Steve Mitchell: some corrections

From Steve Mitchell, October 5, 2006

Subject: RE: Fw: Heresay or a good idea for STRS?

Molly: I would like to correct two items I saw in a recent e-mail from Bob Jones.

First, The Ohio Highway Patrol Retirement System essentially has no investment associates. The Executive Director oversees the investment program which is strictly externally managed (except for cash) by "more expensive" external managers. They have approximately 17 external managers (not 3) managing approximate $750 million. The Executive Director has no idea where the annual firing one out of three associates came from.

Second, inflation in the United States since 1969 has been approximately 4.7% per year. The return on STRS investment assets over that same period has been approximately 9.2% per year. Thus, one can see that the return on STRS assets has clearly beaten inflation over the period.

Steve

Damon responds to Sondra Stratton's 9/26/06 inquiry on what STRS is doing currently to reduce 2008 HC costs

From Damon Asbury to Sondra Stratton, October 6, 2006

Subject: RE: Hc for 2008 [In response to Sondra's letter posted 9/26/06]

Sondra:

In a recent Board News, there was an article that described a joint project of STRS Ohio and the Ohio Public Employees Retirement System. A copy of the article is attached below. As you know, STRS Ohio spends nearly a half billion dollars a year on health care expenses for 114,000 enrollees in the program. Staff is working hard to get the best available discounts on services. This promises to be a significant approach to controlling prescription costs, as is our on-going effort to work with the federal offices of Medicare for our Part D reimbursement. At present, it appears that we will receive over $35 million annually from this effort and that will help to both preserve the Health Care Stabilization Fund and keep costs lower.

Damon

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Pharmacy Benefit Consultant Selection Under Way

STRS Ohio, in conjunction with the Ohio Public Employees Retirement System (OPERS), conducted a Request for Proposal for a pharmacy benefits manager consultant. The purpose is to engage a consultant to evaluate both traditional pharmacy benefits manager (PBM) purchasing models as well the viability of alternative PBM models. The current PBM contracts for both systems end Dec. 31, 2007. Eight consulting firms responded with proposals and STRS Ohio and OPERS staff narrowed the field to three finalists. Staff members interviewed the finalists to assess the capabilities of each organization Aug. 29–30. During the next few weeks, staffs at both retirement systems will select a consultant and finalize terms of engagement. By working with OPERS, STRS Ohio can maximize its purchasing power and share expertise. Collectively, STRS Ohio and OPERS represent about 300,000 lives and more than $650 million in gross drug spend annually. This project began months ago with discussions among all of the Ohio retirement systems, the Department of Administrative Services and The Ohio State University to explore concepts around better approaches to prescription drugs. However, only STRS Ohio and OPERS were able to move forward with the current project.

Thanks to Jim N. Reed for contributing this one
Click to enlarge

Paul Kostyu: GOP candidates dance between party loyalty, distance from scandal

Canton Repository, Oct. 3, 2006

Paul E. Kostyu, Copley Columbus Bureau
.....(Photo: Paul Kostyu)

COLUMBUS -- President Ronald Reagan is credited with saying that the 11th commandment is that “a Republican shall not criticize a fellow Republican.”

Ohio Republican candidates for statewide offices are having a tough time abiding by the commandment because of the various scandals that have rocked state government, which has been controlled by Republicans for 12 years.

In his run for governor, J. Kenneth Blackwell basically ignored the commandment, publicly criticizing current Gov. Bob Taft and his primary election opponent, Attorney General Jim Petro. Now that Petro is out of the way, the commandment is back in play, and we don’t hear Blackwell taking on the lame-duck Taft as much. The governor actually hosted a fundraiser for Blackwell.

New Republican blood is running in three of the four statewide office races — secretary of state, auditor and treasurer. There is recycled blood in the attorney general’s race.

Asked their plans should they be elected, Republicans do a careful dance because fellow Republicans occupy the offices now. The pretenders to the thrones have to distinguish themselves from the public’s perception of Republicans, while staying linked to the party. They don’t want to sound like Democrats criticizing the pay-to-play culture in Columbus. Inevitably, however, they do.

“Ohioans are telling me they’re tired ... of pay to play,” said Sandra O’Brien, the Republican candidate for treasurer. “They’re tired of influence peddling. They’re just tired of it, and that’s the reason I’m running.”

O’Brien said this while trying to criticize Democratic opponent Richard Cordray’s fundraising efforts with financial institutions, until she admitted she had approached the same people he did.

