Saturday, March 31, 2007

CORE member's Letter to the Editor appears in Lima News

From RH Jones, March 31, 2007
Subject: CORE member's Letter to the Editor appears in Lima News
Ann Hanning, Dir., Don Bright, Pres., Tom Seamon Editor & ORTA members:
It would certainly help ORTA to increase membership if the editor of the Quarterly, Tom Seamon, would print constructive articles such as the attached editorial by Bruce Hodges from Lima. This, rather than so much social news no member wants to hear about or cares about, would help let the membership know facts that concern their financial survival in retirement.
Robert Hudson Jones, a CORE ORTA Life Mem.
From John Curry, March 31, 2007
Subject: CORE member's Letter to the Editor appears in Lima News
Strickland plan right for schools
Letter to the Editor - 03.29.2007
I knew that when Gov. Ted Strickland proposed a ban on for-profit private schools, some parents would feel alarmed about choices in schooling for their kids. Republican politicians have pushed vouchers in this state linking them with choice, to the point where voters believe vouchers and choice are the same thing. They are not.
Parents have the right to choose the option of open enrollment to a neighboring public school. You may always choose any private school you want. But now you will have to pay for that choice without expecting me and other taxpayers to pay for your choice. As a taxpayer, I am expected to support only the choice of public schooling. You should pay for your choice of a private school.
When vouchers channel my school tax dollars away from public schools, I end up paying twice. I must still support the public schools with my tax dollars while some unregulated private school is making a profit off of my tax dollar. I have no control over how private schools spend my money. The public cannot even evaluate the quality of education the private schools say they are providing. Yet they are able to channel funds to political campaigns to keep the state vouchers coming their way.
Strickland understands that we, the taxpayers, cannot afford to keep passing school levies for public schools while our state tax money goes to questionable private schools. It is simple. If you are against more tax money for schools, you should be against vouchers for private schools. Follow the money and you will be amazed at how many private schools are in the business of pay to play with our Republican-dominated Legislature. They play while we, the taxpayers, pay.

Will Big Brother continue to allow a successful state program or will the pillmaker lobby win out?

Isn't it amazing what a state-level Rx program can achieve when allowed to "negotiate" for Rx prices (unlike the federal government pressured by Big Pharma lobbyists)? Will Big Brother wipe out a successful and cost-savings program -or- will the pillmaker industry once again win out? Wisconsin... the only state "without a donut hole!" As far as CMS applying pressure to eliminate the Wisconsin program...with the new Congress in place, it might not be a "done deal." Those Wisconsinites... they're so anti-establishment (tongue in cheek)! They just want to save money and serve their citizens... how un-American!
John [Curry]
Thursday, March 29, 2007
Kaiser Daily Health Policy Report
CMS Likely Will Not Issue New Waiver for Wisconsin Rx Program
Acting CMS Administrator Leslie Norwalk on Wednesday at a hearing of the Senate Special Committee on Aging said that the Wisconsin SeniorCare prescription drug program likely will not receive a new Medicaid waiver after June 30, CQ HealthBeat reports (Reichard, CQ HealthBeat, 3/28). According to the Milwaukee Journal Sentinel, SeniorCare, which began in 2002 and has enrolled about 105,000 Wisconsin residents ages 65 and older, "is now the only remaining state-based alternative to Medicare Part D in the country" (Gilbert, Milwaukee Journal Sentinel, 3/28). In 2005, before the implementation of the Medicare prescription drug benefit, HHS issued a waiver to allow Wisconsin to continue to operate SeniorCare until at least June 30. SeniorCare has no monthly premiums, lower copayments than the Medicare prescription drug benefit and no gaps in coverage (Kaiser Daily Health Policy Report, 10/13/05). In addition, SeniorCare, unlike the Medicare prescription drug benefit, does not measure the assets of beneficiaries. Under SeniorCare, beneficiaries pay a $30 annual fee and make small copayments for prescription drugs after they reach an annual deductible based on income. Wisconsin Gov. Jim Doyle (D) has requested a new waiver to allow the state to continue to operate SeniorCare for three additional years (Milwaukee Journal Sentinel, 3/28).
Doyle Testimony
At the hearing, Doyle said that SeniorCare, unlike the Medicare prescription drug benefit, negotiates "big discounts" for the most commonly used medications. SeniorCare in 2006 reduced prescription drug costs for beneficiaries by almost $200 million, Doyle said. According to Doyle, most SeniorCare beneficiaries "love their coverage and don't know what they'll do if it's taken away." He added, "Most of them will be forced into the Medicare Part D program, where they'll face higher payments, more complicated bureaucracy" (Mantell, Dow Jones, 3/28). Doyle also said that the Wisconsin congressional delegation supports a new waiver to allow the state to continue to operate SeniorCare.
Additional Testimony
Norwalk said that SeniorCare has not met "budget neutrality" requirements in the current waiver. In addition, she said that private plans under the Medicare prescription drug benefit can negotiate more comprehensive and affordable options for beneficiaries than SeniorCare (CQ HealthBeat,, 3/28). Norwalk said, "I don't want seniors to be scared about this. What I'd like to do is work with the state so that (seniors) see as little change as possible." Norwalk added that "we believe the transition to Medicare Part D must be made as quickly as possible," although CMS might allow Wisconsin to continue to operate SeniorCare until the end of the year to make the transition "as seamless as possible." Committee Chair Herb Kohl (D-Wis.) said, "We believe it would be a huge mistake for the administration to pull the plug on SeniorCare," adding, "It costs less, it covers more and seniors are happier" with the program than they are with the Medicare prescription drug benefit. Rep. Jim Sensenbrenner (R-Wis.) said, "One Republican principle ought to be to allow the states to be incubators of new and effective programs" (Milwaukee Journal Sentinel, 3/28). Kohl estimated that SeniorCare saves the federal government almost $500 more per beneficiary than the Medicare prescription drug benefit (Dow Jones, 3/28).
CORE Alert
March 20, 2007

