Cook: County's health strategy

photo David Cook

Somewhere inside the Central Office, there is a multiyear strategy to alter - dramatically - the health insurance plans for all Hamilton County public school teachers and employees.

But teachers haven't seen it.

Principals haven't seen it.

School board members haven't either.

But Ed Adams has.

He's the health care consultant hired by the county schools to help craft changes to the current insurance plan.

According to emails he's written, those changes are coming, and they're going to be big.

"A multiyear strategy to get medical costs under control," he states.

This week, the nine-member school board will take a step in that direction. They will vote to choose one of two options to reduce health care costs: 1) teachers will have to pay $100 more monthly to keep spouses on their insurance or 2) those spouses -- if they work -- will get booted from the county insurance and must sign up for insurance through their own jobs.

The first option can be a real gut punch, especially if you're a teacher making $38,000 a year with a stay-at-home spouse and three kids. Another $100 a month for insurance -- when you're already paying $433 -- may be irrecoverable.

Option two is also jarring. For some families, it would result in a net loss of income. That's right -- option two can be like taking a pay cut.

But as big as these two proposals seem, they are just the opening gambit, the first inning in a larger plan designed by Adams and a small committee -- Superintendent Rick Smith and a few other central office folks -- to redirect insurance costs from the county onto teachers and employees.

"Our recommendations for 2015 are just a start," Adams writes.

In an email to school board members, Adams reveals part of the county's strategy:

• Insuring fewer people in order to contain health care costs, while also shifting costs onto employees.

• So they have a vested interest in making wise health decisions and take personal responsibility for their health," he writes.

(Does that sound paternalistic to you? A bit condescending, as if teachers were golly-gee-clueless about their health?)

• A shift toward more high-deductible health plans.

"Our current strategy is to move in that direction in phases," Adams wrote.

But most of that strategy is kept secret. Adams and his committee studied many, many possible solutions that the county could adopt.

Like discounts for nonsmokers. Or health savings accounts. On-site clinics and pharmacies. Health coaches. Asking insurance carriers to craft new co-payment and deductible schedules. Adjusting dental benefits. Cutting long-term disability insurance.

Yet when it came time for Adams and the committee to make recommendations to the board -- and, by extension, the public -- most of these solutions were left unsaid, with board members having no idea they existed.

"[We] ... chose not to make recommendations on all these options in the first year, for many strategic reasons," Adams wrote.

Strategic reasons? This is not a war. Teachers aren't the enemy. There should be no secret objective to slip in health changes while no one's looking. Teachers and board members shouldn't be treated like last-to-know doormats, only told about insurance changes when the time seems Art-of-War-right to a central office committee.

"I don't particularly like to blindly recommend any multiphase strategy," said Jonathan Welch, District 9 board member, in an email back to Adams. "It's poor policy and poor stewardship to everyone."

Last month, Welch challenged Adams on his recommendations; their question-answer-question email exchange is available online with this column, and if you're at all interested in public education please -- please -- read it.

Because we are facing a come-hell-or-high-water decision in Hamilton County: How will we treat our public school teachers in the future?

They've lost their collective bargaining rights. Standardized testing pressure grows. Funds run dry. We continue to lose good teachers to Georgia, where salaries are higher.

Whether anybody remembers it or not, we entered into a social contract with our teachers: You educate our kids, and we will take good care of you.

Decisions about that care should belong to all of us -- responsible board members, outspoken teachers, concerned citizens -- and not just tiny committees.

Contact David Cook at or 423-757-6329. Follow him on Facebook and Twitter at DavidCookTFP.