Chair Talk

May 2013

Well, we are 4 months into the new prescription plan. Many of the problems that were experienced in the first couple of months have been resolved and the calls/e-mails have slowed down somewhat. There are still some questions about Prior Authorizations and formulary tier changes. I encourage all retirees whose prescriptions have gone into the higher co-pay tiers to consult with their Doctor to see if a cheaper prescription is available. We have to be smart consumers when it comes to prescription drugs and their uses. I have a Consumer Reports hand-out about generic drugs and the differences in prices for the same drug at various retail pharmacies.

I have been notified that there will be 2 healthcare contracts that have been sent out for bids and Joint Evaluation Committees will be appointed. I will be the SERA representative on the Vision Care JEC and I have appointed Cheryl Streberger as the SERA representative on the Mental Health JEC. The Vision Care contract will have an October 1, 2013 effective date. The Mental Health JEC will be announced in the near future.

There was a story in the Washington Post (May 8, 2013) about the disparity in medical billings at various hospitals. The story was based on a study comparison that the government released about the wide differences in hospital charges for several in-patient procedures. I looked at the report and here is a small sample of that disparity in billing at hospitals in the state of Michigan:

Breathing problem with Ventilator$23,044 lowest$120,888 highest
Chest Pain$5639 lowest$32,970 highest
Heart Failure$13,960 lowest$75,197 highest
Kidney Failure$16,366 lowest$80,919 highest
Pneumonia$9,727 lowest$51,726 highest

The charges vary based on type of hospital (Nonprofit, For-profit, Government or Physician owned) and location — as you can guess the For-profit hospital charges were much higher than the other 3 types of hospitals. The analysis was released by Medicare: SOURCE: Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) inpatient data for 2011.

Editor’s note: Bob Kopasz is Chair of the Michigan SERA Council. He may be reached at P.O. Box 692, Mt. Morris, MI 48458; phone 810/240-8380.