Republican Mary Taylor, who is running for state auditor, said that there needs to be structural changes to the office and that it should have been able to prevent the investment scandals at the Bureau of Workers’ Compensation. Taylor was careful not to mention by name the current auditor, fellow Republican Betty Montgomery, who is running for attorney general.

“We need the structural changes regardless of who is in office,” Taylor said, adding that the public’s trust needs to be rebuilt.

Republican Greg Hartmann, a candidate for secretary of state, said there has to be a nonpartisan approach to running Ohio’s elections and the secretary should not advocate for a particular ballot issue or candidate. Two years ago, Blackwell, the current secretary, co-chaired the George W. Bush campaign in Ohio and very publicly promoted the constitutional ban on gay marriages.

Hartmann said the secretary needs to be more “hands on” with giving boards of elections better and more consistent guidance, implying, of course, that Blackwell is detached from the needs of local officials.

Montgomery and Blackwell are trying to convince voters they danced with different partners in different rooms and are not part of the Statehouse political culture that has Ohioans so upset.

The Ohio two-step is a difficult dance that all Republicans are trying to master this year.

Reach Copley Columbus Bureau Chief Paul E. Kostyu at (614) 222-8901 or e-mail: paul.kostyu@cantonrep.com

STRS' Gary Russell agrees with CORE's John Bos

From Gary Russell,, October 03, 2006

Subject: RE: Here is the press release from Wal-Mart

John,

Your understanding is correct. If an enrollee uses his or her Caremark card at a participating Wal-Mart and the drug (dosage and quantity) is on the $4 list, then the enrollee with pay $4 and the $4 will be credited toward the $1,500 out-of-pocket maximum for an enrollee in the Aetna or Medical Mutual Plus plans. For an enrollee in the Aetna or Medical Mutual Basic plan, there would be no charge against the enrollee’s $3,100 cap since the enrollee would be paying the entire cost of the drug.

Gary Russell

Director, Member Services

STRS Ohio

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From: John Bos, September 21, 2006
Subject: Here is the press release from Wal-Mart

As I understand this, STRS retirees will be able to purchase the generic for $4.00. The amount will be recorded on the Caremark account and the retiree will pay $4.00. The copayment will count toward the yearly maximum amount. Caremark would be cut out of the action, STRS will save money, and the retirees will save a significant amount fo money on the generic. According to one source, Walmart will go into the states where there are the highest number of retirees. Ohio is high on that list. Fortunately, Ohio snowbirds will be able to get 4 months of drugs while they are living in Florida this winter.

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September 21, 2006

Wal-Mart to sell generic drugs for $4

Wal-Mart Stores (WMT, news, msgs), facing pressure from critics who call its employee health care coverage inadequate, plans to begin selling nearly 300 generic prescription drugs for a sharply reduced price of $4 for a month's supply.

The world's biggest retailer said Thursday that it will test the program in Florida and it will include 291 generic drugs available for conditions from allergies to high-blood pressure. The plan is available to its employees and customers, including those without insurance.

Wal-Mart officials said the reduced price represents a savings to the customer of up to 70 percent on some drugs.

"Wal-Mart is taking this step so our customers and associates can get the medicines they need at a cost they can afford," Bill Simon, executive vice president of the company's professional services division, said in announcing the plan at a Tampa, Fla., store.

The program will be launched on Friday at 65 Wal-Mart, Neighborhood Market and Sam's Club pharmacies in the Tampa Bay area and will be expanded to the entire state in January.

Simon wouldn't be specific about why Florida and specifically the Tampa Bay area were chosen for the rollout of the initiative, saying only that there was a need for it here.

More states to come

The company said it plans to expand the program to as many states as possible next year.

Simon said the 291 generic drugs include "the most commonly prescribed drugs for the some of the most common illnesses that face Americans today, including cardiac disease, asthma, diabetes, glaucoma, Parkinson's (disease) and thyroid conditions.

"Simon wouldn't give details on how much the plan is expected to cost Wal-Mart or the company's dealings with the drug companies involved.

"We're able to do this by using one of our greatest strengths as a company -- our business model and our ability to drive costs out of the system, and the model that passes those costs savings to our customers," he said. "In this case were applying that business model to health care."

The $4 prescriptions are not available by mail order and are being offered online only if picked up in person in the Tampa Bay area.

In a conference call with reporters, Simon said that the generic drugs would not be sold at a loss to entice customers into the stores, a strategy that has been used in Wal-Mart's toy business.

