most experienced.
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And I get that. But I honestly, we're at a loss for words.
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At this point, I am seeing posts saying Meemaw from Young Sheldon should be president.
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So, yeah, well, I mean, it's sure to be an exciting next, what,
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five months, six months?
24:37
Not six months. We're already at the seventh month of the year.
24:40
It'll be like four months. Well, I mean, for so many reasons,
24:44
the presidential debate was different.
24:46
And then the Supreme Court came out with their ruling on immunity for presidents,
24:52
depending on whether it's an official or unofficial act, which is a really weird
24:56
ruling to try to understand, but very huge. It really is.
25:00
Like from elementary school, you're told the story about how America did not
25:06
want, the colonists did not want a king.
25:09
And so they revolted, right? And that's what this country was built on.
25:13
And you hear from a young age that, you know, no one is above the law in America.
25:18
And it's just, it just seems like you wouldn't want either party to have that
25:22
much power. No, no, no, no one should.
25:26
Well, that's not what we were founded on.
25:29
Again, I think the ruling is really bizarre, but it's got a lot of folks talking.
25:34
I think, yeah, I don't know.
25:36
What do the young people think of this one, Sam?
25:38
I think the main thought is what's going through my head right now,
25:41
which is, are we allowed to just scratch all the candidates we got right now
25:45
and start over? Yeah, it may happen before it's over, too.
25:48
I mean, it's just a mess. It's all a mess. Yeah, it is.
25:53
There's been a lot of fake little designs made that are different celebrities
25:59
that they're like, at this point, this person should win.
26:01
Right. Well, I mean, and again. What about Taylor Swift?
26:04
Like, she could win. She'd be great. I think she'd probably win, right?
26:08
She'd be great. Oh my gosh. I actually saw something where Trump spoke on her in an article.
26:14
Even Trump was like, she's great. So let's get to John's Wacky Weird. Play the song.
26:24
So my question this week, it's kind of a two-parter, or you could take it two ways.
26:30
Common phenomena among North Carolinians, North Carolina natives,
26:35
is that each family has a beach.
26:38
Do you understand what I'm saying? Like, you know what beach you go to,
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right? Every family goes to a certain beach.
26:45
Right. And so my question is, what is your beach? Or, if you don't have a beach,
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what is your favorite spot in North Carolina to vacation at?
26:54
Do I got to go first? Yes, because you're the new person.
26:57
I don't know if we technically have a beach because we don't live in North Carolina.
27:00
Our whole lives. I've lived in Tennessee for the first 10 years of my life. I didn't realize that.
27:05
Because when we were little and we would come visit North Carolina,
27:08
it would be more we'd go to South Carolina and meet there and go to Myrtle.
27:12
Myrtle, yeah. But once we moved to North Carolina, we were a Wrightsville family.
27:19
Oh, okay. Yeah. My wife's family were Carolina Wrightsville type folks.
27:23
So, my beach, and I'll be going there this weekend, is Holden Beach.
27:28
You ever been to Holden Beach? It's like a very nice little quaint beach, and I really enjoy it.
27:35
And I hope my kids grow up going to Holden Beach, right?
27:38
Do you have a beach? I know you're from Texas, so I was thinking,
27:41
is yours like Galveston?
27:42
No, it was south of there, about 30 miles north of Corpus Christi,
27:46
Rockport, Texas. But it's really not a beach town. It's a fishing town.
27:50
It's not much beach in Rockport. But here in North Carolina,
27:55
the Outer Banks. Oh, yeah. Without question. Beautiful.
27:58
I love Ocracoke the best, but Ocracoke takes so long to get to that,
28:03
you know, hey, there is not a bad spot on the Outer Banks.
28:06
As far as I'm concerned, I think it's one of the big treasures.
28:09
Once I went to Corolla, that was so pretty.
28:12
Such an awesome place. I've never been to like the, like I've always wanted
28:16
to go to Cape Hatteras. I've never been there.
28:18
And I feel kind of like a fake North Carolinian because I've never seen this
28:22
lighthouse, right? Right. But yeah.
28:23
So in honor of Fourth of July, the question is, what is your beach?
28:28
And it's not Galveston. Have you heard Charles Barkley talk about Galveston?
28:32
No. Oh, you got to look that up. Okay.
28:35
We never did Galveston. What about
28:37
other places in North Carolina that you treasure for a vacation spot?
28:41
Oh, anywhere in the mountains. Yeah. It's kind of like the Outer Banks you can't
28:44
miss, but the mountains in North Carolina. Calloway.
28:48
Sam loves Calloway, period, for any day and any occasion.
28:52
But yeah, I think that... We're so blessed to have beaches and mountains.
28:55
Right? Yeah. I mean, we are.
28:57
Yeah. Because coming from South Texas, where any mountains were a long,
29:01
long way away, it's pretty unbelievable that we can get in the car and within a few hours.
29:07
Especially during the summer, because Sandhills, Raleigh, all of that, so hot and humid.
29:13
Being able to go to the beach and get the ocean breeze or go to the mountains
29:16
and get the mountain breeze.
29:18
Float in the rivers or the lakes. Someone told me when I was younger that North
29:23
Carolina was the only state with mountains and beaches. And I think they meant
29:26
it in this context, but it just blew my mind. Like, that's probably not true.
29:31
Well, California has it, right? Lots of the East Coast.
29:35
Yeah. Well, Virginia may, but I can't think of it. Virginia may.
29:40
Virginia does, but like South Carolina doesn't have mountains, right?
29:44
Yes. They do. Oh, really? Yes, like Greenville, South Carolina.
29:47
But that's kind of like just hilly. They don't have like mountains.
29:50
No, that is mountainous. No.
29:52
Okay. Sorry about that. But that person was wrong.
29:56
But we're again off the rails here. But I hope you enjoy your fourth and listen
30:01
to this podcast on the way down to the beach and on the way back.
30:04
If you wait long enough at the beach, we may have another episode for you.
30:07
Happy Independence Day.
30:09
Go America. Thank you. Enjoy the fireworks.
30:11
Music.