The Dougherty County Commission “has an obligation to select a plan through an open, fair and competitive bid process, that provides the best possible quality health care at the lowest possible cost,” Tom Schatz, president of Citizens Against Government Waste, wrote to the commissioners in a letter dated Thursday.
After several months of discussion, Dougherty County government’s insurance broker, Kirk Rouse, recommended Monday that the County Commission keep its existing benefits plan, in which Phoebe Putney Memorial Hospital is considered an in-network hospital and Palmyra Medical Center is not.
Schatz, whose Washington, D.C., organization publishes an annual “Congressional Pig Book” that’s said to be a favorite of Sen. John McCain, said Thursday that Rouse owes the commission, and taxpayers, “a full accounting of how he arrived at his recommendations.”
Rouse “should reveal all options that were available to him. Simply comparing various forms of exclusive deals for Phoebe Putney Memorial Hospital is not the kind of rigorous exercise that the county employees and the public deserve,” Schatz said.
The letter to Dougherty commissioners questioned whether a formal request for proposals was issued to health providers, whether competitive bids were considered that did not require exclusivity and what kind of criteria Rouse used.
Another organization, Americans for Prosperity, issued a similar statement Friday in an advertisement placed in The Albany Herald.
Rouse, vice president of Doherty, Duggan and Rouse Insurors, responded Friday that the county never set out to shop around for a new benefits plan.
“This process was never started out as an request for proposals,” Rouse said. “It was simply taking the existing health plan that they’ve been with for a number of years, and finding a way to get deeper discounts within that plan.”
Rouse said he recommended the county stay with Phoebe Health Partners based on “business sense,” including the fact that only 14 of 1,044 county employees went to Palmyra last year. Palmyra is not in the Phoebe Health Partners’ network of providers.
“Palmyra is asking to get in the network when our contract with Phoebe Health Partners does not allow it,” he said. “It’s not our fight to fight. It’s Palmyra and Phoebe’s fight. It’s not our battle.”
Palmyra has filed an antitrust suit against Phoebe Putney Memorial Hospital and its parent company, Phoebe Health System, alleging the companies engaged in anti-competitive practices.
Dougherty County reviews its contract with Phoebe Health Partners each year, and it will remain in place until either party asks to opt out, Rouse said.
On Monday, when the commission is expected to vote on the plan, and employees will be given three alternatives, all of which take into account a 10 percent increase in costs, Rouse said.
County personnel may opt to stay with existing coverage, which allows them to pay out-of-network charges to use Palmyra services, he said.
They also may choose to pay slightly lower premiums with a higher deductible.
A third option, new to the table, is one in which employees agree to stay in-network only, Rouse said.
“They’re going to give the county the higher discount for everyone in that plan only,” he said.
Dougherty Commissioner Jack Stone said he and Phoebe CEO Joel Wernick had come up with the third proposal after the Monday commission meeting.
“I want the employees to have a choice,” Stone said. “But people that sign up for Phoebe Health Partners exclusively, they get the deepest discounts.”
The savings will be shared between the employee and Dougherty County, Stone said.
Stone questioned the involvement of Citizens Against Government Waste in the debate.
“These people need to know the facts and figures on everything before they jack their jaw,” he said. “Straighten up Washington, D.C., then come down to Albany.”
The conservative Capital Research Center says that Citizens Against Government Waste has received grant funding from cigarette manufacturer Philip Morris, ExxonMobil and HCA Foundation. Nashville, Tenn.-based HCA is the parent company of Palmyra Medical Center.
HCA Foundation gave millions of dollars to Tennessee charities during 2006 and 2007, but lists no contributions to Citizens Against Government Waste on income tax filings.
David Williams, vice president for Policy with Citizens Against Government Waste, said the organization did not typically discuss its supporters, but said HCA and Palmyra financial involvement had been “zero.” The organization does not list the names of corporate grant providers on publicly available tax filings.
Williams echoed Schatz in saying the group was interested in Dougherty’s choice of a health benefits plan because of “transparency aspects of what’s been going on in the states.”
Palmyra spokesman Eric Riggle also denied HCA’s financial involvement with Citizens Against Government Waste. “They don’t see any contributions of any sort to this group, and they checked back 10 years,” Riggle said.
Riggle said Dougherty County could select a plan that included both Phoebe and Palmyra in its network. Palmyra offered the option, with accompanying 40 percent discounts for county employees, he said.
“We’ve offered up a very good option. Our question is, what research has been done to include us? There are still options out there that could include both hospitals in the network,” Riggle said.
The options to be presented Monday, however, were already being discussed with Dougherty department heads Friday.
“One is a little less expensive, but the deductibles and co-pays are going to go up a little bit,” commission Chairman Jeff Sinyard said.
A second, the county’s existing plan “with all the bells and whistles,” will cost 10 percent more, while the third will offer employees and the county “discounts of up to 40 percent” for employees who agree to go exclusively with Phoebe Health Partners, Sinyard said.
“As of 11:05 on this Friday morning, it is my understanding that the employees will get to choose which package they want. They can look at all options available and pick whichever one best fits their needs. That’s the kind of thing I’ve been pushing for months now,” he said.
Phoebe Health Partners Executive Director Pat Sumner said the network of 12 hospitals and approximately 400 physicians was committed to providing the best coverage.
“Phoebe Health Partners will continue to work diligently to give the county taxpayers and employees the best possible health plan, to save taxpayers money and give employees the best coverage,” Sumner said a statement.