CORE Alert March 20, 2007 Russ Harris of OEA asked to speak to CORE at the CORE meeting of March 15th for the purpose of soliciting CORE's help in the dissemination of an Initiative Petition which Gary Allen discussed when he spoke to CORE on January 22nd. This Petition is being passed to obtain signatures for putting an amendment on the ballot titled "Guaranteeing High Quality Public Education". Due to the fact that this Petition contains three pages of explanation and four pages of definitions, it is too lengthy for CORE to duplicate in this Alert. A brief overview follows:

1. There are two documents, the petition itself and also a petition guideline.
2. Any Ohio registered voter may sign the petition.
3. A voter can sign only one petition.
4. A voter should not sign the petition he/she is circulating.
5. When signing the petition, the voter must use his/her address on file with the Board of Elections.
6. The petition must be signed in ink.
7. One petition has spaces for 72 signatures.
8. The date must be correct on the petition.
9. The ward/precinct referred to on the petition does NOT have to be completed.
10. All signatures must be registered voters residing in the county listed on the first page of the petition.
11. A petition circulator may circulate petitions from more than one county at the same time, provided that each county is on a separate petition.
12. All completed petitions must be returned to the Labor Relations Consultant who will then forward to Bonnie Joseph at OEA headquarters.
13. The circulator of the petition must complete the Statement of Circulator at the back of the petition but the name and address of the employer is NOT necessary. All other information is required of the circulator.
14. The circulator must circulate original initiative petitions. Reproducing the petitions is not permitted.
To obtain Initiative Petitions and the Petition Guidelines, call Tom Ash at 614-846-4080 or email Bill Phillis at or petitions can be picked up directly at the OEA office in Columbus. You may request as many Initiative Petitions as needed in your county, school system, Retired Teacher Association, etc. This is an opportunity to give support to an effort to improve education in Ohio. Perhaps this collaborative effort will help to win favor with the school boards which may cause them to think more favorably on our pending Health Care legislation. A big plus for this amendment if it is successful, is that it may reduce the property taxes of senior citizens. CORE is sending this information as an Email Alert in an ongoing effort to keep members informed of what is happening in our state regarding education.

Friday, March 30, 2007

Update on Board member John Lazares

From Molly Janczyk, March 30, 2007
Subject: John Lazares
IS healing. His wound is still seeping due to 3 surgeries on that knee altogether and scar tissue. But, the Dr. said it does not look infected and it should subside. He was out for the second time for his 3 wk ckup and sounded tired and is going back home. Physical therapy is in his home for now and he may be approved for outside therapy in early April.
His healing will take longer than a one time surgery as this site, as mentioned, has been opened 3 times. But, most importantly, there seems to be continued progress this time and with the infection healed, pain is not the issue except on therapy days which makes it more uncomfortable.
He can probably take calls now : 513-583-7611 (hm)

513-967-8786 (cell) but I don't know if his cell is yet receiving calls.

8133 Devonshire Pl.
Maineville OH 45039

CBS to air exposé on Big Pharma this Sunday

This Sunday, April 1, CBS News 60 Minutes will focus on Big Pharma's lobbying efforts influencing Congress. Included will be an expose of the dirty tricks that were used to gain passage of Pharma's biggest profit windfall: the Medicare Prescription bill which forbids price negotiations.
Congressman Walter Jones, a Republican from North Carolina who along with Dan Burton, ar Republican from Indiana, tried but failed to prevent the stampede. Jones says: "The pharmaceutical lobbyists wrote the bill." "I've been in politics for 22 years and it was the ugliest night I have ever seen in 22 years," says Jones of efforts by Republican Congressional leaders to persuade defecting Republicans to vote for one of the most expensive bills ever before the House.
The 60 Minutes airing coincides with a report to be issued by the Center for Public Integrity, will focus on the number of government lobbyists employed by pharmaceutical companies.

