Shirlee Zerkel: Some questions concerning the February 20 Health Care Report

From Shirlee Zerkel, March 11, 2009
Subject: Questions concerning the Health Care Report on Feb. 20th

Dear STRS Board members and STRS Member Benefits Department:

After reading the Health Care Report from Feb. and listening to the tapes, I have some concerns that need some clarification. First I want to know what the Staff Benefits Department means by the terms: 1. value-based programming for hypertension and diabetes; 2. Ohio-based service.

Next, I want to know what STRS means by pre-cert for x-rays/scans. Does this means any and all -- even in emergency situations and very serious illnesses?

My next concern is that your health care program has 5 goals and the first one states: "Continue the integration of Medicare Part D to preserve the viability of the STRS Ohio Health Care Program." Great goal, but then in 2012, you plan to eliminate current Medicare Rx and members would have to get coverage through an outside source. This goal and your proposed future changes do not work together. Please explain to me how this is a savings as you will lose your federal subsidy of about 33 million?

You were also discussing the cost for ER of $100 and $200 in patient and then the regular benefits would kick in. What does that mean for your traditional Medicare retirees like me? Is that cost for each and every visit? I know that if I should have to enter the hospital for a stay now, the Medicare A, ticket in, is paying the first $1,068. Since I have STRS supplemental. I would pay $500 of that and then STRS would pay 80/20 on the rest of the $1068. With the changes in 2010, I know I know I would have to cover the first $1,000. That may leave only a little part of $68 for STRS to pay. I never even met my deductible last year and certainly in 2010, I would not either. So the ever increasing premiums and deductibles would be of great benefit to STRS, and I would still pay all my medicare bills after Medicare coverage. That is no supplemental!

The proposed changes in Rx cost are also drastic and will bring death to some retirees who can not afford to pay medication costs to live.

I also noted that you plan in 2012 to possibly only insure those retirees who are 62 to 64. Where does that leave retirees who have been currently receiving health care benefits through STRS and would not be 62 by 2012. Would they be grandfathered? I heard on the CDs that grandfathering had not been considered? Why, when other systems like OPERS do grandfather?

In 2014, your report states that the plan is to drop Medicare members. Which Medicare members do you mean:

1. Those who have the traditional Medicare A and B?
2. Those who only have traditional Medicare B and depend on STRS for their Part A?
3. Both groups?

I also heard you speak on the CDs that you want to retain the retiree who is in good health or in other words does not use the benefits a great deal. These drastic cuts will not help in that retention. We who are on Medicare A and B cost you very little a year and we pay your premiums and many of us already received no or very few benefits in any given year. The health care program that you propose is not health care.

I do understand that times are difficult and I heard on the CDs that you need to cut 82 million dollars in health care for the members. What are the cuts to staff health care? I realize that I am speaking of a much smaller number of persons here, but why shouldn't the staff have the same benefits and premiums that we the retirees have?

Since you expect to cut that from retirees' health care, have you made comparable cuts in other areas of the retirement system in order to save money? If so, what are they? I hope to hear from all of you on these questions and concerns.

Shirlee Zerkel