My Final Blog Post

This post was written by William McLaughlin. He assumes all responsibility for its content. No other member of FVHCTI contributed to this post and agreement by other members with the content should not be inferred.


Dr. Merton Finkler and I embarked on an effort, begun nearly four years ago, to inform the Fox Valley community about the reasons why medical care costs had become such a burden on local counties, municipalities, schools, businesses, families and individuals and what might be done to reduce that burden. Initially, our plan was simply to meet with various organizations and community groups to offer our thoughts and proposed solutions. We met with mayors, county executives, United Way, League of Women Voters and many others. I am grateful to all who invited us to speak and discuss this important issue.


Just short of two years ago FVHCTI met with a large group of public organizations including Outagamie County, City of Appleton, Fox Valley Technical Institute, Calumet County and the Appleton Area School District (AASD). Out of that meeting emerged a single organization with the most interest in pursuing change we had seen to date: the AASD. Accident and illness insurance (what most people call “health” insurance) for the AASD had been trending at 8% to 10% for a number of years. This trend had made it difficult for the AASD to fund important programs for students as well as wage increases for staff. Over the next several months the AASD assembled a meeting with seven local school districts (AASD, Kimberly, Kaukauna, Little Chute, Neenah, Menasha, and Hortonville). For approximately one year our group (FVHCTI) met monthly with these districts to discuss the creation of a cooperative (a particular type of business entity under Wisconsin Statutes) that would go to the insurance market as a single entity to purchase A&I insurance. Unfortunately, the effort to create a cooperative with the seven districts failed. Nevertheless, FVHCTI worked, diligently, with the AASD and a Madison insurer (NeuGen-a subsidiary of the Wisconsin Education Association Trust) to create a new plan of insurance for the AASD which took effect on January 1, 2021. Under the terms of the new insurance plan employees of the AASD were offered two options for A&I Insurance. The first option was a familiar plan with significant deductibles and coinsurance much like what had been offered previously. Employees were required to pay 18% of the total premium for this plan. The second option was an innovative plan that had no deductibles or coinsurance. There are copays for certain services (specialist visits, certain diagnostic tests, etc.). All visits to primary care providers are available at no additional cost to plan members. Employees pay 10% of the premium of the new plan. Slightly less than two thirds of AASD employees selected the new “Health Traditions” plan. The remainder selected the old model. The preliminary indication (yesterday from a NeuGen executive) is that the new plan is meeting expectations. The AASD received a 0% increase in premiums for 2021. This constitutes an approximate annual savings of $2 million from the typical 8% to 10% increase. The new program has allowed the AASD to increase wages for employees significantly more than in the previous five years. This is all good news for the AASD. So what is the problem?


The ultimate goal of FVHCTI was to compel local medical care systems to modify their business model in a manner somewhat similar, but much more substantial, to what emerged as the Health Traditions plan offered to AASD staff in 2021. The beneficiary of such change was to be the entire community-not simply the AASD. I had made it clear from the outset that my efforts as a volunteer were predicated on the creation of a cooperative, “anchored” by the AASD and/or other school districts or public organizations, that would allow any local government entity or business (ultimately families and individuals) to join the cooperative. Regrettably, the AASD has not been willing to follow through on what I believed to be a firm commitment to create such a community-wide cooperative.


I have avoided writing blog posts recently based on the expectation that I would be able to announce the creation of a Fox Valley Cooperative for purchasing A&I (“health”) insurance. Sadly, it appears such an announcement will not be forthcoming. This development has caused me to withdraw my support from the AASD project or any other similar project that does not support the goal of a community-wide purchasing organization. I am the only FVHCTI member who has made this decision. I am grateful for the support my friends and colleagues in FVHCTI have provided over the last four years and I wish them all the very best.

William McLaughlin






 

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