Wednesday, March 28, 2007

Tom Curtis re: STRS Newsletter

Tom Curtis to Damon Asbury, March 27, 2007
Subject: 032707 Curtis To Asbury, STRS Ohio Newsletter
Hello Damon,
Congratulations! I have just finished reading the latest spin on words in the STRS Newsletter I received today. As usual, the newsletter indicates just how happy the membership is with the direction of the STRS and just how much you are doing for us. Blah! Blah! Blah! What a bunch of expensive manipulated information! You should be so proud of yourself for doing such an outstanding job. Not!
You must truly consider yourself to be a master at deceiving people. I understand from others that have worked under your authority that this has been your paradigm for much of your career. How pitiful, but then if not you, it would probably be someone other greedy person? Remember one thing Damon, you can fool some of the people some of the time, but you cannot fool all of the people all of the time.
Why is it you fail to ever mention the members that have grave issues with your operation? You know the ones that show up at the board meetings and are allowed a whole 3 minutes to speak, which it appears you totally their concerns. You know the ones that are so tired of your foot-dragging, lame excuses and failure to follow the ORC 3307.15, ones that have no faith or trust in much of anything you say or do. These are all things you have taught us. But then you already realize this, don¢t you?
It is unfortunate that the vast majority of teachers are so lacking in business knowledge and are so complacent that you and others like you at the STRS are permitted the latitude you are extended.
Thank God for Dennis Leone and John Lazares. Their contribution to the board, which you rarely and truly do not support, has been the stakeholders' only saving grace. Dennis is someone both you and Herb totally underestimated, as you often do with most of your stakeholders.
What the STRS membership does not seem to understand is just how much money your type of management costs our retirement fund. You never seem to acknowledge that aspect, do you?
...• Why don't you print the truth and tell your stakeholders that the cost of management at the STRS is far greater then any of the other four retirement systems?
...• Why don't you tell them that you are still grossly overstaffed?
...• Why don't you tell them that most employees have benefits that far out-shadow what the stakeholder could ever conceive?
...• Why don't you tell them that upper management and many other employees have never gone without a substantial raise each and every year, regardless of the $12.3 billion loss at the end of 2002?
...• Why don't you tell them that you have far more space in the building then you need and find no need to utilize it more efficiently?
...• Why don't you tell them they are still paying for the subsidy of the children of employees in the child care program, when you promised years ago that would be cost neutral?
NO, we are never going to see that kind of printed information, are we? That is truly pathetic on your part. What a disservice you have permitted to be done to your fellow educators, all in the name of greed.
God bless you,
Tom Curtis
Click here to view newsletter]

Tuesday, March 27, 2007

"The drug companies are going absolutely crazy trying to stop this from happening"

Kaiser Daily Health Policy Report

Kaiser Daily Health Policy Report
Monday, March 26, 2007
AARP Launches Ad Campaign Urging Lawmakers To Allow Medicare Prescription Drug Price Negotiations

AARP is launching a newspaper and radio advertisement campaign in 10 states and Washington, D.C., urging the Senate to approve legislation (S 250) that would allow the federal government to negotiate Medicare prescription drug prices with pharmaceutical companies, USA Today reports. A provision in the 2003 Medicare law specifically bars the government from negotiating prices under the drug benefit. The House in January approved a bill (HR 4) similar to the Senate proposal. AARP has selected certain states for the ads "in an effort to influence senators whose votes could make a difference" -- in most cases undecided Republicans -- USA Today reports. Sen. Ron Wyden (D-Ore.), an author of the bill, said he has the support of about 58 of the 60 senators needed to allow a vote on the proposal. A two-thirds majority ultimately would be needed to override an expected presidential veto if the bill were approved. The ads will "clash on the airwaves" with the Pharmaceutical Research and Manufacturers of America's advertising campaign in opposition to the proposal. AARP Director of Advocacy Management Fred Griesbach said that "the drug companies are going absolutely crazy trying to stop this from happening." PhRMA Senior Vice President Ken Johnson said the Medicare drug benefit can be improved, but not by allowing government price negotiations. The Congressional Budget Office has said that government price negotiations would have little effect on drug prices in the absence of drug formularies, which are not included in either the Senate or House bill (Wolf, USA Today, 3/26).

Enrollment Penalties
In other Medicare news, Reps. Jason Altmire (D-Pa.) and Steve Kagen (D-Wis.) have proposed a bill (HR 1310) that would nullify the late-enrollment penalty for the Medicare drug benefit (Sherman, Pittsburgh Post-Gazette, 3/25). Under the current rules, beneficiaries who were eligible to enroll in the drug benefit last year but did not do so before May 15, 2006, had to pay a penalty of a 1% premium increase for each month of delayed enrollment. Because the next enrollment period began Nov. 15, 2006, affected beneficiaries had to pay a minimum late-enrollment penalty of 7% (Kaiser Daily Health Policy Report, 5/15/06). Going forward, people who are turning 65 must enroll during the period starting three months before their birthday and ending four months after their birthday. Altmire said he has spoken to many individuals who "missed the deadline and are in the penalty phase." Altmire said House Democratic leaders have promised to hold a vote on the bill (Pittsburgh Post-Gazette, 3/25).

