Arkansas legislators are preparing to meet in special session for the second time in less than a year to discuss rising school employee health insurance rates. It’s a difficult issue, but it’s a “lowercase p problem.” The “capital P Problems” are beyond what state legislators can address by themselves.
Let’s start with the “lowercase p problem.” The cost of health insurance for school employees is rising faster than the system or many employees can afford.
In a special session last October, legislators poured $43 million in one-time money into the system and added another $36 million annually from other sources as a quick fix. They also appointed a task force chaired by Sen. Jim Hendren, R-Gravette, to craft long-term solutions.
That task force has proposed two bills for legislators to discuss for now, with more on the way sometime in the future. One would, among other changes, exclude spouses of school and state employees from coverage if they can obtain it elsewhere, as is common in the private sector. The other would exclude part-time school and state employees who work less than 30 hours. That would involve a lot of school bus drivers and cafeteria workers, and it’s more controversial, even though the practice of excluding part-timers is also common in the private sector.
Legislators will be called into special session in the next few weeks if they can arrive at consensus on at least one of the bills beforehand. Other important changes can be made administratively, such as changing the way the school employees’ super-cheap bronze plan and expensive-but-generous gold plan are structured.
Health care has become the dominant issue in the state Legislature, just as it is the most contentious one in Washington. The past two legislative sessions have centered around the debate over the state’s “private option,” which uses Obamacare dollars to buy private insurance for 150,000 Arkansans who beforehand were not quite poor enough to qualify for Medicaid. As a result of this year’s primary and runoff elections, there will be two less senators supporting it. During this past fiscal session, it passed with no Senate votes to spare.
What to do about the private option is a big concern, but it’s not one of the “capital P Problems.”
One of those is the health care system itself, over which state legislators can have only limited influence. America’s health care system, pre- and post-Obamacare, is far too expensive and doesn’t allocate its resources effectively. In many cases, it doesn’t make us healthier, and in quite a few cases, it actively makes us sicker and even kills us.
That’s a Problem. But there’s a bigger one — one that deserves not only a capital P but instead all-caps. The PROBLEM is this: America is not a healthy place, and Americans are not healthy people. Sixty-nine percent of us age 20 and above are overweight, and 35.1 percent are obese, according to the Centers for Disease Control and Prevention. Eighteen percent of children ages 6-11 are obese. More than 18 percent of adults smoke cigarettes despite all the efforts that have been made to encourage them never to start. According to the National Institute on Drug Abuse, 9.2 percent of Americans age 12 and above in 2012 had used an illegal drug (including marijuana) or abused a psychotherapeutic medication during the past month.
The health care system does little to discourage these realities, but it is not the principal cause. Unhealthy daily habits and lifestyle choices are woven into the fabric of American life, and it’s not just what we eat, drink and smoke. Our lifestyles are both sedentary and stressful. We’re rushed much of the time, but from a seated position. Our lives are marked by excess in many areas and deficiencies in others, such as sleep, joyful time with family, and meaningful community activities. Most of us know we’re not living right just by looking in the mirror.
Health care systems can be engineered to encourage healthier behavior, but no system can free us from the consequences of our own choices. Our health care is unaffordable because our health is unaffordable. Ultimately, we are the problem with health care, and the solution must begin with us.
(Follow Steve Brawner on Twitter @stevebrawner)