He said Wal-Mart is working with drugmakers to help them be more efficient, but added, "We are working with them as partners. We are not pressuring them to reduce prices."

Tampa Wal-Mart pharmacy customer Pat Sullivan praised the company's initiative. The retired Massachusetts police officer said $4 generic prescriptions are a tremendous help.

"I'm on disability and my benefits run out by the end of the month," he said. "It comes down to where do I go for a $100 prescription? I have no outlet other than to break a pill in half and take half today and half tomorrow

Wally World is finally doing what the majority in Congress prohibited Medicare from doing -- forcing competitive bids

"Unfortunately for America’s senior citizens, its benefits were lost on a Congress that denied seniors such price advantages."

From John Curry, Oct. 3, 2006: Isn't it ironic that the very same company that leads some states' statistics as one of the largest employers of those on the Medicaid rolls is, by its very own profit motive, this time benefiting seniors throughout the country? .... all of this at a time when the majority in our very own Congress coalesced with Big Pharma to prohibit competitive Rx bidding for the very same people that our Congress is supposed to look out for (its Citizens)? For those who wish us to shed a tear for the Pillmakers profit margin I say, "This time 'round, you got a dose of your own medicine!" Maybe your CEO's, using an STRS's Herb Dyer coined phrase, "will have to eat out less often."

This time, the squeeze is being put on the pillmakers' bottom line. Kind of refreshing to see, isn't it? I am not an admirer of Wally World's track record as it applies to benefits for its associates, but this time 'round it appears as if the Wall Mart CEO's have stepped on the toes of Big Pharma's CEO's. This is a battle that is fun to watch from the sidelines, isn't it? Both this battle and November 7th are just around the corner - I can't wait, how about you? Will today's "majority" in Congress be tomorrow's minority? For the working man and retirees... I can only hope and pray.

John

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Buying power

Retailers’ big cut in drug prices is good medicine for U.S.

Columbus Dispatch

Tuesday, October 03, 2006

Wal-Mart’s decision to slash prices on many generic prescription drugs doesn’t mean affordable health care for all, but it could force a dramatic shift in the way drugs are marketed and priced.

The move will help millions of Americans.

Already, Target Corp. has said it will match Wal-Mart’s new price for nearly 300 generic drugs, which is as little as $4 for a 30-day supply.

Wal-Mart and Target have the efficiencies of scale to withstand losses or lower profits on drug sales, and they have the bulk-buying power to command price cuts by generic-drug manufacturers.

Whether this will hurt those manufacturers is debatable. Critics say Wal-Mart squeezes the profit margins of its suppliers mercilessly. The company says it is working with 30 participating drug manufacturers "as partners" to help the suppliers cut their own costs.

The head of the Generic Pharmaceutical Association says Wal-Mart’s plan won’t affect members much.

The power of bulk buying is perhaps the most important lesson of all in Wal-Mart’s initiative. Unfortunately for America’s senior citizens, its benefits were lost on a Congress that denied seniors such price advantages. Lawmakers prohibited Medicare from negotiating with drug companies for its prescription-drug program.

The pharmaceutical industry doesn’t want to see lower drug prices, and its lobbying clout won the prohibition on negotiation, ensuring that Medicare patients pay more than they otherwise would have to. Fortunately for the people who depend on the drugs on Wal-Mart’s list of 300, Congress can’t prevent giant retailers from getting the best prices for their customers.

Sondra Stratton: A not-so-pleasant experience with our HC insurance

From Sondra Stratton, October 03, 2006

Subject: yet another experience with our good old HC insurance

Many of you know a little about Brown County. We are a rural area just on the edge of the Appalachian area. We are about 30 minutes from the KY state line. We have doctors but not on every corner and those who practice in BC are very busy. It sometime seems that I have to schedule an illness as I usually can not get in to see her for weeks if not months. There are times that you can not even see the nurse practitioner ( not that I like paying the same price to see a nurse that I would pay to see the doctor). In other words, there is no over-abundance of doctors here.

Last winter, when I could not get in to see my doctor to get medication for a sinus infection, I was told that I could go to the Urgent Care that is being held in the building after the doctors' hours. It is open from 6 PM to 10 PM. While that is not a long time, it is good for needing to see a doctor as opposed to visiting an emergency. Abundantly cheaper and less time consuming.

As far as I know, this is the ONLY Urgent Care in the county. A welcome one at that!!! It would require 60-90 to get to one down around the city. Not something to look forward to when you are aren't feeling well in the first place. THEN they might not be providers....who knows!!! It would take HOURS to go to the Emergency room and then those who are in need of urgent medical care are always taken first as they should be!