Jim N. Reed to ORTA re: Dennis Leone's STRS Report

Jim Reed to Ann Hanning and Tom Seamon, March 21, 2007
Subject: One Step Forward And Two Steps Back!
Dear Ms. Hanning and Mr. Seamon,
I have been closely following over the past few days the issue regarding the publishing of Dr. Dennis Leone's STRS report for ORTA's magazine. I have tried to digest the reasoning proffered by ORTA officials for their decision to refuse to publish Dr. Leone's summary of recent STRS Board policy. I keep coming up with indigestion!
I am offended, insulted to be condescended to with the feeble excuse that Dr. Leone's report would be stale published in the ORTA magazine a few weeks after the article was released as a "CORE Alert" to members of Concerned Ohio Retired Educators.
I would have more respect for the rejection decision if ORTA would have the fortitude to simply admit it was not in support of the approval of the litany of policy alterations approved by the current STRS Board. Hiding behind a frivolous, arbitrary timeline as rationale for non-publication of Dr. Leone's quarterly review is senseless and should be totally unacceptable to all retired Ohio teachers.
Common sense, alone, begs to be heeded. It is not more likely that far more retirees have access to disseminated information through ORTA's magazine than through a CORE Alert? Is ORTA ethically in a position to promote censorship? Are not all retirees and stakeholders entitled to know how their caretakers are performing? What's incorrect about transparency and what harm is done by learning of this critically important information twice? Many have never learned it once! And what about those retirees who do not have access to, nor the willingness to use, the inter-net? Is ORTA suggesting it is acceptable to withhold this invaluable information simply because a retiree is unable or unwilling to use a computer?
Many of us were so pleased to see Dr. Leone's quarterly report in the previous ORTA publication. It restored some faith and trust and it seemed new ground had been broken. It appeared there may be a joining of the retiree ranks to stand together to demand our retirement system continue to clean up its act and be more accountable to its membership. A closing of the gap between ORTA and CORE looked promising. And now ORTA has taken two steps back.
Is ORTA's main purpose for being not the betterment of the lives of all of Ohio's retired educators? If yes, can that goal be reached by being nothing more than a social organization, quarterly meetings where the luncheon and entertainment are the keynotes of the afternoon? Would not the membership's insistence that their STRS Board strictly adhere to ORC 3307.15 produce a more promising path to a secure and affordable retirement for members and their families? What is more important than a thorough understanding of how those three decades of contributions are being used by the STRS Board? What issue trumps affordable healthcare for retirees?
Has ORTA recommended to its county units the recruitment of and invitation to its members to appear before the STRS Board and participate in the "Public Speaks" segments that are part of monthly meetings? If yes, I have not heard nor seen any of them lately. If no, simply, why not?
If ORTA does not support Dr. Leone's findings of fault at STRS through his award-winning, STRS-based research in 2003, than why not legitimately challenge specific allegations with your own research? Certainly, ORTA does not support the unacceptable position of Chairwoman Ramser that past offenses have no relevance so there is no need to be knowledgeable of the roster of abuses and waste of retirees' pension funds. That continues to be a slap in the face to retirees, especially the less fortunate ones.
It seems to me that CORE and ORTA have the potential of forging a formidable partnership for the advocacy of an affordable and secure retirement for all of Ohio's retirees. But first we must get on the same page as to what are our preambles for existing are.
There is an ongoing Renaissance at STRS and I invite your leadership to encourage a more proactive participation by ORTA and its county units in supporting this enlightenment and literacy of STRS issues.
I challenge you to reconsider your recent position of blacklisting Dr. Leone's excellent summary of STRS policy changes and forecasts of future concerns for your publication. Your members deserve no less.
Thank you in advance for your serious consideration of these issues.
Jim N. Reed

RH Jones: 'Mysterious' ORC changes

From RH Jones, March 27, 2007
Subject: Re: The Ohio Administrative Code
Kathie and all:
The Canton Repository today, 03/27/07, has an article by Paul Kostyu (Pulitzer Prize nominee), "GOP still looking for chinks in new governor's armor."
In regard to changing the Ohio Revised Code (ORC) -- perhaps illegally -- I would like to add a quote from the above article: "Then we come to find Republicans regularly retrieved bills that had become law, even those with Taft's signature, to make changes." A few years back, Dr. K. Fluke and I took a whole day at the public library to research the ORC in two prestigious law texts to find data in the ORC3307 that applied to retiree Health Care (HC). The STRS Director of that time, Herb Dyer, and others, was contacted by both of us. I had also looked up the law on the Ohio ORC Web-site to find out similar conclusions of the ORC that we had found in the law texts. No response was received from STRS until a week or so afterwards. And, perhaps predictably, the law was now negative to our findings. The ORC had mysteriously changed.
Our data has been buried in a mass of papers that we both have gathered over the years. And, without a secretary, it would be extremely time consuming to dig the papers back out again. We had paid our dues to our associations to monitor such things. But they failed us. Tons of excuses poured forth from these unions. Good salaries had been paid to union employees to monitor the STRS, but they claimed that was not in their duties. CORE then came into being. At a CORE meeting, Dr. Fluke and I then made the CORE leadership, and the lawyer present, knowledgeable of our findings. Afterwards, not enough money could be raised by CORE to hire a powerful law firm to go to court. So the matter still stays unresolved. Fluke and I would like to ask: Where was the Health Care Advocates, the ORSC and OSBA on this, as well?
Fluke and I feel that all of us retirees before 1998 should be "grandfathered" with fully paid HC/Rx. That is where the fraud may come in. Pre-1998 retirees were disenfranchised. At that time, we also did not get the DROPbenefit, but Police/fire did. And, did you know, by law, the Police/fire receive a $400,000 bonus when they retire. That is almost 1/2 million dollars? That was in their ORC also. By the way, Dr. Damon Asbury, the present STRS CEO, was the Assistant CEO during 1998.
Perhaps the new Ohio administration through the new AG Ted Dann could look into the mysterious ORC changes? Let us hope.
RHJones, Asst. to Dr. Fluke who is Chair of the SummitCRTA leg. CMTE for more that 10-years.
[From John Curry, March 27, 2007:
Bob, I don't think this sentence is totally true. Not all police or fire are guaranteed 400K -- this depends on how much they deposited in the DROP fund after they retired. John
" And, did you know, by law, the Police/fire receive a $400,000 bonus when they retire."]

