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Without a national healthcare system, employers increasingly are shifting costs to their employees by increasing health care premium sharing, deductibles, and copays. Cost shifting strategies ignore other beneficial approaches to control health care costs and improve quality, such as collective group purchasing, efficient plan administration, and improving member health The emphasis of the HayGroup's report, the company commissioned by supporters of a statewide healthcare plan for school employees (SB 55/56), is to cut benefits and reduce administration cost. The HayGroup report that explored the feasibility and cost-effectiveness of a consolidated health care plan for K-14 public education employees, including charter schools, offers many findings on potential areas of cost savings. The strategies suggested in the report will greatly restrict collective bargaining for health care benefits at the school district level. Further, the HayGroup approach also eliminates the benefits of heath care plan competition on cost and quality. It is our belief, however, that the savings identified in the report can be achieved without jeopardizing the integrity of the collective bargaining process or the efficiencies found in a competitive market environment. Is requiring school employees to be in a health plan totally controlled by the state the right answer? No. Monopolies, by definition, eliminate competition. While some may argue that health care does not lend itself to competition, Medicare, the largest health care purchaser, is aggressively moving in directions that promote competition, not limit competition. Local markets with significant health plan competition have seen aggressive pricing and high levels of innovation. Rather than just criticizing the Hay Group's results and proposed approach, we suggest using the findings to develop an alternative model for school employee health care insurance. The proposed model maintains employees' current bargaining rights for health care coverage, the freedom to choose their health plan, proactive approaches to improve their health and the health of their family members. The estimated first year savings for the proposed model are $156 million, more than reported in two of the HayGroup options. Additional savings can be realized through the use of chronic care management programs, and PPOs. The following elements form the foundation of the proposed model for public school employee heath insurance
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