Recently, I received an EOB from MMOH from last winter stating that I would owe something like $71 as the Urgent Care was not a provider for my insurance. I immediately called MMOH and talked to a representative. She told me that MMOH would not cover the Urgent Care as they had NEVER done any paper work and asked to be included as a provider. I told this lady that I thought they were just out to see what they could get out of paying which didn't set well with her. I told her we did not have doctors on every corner in Brown County and this are a better solution to the problem than the ER. I asked for papers to send to refute the decision. I intended to do this but somewhere in the line of cleaning I misplaced the papers. I also told this lady that I COULD have gone to the emergency room and cost the the insurance company a whole lot more money AND they would have paid for it. It made no sense to me that my doctor's office and the Brown County Hospital that operates the Urgent Care were all providers and it made absolutely NO SENSE that the Urgent Care was not also included in our insurance.

Anyway, I went in for sugar blood work as couple of weeks ago and asked about it. By this time there is a BIG sign on the window they are NOT MMOH providers. I asked why that was and why that has not been placed in view before now AND I asked WHY they had not applied to be a MMOH provider. I learned that, according to the staff,

they had indeed applied and had been refused for.....get this reason,,,,,,,,,,the Urgent Care was not open long enough so MMOH would not accept them as a provider. Someone is lying.....you figure it out! I KNOW who I think is lying!!!

SO our good old insurance company is at it again......working for our benefit!!! NOT!!!!!

It makes no sense to me that an URGENT CARE that is open for at least 4 hours longer than ANY doctor's office would not be granted permission to become a provider!!!!! It seems, according to my doctor's staff, that MMOH wants the Urgent Care to be open for at least 8 hours. Eight hours would be nice but I will take the extra 4 and be happy that I have some place to go when I need medication but not EMERGENCY attention. NOW I ASK YOU, is it better to have an extra 4 hours ( as opposed to no other option than going to the ER) to see a doctor to keep from going to the emergency room?

I could understand it maybe in the city where there are doctors on every corner and around every bend and Urgent care facilities in most communities or near-by BUT not in an rural area that is in need of doctors. I would think the company would be interested in saving money. It would seem to be that $71 would be a better deal for MMOH than say.....$3-400 for an emergency visit. I am not a brain surgeon but think that maybe that is needed by MMOH and its employees and if these kind of decisions are being made by STRS employees, then maybe they need to see the surgeon as well.

It really makes me angry to pay for the insurance and then be told that it is not covered. Especially in a case like this!!!! Yes, I now have a book that includes doctors on the plan. It was a new service and would not have been in the book in the first place. When you are sick, it is positively stupid to ask someone to CALL the insurance company and find out if this or that is ON THE PLAN!!! It sometimes takes a lot of time to get a representative and they are not available evenings and night-time. Besides, there ARE illnesses that need attention but not EMERGENCY ROOM attention!!!! PURE STUPIDITY!!!!!!!!!

I hope this situation gets rectified.....QUICKLY!!!!!!! STRS, are you listening??

SO, retirees BEWARE if you need medical attention and can't get in to see your doctor and go to an Urgent care facility, you need to ASK first if they are on your plan!!!!!!!

Sondra

Columbus Dispatch: Richard Cordray for state treasurer

Richard holds up a delinquent tax bill. His mantra: more tax collections mean more money for schools

Cordray’s career record of competence, integrity make him standout choice

Sunday, October 01, 2006

Ohioans should not hesitate to vote for Democrat Richard Cordray for state treasurer in the Nov. 7 election. As Franklin County treasurer, he is eminently qualified, has demonstrated leadership and integrity and clearly is the better candidate. Since being elected to a partial term as county treasurer in 2002, Cordray has developed innovative programs to recover millions of dollars in money owed by tax scofflaws.

He auctioned off long-delinquent tax accounts to banks and other financial institutions and prodded some delinquent owners to pay simply by sending them a letter warning that he would file tax liens on them if they didn’t.

Before the legislature voted to phase out the personal-property tax on business equipment and inventory, Cordray squeezed some of those unpaid taxes out of business owners by warning them that he would inform the Better Business Bureau, credit bureaus and local banks of their unpaid debts.

Cordray has an impressive resume beyond his excellent performance as county treasurer.

He served as a law clerk to U.S. Supreme Court Justices Byron R. White and Anthony M. Kennedy, represented Ohio’s 33 rd House district in the early 1990s and was state solicitor in 1993 and 1994.