From Molly Janczyk, March 27, 2007
Subject: Re: The Ohio Administrative Code
Bob, Please read the ORSC site info on pension systems. The law states STRS is allowed to change benefits at any time. Our STRS HC pamphlets say the same thing. Law is like the bible-any who read it can interpret it differently if we try. That is why we sat with the attorney early on and I believe you and Dr. Fluke were there. He is well versed in pension law and told us HC is not vested and the STRS is allowed by law to change benefits for HC based upon funding for pensions.
I, too, fought very hard for grandfathering on a multi-daily basis. Unfortunately, lack of planning made US the ones to save HC . Go to HC under OP&F, OPERS, STRS sites and you will see very different funding scenarios which I did send you and reasons for different contributions to HC fund and premium coverage. I too all that info directly from those sites.

Monday, March 26, 2007

A retiree writes to Dennis Leone re: The 'no spike' rule

To: Dennis Leone, March 14, 2007
Subject: You are right on the "no spike" rule
Dear Dr. Leone,
My brother-in-law, [xxx], who has followed your STRS activities closely for some time and drove to [xxx] from [xxx] to hear you speak to the [xxx] County Retired Teachers a few years ago, forwarded to me an e-mail regarding your remarks in [xxx] about the "no spike" rule.
I'm sorry you were "hurt" by your principled stand on this issue, but you are right. It makes no sense for someone to get large salary boosts during their last three years of teaching in order to spike their retirement when they have not been contributing to the system at that rate all along. The OEA has been very short-sighted about this. In 19[xx], [xxx] district, where I taught, was goaded into a strike by the OEA urging (among other things) a salary schedule that stayed relatively flat for several years and then spiked in the last three years. I argued then that such a plan would eventually bankrupt the retirement system, but no one seemed to see the logic of that.
Keep up the good work.

Oldie but goodie -- It STILL pays to "shop around" before you send in your mail-in Rx -- you may be surprised!

