Here’s what it said in my Treo (copied and pasted from an e-mail from Cindi, who set up the meeting):
The Editorial Board will met at 9 am on Thursday, Oct. 18, with Emma Forkner, the (still sort of) new director of the Department of Health and Human Services. There’s nothing in particular on the agenda, although the agency has been in the news lately over questions about its new private Medicaid transport system. And there is of course the ever-present issue of how our state (and others) pay for Medicaid.
We will meet in the Board Room on the third floor.
And that was what it was, a get-acquainted meeting. But I report it for the same reason I’m trying to report all such contacts, because I want you to know who I’m talking to, and some readers — such as "GreenvilleGuy" on this post — are very suspicious of the supposedly cozy relationships between us and newsmakers.
Since there was nothing in particular we were looking for in the meeting, I had a good time talking big picture, and I was able to launch freely onto digression without Cindi kicking me under the table.
For instance, we learned that while 25 percent of Medicaid recipients were on some kind of managed care plan — translated into private-sector terms, either a PPO or HMO — 75 percent of recipients are on, essentially, a fee-for-service plan. She hopes that, thanks to the waivers GreenvilleGuy decries, those numbers will be reversed in 18 months to two years.
Fee-for-service? I asked. Isn’t that essentially what we in the private sector had 30 or 40 years ago? Yes.
After acknowledging that she was new to this world, I asked why she thought it took so long to institute such cost-saving measures as managed care in the public sector, when out here in the private world, our employers are constantly tweaking our insurance to save costs? (I had spent two hours the previous day hearing how my own insurance will change come Jan. 1.)
She hesitated to answer, so I gave her MY answer: Because whether you’re talking state employee insurance or Medicaid, the public at large doesn’t really want to take anything away from anybody. That makes it tough for anybody who answers to voters, or anyone who answers to someone else who answers to voters, to institute cost savings — whereas private employers can change things as they please, and what the hell are their employees going to do about it?
She agreed. This led to her problems with getting anything done in the civilian public sector. She had come up in the military, where you’re part of an organization that is disciplined to turn on a dime. That makes the military less regulation-bound that the civilian public sector, which for a lot of people is counterintuitive.
Since I grew up in the Navy, and have always thought the military way of running things superior (to ALL civilian systems, public and private), we got along swimmingly.
"NEVER? Whaddaya mean, ‘never?’"