His Republican opponent, Ashtabula County Auditor Sandra O’Brien, can’t match Cordray’s resume and has shown little of his professionalism.

In her primary race against incumbent state treasurer Jennette Bradley, O’Brien repeatedly touted her stances against abortion rights and gay marriage, despite their complete irrelevance to this office.

After the tactic won O’Brien a surprise victory, fueled by values-oriented conservatives, she has had much less to say about those issues that she earlier deemed so important.

Cordray’s qualifications and good reputation even have earned him the endorsement of prominent Republicans: former Columbus Mayor and ex-Franklin County Treasurer Dana G. "Buck" Rinehart and Joan Lawrence, former head of the Ohio Department of Aging and an eight-term state representative.

If the choice is that clear to these Republicans, it should be even clearer to other Ohioans.

Cordray is the better choice for state treasurer.

http://www.cordraycommittee.com/

CORE/STRS Board Meeting: 10/19/06

John & Dennis

From Molly Janczyk, October 2, 2006

Subject: CORE/STRS Board Meeting: 10/19/06

October Board meeting and CORE meeting promise to be an interesting at STRS -- one that STRS membership hopefully will attend showing support for Dennis Leone and John Lazares. Last month, the support really made for rich dialogue and exchange and both Leone and Lazares felt it was due to the large turnout obviously supporting them. They took these seats on the Board because we asked them to and we must attend to show our backing of them. It is a lonely and frustrating job for them fighting so many uphill battles. When we are there to show how we feel and that we support them, it clearly makes the rest of the Board behave differently as evidenced last month. It does provide a pressure to act on behalf of membership. For ex., some items Lazares and Leone were fighting for on our behalf were actually put on the agenda for future discussion vs. being voted down because the Board heard from us in the audience. Damon actually told each Board member to bring ideas for this discussion.

A new appointee, Johnson, by the Gov. will be seated. We will want to meet him and show our interest in his decisions and encourage collaboration vs. rubber stamping.

Some items of GREAT interest will be on the agenda and I promise you will not be disappointed. For now, they are not public.

CORE will meet at 11:45 am in the Sublett Rm on the 2nd flr. It is unsure whether we have the entire room or the rear of the room which is accessible through the door in the rear of the cafeteria. You can stop and buy lunch to bring into the meeting.

The voting for CORE Officers is on the agenda so they can take their office and begin their efforts to work with other organizations and legislators. CORE will finally have actual contact persons to act on behalf for membership based on majority approval.

Accepted nominations are:

Pres. : Dave Parshall: experienced with high level boards , meeting with organizations and legislators. Responsible for incorporating CORE and overseeing its finances

VP: Mary Ellen Angeletti: works closely with Dave and experienced with all workings of CORE with a determined and dedicated mentality to keep CORE active and knowledgeable.

Treas: CJ Myers: in communication with and in proximity of Dave P. to take over the CORE accounts. She is a responsive and enthusiastic in wishing to help her fellow retirees.

Secretary: no nominee has accepted due to interest or ability. Substitutes have agreed to fill in temporarily UNTIL this office is seated. I have posed an amendment that this position be open for subs or for an elected position as it seems difficult to fill. That way, someone can act as scribe even if no one accepts this job.

I will forward agenda info when it becomes available.

PLEASE SEND A REP FROM YOUR AREA TO SHARE INFO AND PROVIDE INPUT . We are all in this together and need to help show support and direction.

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I would like to "second" what Molly said above about attending STRS Board meetings to show your support for Dennis and John. The difference in the atmosphere at last month's meeting was dramatic. You had to be there to believe it. It was almost like some of those Board members were on trial and we were the jury -- a BIG, highly visible jury. Many people give lip service to supporting our guys in the trenches -- Dennis and John -- and it is difficult for many to get to Columbus for meetings. But I encourage all who can possibly get here once a month to do so. Your presence DOES make a difference -- a HUGE difference! Remember -- it's YOUR future! Gas is expensive, but a future without healthcare is a lot more expensive! Please come -- every month, if you can. You'll be glad you did.

Kathie Bracy

Nominations submitted for CORE Officers

From Mary Ellen Angeletti, October 1, 2006

Nominations for CORE Officers
President -- Dave Parshall
Vice-President -- Mary Ellen Angeletti
Secretary -- no nominations
Treasurer -- C.J. Myers

NOTE: Voting will occur at the CORE meeting on Thursday, October 19th at 11:45 in the Sublett Rm. at STRS.