February 15, 2005
Generic Drugs By Mail Can Be a Raw Deal
In an attempt to rein in its employees' fast-rising prescription drug costs, General Motors Corp. requires its workers to fill prescriptions for chronic conditions through the mail-order operation of Medco Health Solutions Inc. But some simple comparison shopping shows that GM, despite its formidable bargaining clout, is paying far higher prices for some drugs than ordinary individuals can get walking into retail pharmacies.
Consider GM's price for ranitidine, the generic form of the popular anti-ulcer pill Zantac. GM pays Medco $176.22 for 90 pills mailed to a worker, who pays an additional $5 co-pay, bringing the total cost to $181.22, according to Medco's Web site for GM employees. If a GM employee were to simply buy the same ranitidine prescription at a retail pharmacy, it would cost a total of $62.88 for the 90 pills. A person without insurance could buy the same medication at Wal-Mart in Secaucus, N.J., for $78.62. At Costco Co.'s online service,, the prescription would cost only $22—and include 10 extra pills.
That GM pays Medco higher prices for many generic drugs than regular pharmacies charge customers without insurance illustrates the complexities, and potential pitfalls, of prescription-drug coverage. It's also a rare glimpse into how such plans work.
Pharmacy-benefit managers, such as Medco, administer the drug benefits of large employers, acting as the middlemen between the employers and the pharmacies. Such PBMs create large networks of participating pharmacies and use their size to drive down prescription-drug prices. Some, including Medco, also own their own mail-order pharmacies, and prod employers to move more of their workers' prescriptions into the mail business.
PBMs promise to realize savings for their corporate customers by keeping the overall cost of prescription medications down. But they also preserve large profit margins for themselves, as the GM prices show. The price GM pays for prescription drugs is available to any of its employees or retirees through the workers' benefits Web site. The Wall Street Journal reviewed Web page printouts provided by a pharmacist with access to the site and who is working to get GM to roll back its mandatory mail policy—in which employers require workers to fill prescriptions through a mail program.
Some companies, like GM, say they are satisfied with the overall savings Medco is providing. But others simply aren't aware of the vast price discrepancies on generic drugs.
Susan Hayes, a consultant with Pharmacy Outcomes Specialists in Lake Zurich, Ill., which helps employers control their drug costs through audits and contracting, says some companies are surprised when she tells them about the price differential. "It's a big deal," says Ms. Hayes. "Why should you pay more than $1 a pill for generic Prozac to the mail-order pharmacy when you could get it for 23 cents in the retail store?" she asks.
GM has used Medco to manage its drug benefit since 1994, yet the auto maker's drug costs are climbing by more than 15% a year, almost double the rate of increase of GM's overall healthcare costs.
GM's pharmacy chief, Cynthia Kirman says GM is getting a good deal from Medco, saving $80 million by using mandatory mail based on 2003's drug costs of $1.3 billion. GM declined to explain how it figures it would save $80 million. The company spent $1.5 billion on prescription drugs in 2004.
Last week GM moved to strengthen Medco's mandatory-mail program further by preventing its 1.1 million employees and retirees from filling any prescriptions at the Walgreen Co. drugstore chain.
GM's Ms. Kirman says its not fair to "cherry-pick" certain drugs for a price comparison, though she declined to provide a list of GM's most-used generic drugs. "Numbers on the Medco Web site may not be reflective of the actual GM prices," a GM spokeswoman said yesterday subsequently. The GM spokeswoman declined to explain why the numbers may not be reflective.
A Medco spokeswoman, too, says it is misleading to look at individual drug prices for GM and draw any conclusions about overall costs. The spokeswoman, Soraya Rodriguez-Balzac, said in an e-mail response to questions that "mail-service pricing for generics is usually a flat percentage discount for all drugs and adds value in aggregate."
Because generic drugs are so cheap to begin with, PBMs and retail pharmacies alike typically make big margins on generic drugs, which account for about half of prescriptions filled in the U.S. That's why pharmacies have a big incentive to switch prescriptions for branded drugs to their generic versions.
Aggressively switching of branded prescriptions to generics does help reduce employers' drug costs. Employers also believe they are getting better prices on branded drugs through PBMs, which is why they are willing to pay bigger markups on generic medications.
Mail-order pharmacies generally fill a three-month's supply of medication at once. Medco benefits greatly from its mail-order pricing system. When a patient fills a prescription through Medco's mail pharmacy, the full profit belongs to Medco, rather than having to split it or get very little when the transaction happens at the retail store. The Franklin Lakes, N.J., company derives more than half of its corporate profits just from selling generic drugs from its own mail order unit.
For example, 90 ranitidine pills usually cost pharmacies about $7. At retail, customers can pay $22. Medco's mail-order price to GM is $181.22. Medco can show its customers a great savings because the list price, called the average wholesale price, quotes ranitidine at about $264 for 90 pills. Medco declined to comment on specific prices on its Web site.
The dizzyingly complex system of drug pricing makes it difficult for employers to know whether they are getting the best prices. Generic drug prices in mail programs are based on average wholesale price, or AWP. AWP is considered an inflated price among those in the drug industry. For example, the average wholesale price for 90 fluoxetine pills, the generic drug for Prozac, is $240.12 but pharmacies usually pay less than $5.
Employers can't choose to use a PBM for only brand-name drugs, where they get a price break, and use another service for generic drugs. PBM services are purchased the way employers purchase a health plan—the same health insurer covers all the different physicians and services for a worker.
Medco's generic pricing policy isn't unusual. Caremark Rx Inc., the pharmacy-benefit manager for millions of federal government employees, charges $96.05 for 90 pills of fluoxetine and $105.42 for 90 pills of ranitidine from its mail-order pharmacy. The prices are available to federal employees on Caremark's Web site.
In addition to GM, International Business Machines Corp., Southwest Airlines Co., Citigroup and numerous states and municipalities, have started mandatory-mail programs in recent years. A survey by consultant Hewitt Associates found that 22% of employers will have mandatory mail plans in place this year, with another 51% considering such programs.

A forwarded message to everyone re: An opinion on Ohio's charter schools & their supporting state reps

Sent: March 26, 2007
Subject: Re: a study of the White Hat
Subject: Re: An opinion on Ohio's charter schools & their supporting state reps
The OEA needs to hire a very good private detective agency to work with their lawyers in identifying any illegal deals that may have come down concerning certain state representatives. Those are the politicians want to make educators accountable and public education unaffordable. They are those who have been most vocal and active in supporting this movement that has been so destructive to traditional public school students K-16, their active and retired teachers.
Ohio businesses, and the public, have been severely impacted economically due to this "experiment in failure" that has burdened the property owners, particularly those of us that are retired, and the land-owning farmers. And Ohio is known as a farming state! And, even further, college students have been hurt too. Many students have had to work for substandard wages to pay for their inflated tuition and book prices, have had their higher education made unaffordable.
In conclusion, they will be identified public and will be held accountable and responsible by the voters. But, any wrongdoing that may have occurred during this "rip-off" of public funds needs retribution. They should be held responsible by the public court system so that they can never run for office again. The public does not need these "grandstanders" who, while in office, have been so active in burdening local school districts with their political arrogance. They have not gotten the message that the public sent in the last election. Perhaps, rightly so, the courts will send them the message: Quit hurting the public's youngsters, their active and retired educators.
Name withheld, A now proud OEA-R member & an always proud CORE member
From John Curry, March 25, 2007
Subject: a study of the White Hat
Below is a link to a report (26 pages/Adobe Acrobat Reader) which was compiled by Policy Matters Ohio -- a research organization. This study, funded in part by the OEA, really makes me understand why Ted Strickland wants to ban operation of charter schools by a for-profit company! I know, some people will say this study has a slant because it is funded by an organization that dislikes for-profit operation of charters (me too), but it is kinda' hard to fudge budget items that are listed as ZERO when they don't have to be reported to the State of Ohio - unlike public schools' line items. This paper contains some excellent full-color graphs and, the part I find most interesting, is the page after page of Zeros in the White Hat Management budget report to the State of Ohio. I would suggest that you read this report on an empty stomach as otherwise you may have to make a rush trip to the porcelain bowl! It's a long read, but it's worth the effort. John

Sunday, March 25, 2007

Getting it Right for Ohio's Future

From RH Jones, March 24, 2007
Subject: Getting It Right for Ohio's Future newsletter
March 22, 2007
"If we, as a free democratic society, are to survive, we must nurture the skills and abilities of everyone. We cannot afford to lose great numbers of our best and brightest just because we did not give them the opportunity to succeed. Our whole system of education needs to be revamped."
BILL HORNE Columnist & professor of economics, Southern State Community College The Times-Gazette March 19, 2007
OUT LIKE A LION March campaign efforts are roaring out like a lion with a high-energy petition drive in full force.
Members of the 90 chapters of the Ohio Retired Teachers Association are actively circulating petitions statewide. “After you’ve spent your career helping children and standing on the front lines of education issues, you don’t leave your passion behind once you retire. Your heart is in it,” said Ann Hanning, executive director of the Ohio Retired Teachers Association. “Our members understand that the time to act is now and want to do everything possible to help spread the word about Getting It Right for Ohio’s Future.”
A TIMELY TIP This Saturday, March 24, marks 10 years since the Ohio Supreme Court first ruled the state’s school funding system unconstitutional. It will be a great day to get out, remind voters of Ohio’s education crisis and fill up those petitions. Here are some talking points to pass on to volunteers collecting signatures this weekend.
“Ten years ago today, Ohio’s school funding system was ruled unconstitutional for the first of four times by the state Supreme Court. And it remains broken today.” “Now is your chance to help fix the system.” “Would you like to sign a petition to place a solution on the November ballot?” Volunteers should be sure to follow petition protocols while gathering signatures. Ask potential signers if he/she is a registered Ohio voter. Ask which county he/she is registered to vote in. Fill out a separate petition for each county. To ensure a valid signature, voters must sign their full names and home addresses as they appear on their voter registrations. Precinct information does not need to be completed. The individual collecting signatures should sign and date the petition only when finished collecting signatures for a particular petition. Petitions do not need to be completely filled out to be submitted to the campaign. Petitions should be mailed every two weeks to: Getting It Right for Ohio’s Future, 8050 North High Street, Suite 100 Columbus, OH 43235-6481
THANKS FOR YOUR SUPPORT Getting It Right for Ohio’s Future would like to thank the Forest Hills school district in Cincinnati, the Springfield Local school district in Mahoning County and the Zanesville Board of Education in Muskingum County. This week, all three passed resolutions in support of the amendment. The Zanesville resolution states, “…we encourage all Ohioans to embrace this amendment by supporting the signature drive to place the initiative on the General Election ballot and voting to adopt this proposed amendment to the Ohio Constitution.”
If your organization would like to officially support Getting It Right for Ohio’s Future, please click here for a sample resolution.
A PERMANENT SOLUTION Following Governor Ted Strickland’s State of the State address and budget proposal, Getting It Right for Ohio’s Future renewed its willingness to work with the governor, General Assembly and all interested parties on a permanent comprehensive solution to Ohio’s school funding crises. The campaign issued the following statement:
“We appreciate Governor Strickland’s expressed commitment to repairing Ohio’s school funding formula, which remains unconstitutional since the first landmark Ohio Supreme Court ruling 10 years ago. However, we are disappointed that under his budget proposal, nearly half of Ohio school districts would receive no additional state dollars next year and nearly 250 would receive no additional funding for the two-year biennium. “We trust that the Governor and legislature will work with all interested parties to achieve the common goal to gain adequate resources to educate Ohio’s children. The sponsors of the amendment would welcome the opportunity to discuss a permanent comprehensive solution with the Governor and members to the General Assembly. Meanwhile, we anticipate that the constitutional amendment will be on the ballot this November so that the voters of Ohio can express their concerns as well. We are currently collecting signatures to ensure this process.”
The campaign also pointed out that the governor’s vision aligns with specific provisions contained in Getting It Right for Ohio’s Future in the following ways:
Governor Strickland:
“…we must create a better system for knowing what we’re getting for our money.”
Getting It Right for Ohio’s Future:
“…the Education Accountability Commission… shall monitor and annually report to the Governor, the General Assembly, the State Board of Education and the public regarding… the components of a high quality education… are being delivered in a cost efficient and effective manner…"
Governor Strickland:
“…too many teachers can still say, without fear of contradiction, that their districts lack the resources necessary to provide their students with the quality education they deserve as citizens of Ohio.”
Getting It Right for Ohio’s Future:
“Each public school pupil has the fundamental right to the opportunity for a high quality public education.”
Governor Strickland:
“…we (will) focus our aid formulas to put the emphasis on meeting students’ needs.”
Getting It Right for Ohio’s Future:
Establishes a school funding system based on student need, consisting of “all of the necessary resources to provide a high quality public education for all public school pupils at every level and for every type of pupil…”
Governor Strickland:
“For those over 65, and the disabled, regardless of income, (expanding the Homestead Property Tax Exemption) will mean no property tax… on the first $25,000 of value in their homes.”
Getting It Right for Ohio’s Future:
Exempts senior homeowners and disabled homeowners from property tax on the first $40,000 of the market.
HIGHLIGHTS FROM THE HEADLINES With the 10th anniversary of the first landmark DeRolph ruling approaching, this week’s headlines have gravitated towards a clear need for a comprehensive school funding solution for all Ohioans. Here’s a glance:
The Dispatch March 21, 2007
UTICA – As four kindergarten students work on reading exercises with volunteers, Lori Carver watches with pride.
Click here to read the rest of the story.
The Western Star March 18, 2007
HUBER HEIGHTS — Victor Oakes doesn't know how he would vote if a proposal to overhaul school funding makes it on the November ballot, but the Huber Heights father of two school-age children strongly endorses one of the constitutional amendment's main goals: Reducing reliance on local property taxes and the frequent elections required to raise those taxes.
Click here to read the rest of the story.
Please check daily for the latest headlines and campaign updates.

PBM's... an unregulated industry (at least in most states -- including Ohio)

Consumers Deserve More Choice, Protection When It Comes to Health Care http://www.drugnewswire/14128/
March 23, 2007 - 12:15 PM
By DrugNewswire
Pharmacy Group Testifies Before State Legislators to Increase Patient Protections, Regulate Giant Pharmacy Benefit Managers
ALEXANDRIA, Va. March 1 /PRNewswire-USNewswire/ -- In an effort to establish standards and provide better protection for patients, a representative from the National Community Pharmacists Association (NCPA) testified today before a committee of state legislators in support of model legislation that would force pharmacy benefit managers (PBMs), the largely unregulated corporations that administer the prescription drug benefit portion of health insurance plans for employers and unions, to end their deceptive business practices.

Reginia G. Benjamin, Esq., director of government affairs for NCPA, testified before the National Conference of Insurance Legislators' (NCOIL) Health, Long-Term Care, and Health Retirement Issues Committee in support of the Model Act Regarding Pharmacy Benefit Managers. The act would, among other things, require PBMs to pay pharmacy claims within 15 days, provide transparency regarding financial and drug utilization information, disclose incentives received for making drug substitutions, and pass on to the plan sponsors any rebates, payments, or benefits received from drug manufacturers. Currently, PBMs receive billions of dollars in rebates from drug manufacturers each year in return for dispensing higher-cost brand-name drugs but keep the majority of those rebates instead of passing them along to their clients.

"These drug 'middlemen' restrict consumers' choice and frequently and purposely switch patients to drugs that earn them higher rebates, even when cheaper and therapeutically similar or identical generic drugs are available," said NCPA President John Tilley, RPh, a pharmacy owner from Downey, Calif. "PBMs are robbing America's already strained health care system as a result of a lack of regulatory oversight, and that needs to change."

In addition to switching patients to medications that earn higher rebates, PBMs also limit patient treatment options by offering shrinking and shifting formularies, the lists of drugs that are covered for specific groups in a health insurance plan. PBMs often require excessively burdensome pre- authorization requirements in order to obtain refills or formulary-restricted medications, resulting in red tape and sometimes discouraging patients from trying to obtain their medications.

In most states, the business activities of PBMs are unregulated and unmonitored, in spite of numerous investigations into deceptive and anticompetitive business practices. PBMs regularly have faced litigation related to the federal False Claims Act, antitrust and unfair competition, deceptive practices, and their roles as fiduciaries. Some of those who have sued the PBMs include state attorneys general, unions and health plans, and the United States Department of Justice.
In her testimony before the committee, Benjamin cited a number of recent settlements and judgments against PBMs, including more than $378 million, not including interest, paid by two of the largest PBMs between 2004 and 2006 in cases involving deceptive business practices.

"In our view, these settlement amounts represent health care dollars," Benjamin testified, "dollars that could have been spent to provide health care to covered persons and lower the cost of the prescription drug benefit for employers."

The model act is sponsored by NCOIL member Harvey Morgan, a state delegate and a retired pharmacist from Gloucester, Va. NCOIL is composed of state legislators whose main area of public policy concern is insurance legislation and regulation and who are members of the committees responsible for insurance legislation in their respective state houses across the country.

If adopted by NCOIL, the model bill could be introduced by NCOIL members in their respective state legislatures.

Currently, eight states have enacted laws regulating PBM operations. The most comprehensive regulation to date is found in the Maine law. Despite repeated efforts to overturn the law by the Pharmaceutical Care Management Association (PCMA), the lobbying group that represents seven giant PBMs, every court has upheld Maine's right to regulate PBM business activities.

"These sorts of 'transparency' statutes protect both employers that provide drug benefits for employees and retirees, as well as consumers themselves, who pay the premiums," said NCPA Executive Vice President and CEO Bruce Roberts, RPh. "Every state should have the right to exercise its authority to provide a level of oversight of the PBM industry in an attempt to protects its consumers from PBMs' abusive practices."
The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 24,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines.

Source: National Community Pharmacists Association
CONTACT: Robert Appel, Senior Vice President, Communications, of National Community Pharmacists Association, +1-703-838-2682,
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