Monday, March 11, 2013

PEBB Debates Whether Policy Should Be Authoritarian or Cost-Based

Oregon's Public Employees Benefits Board (PEBB) has a real dilemma. After switching from fining people who don't participate in their wellness program ($17.50/mo for individuals and $35/mo for couples) to rewarding people who participate the same amount, they now have to decide what to do about activities of young adults 18-26 still on the parents' health plan.

Last May PEBB was forced to change from fines to incentives because of an uproar from public employees and more importantly their union representatives (four of the nine board members of PEBB are union representatives).

This February PEBB decided to keep the current structure of paying those who play along, but another disturbing item has arisen. Currently those who smoke have to pay a $25/mo surcharge.  Board Member Joan Kapowich wants to see that fee applied to all 18-26 year old children who are on the plan as well. Hannah Hoffman of the Statesman Journal explains:
The board heard a proposal from Kapowich to extend the monthly tobacco-use surcharges for dependents ages 18-26. Right now, only employees and their spouses are charged $25 each if they smoke or chew tobacco.

Under federal health care reforms, young adults can now stay on health insurance plans until they turn 26. That leaves PEBB trying to figure out if they should be subject to the same fees and rules.

Some members said Tuesday that it didn’t seem fair because young people wouldn’t have many health problems, even if they do smoke. Others said it may be good public health policy to encourage quitting tobacco use early. [emphasis added]
The debate is over whether people should be punished merely for not doing what PEBB encourages rather than for any actual costs that will be incurred. The authoritarian bent of some PEBB board members is clear. Their position is that the state should be able to punish you just because it doesn't like what you do irrespective of the fact that you are not hurting others or likely to do so.


MAX Redline said...

And it is, in fact, punitive - Oregon thus far has collected nearly a billion dollars from the Big Tobacco settlement; not a penny of which has thus far been spent as everyone was told it would be: on cessation and ameliorating the additional health impacts due to smoking.

This means, obviously, that the funds were to go into health-care.

It surely comes as a shock, but it appears that our state "leaders" lied.

T. D. said...

They just consider it free money and could care less where it comes from and what its supposed to be for. And where is the watchdog press on this issue? MIA, as usual.

The board members who are at least somewhat accountable to the employees (the union reps) are the only firewall against tyrannical proposals like the one Joan Kapowich made.

MAX Redline said...

I read a bit earlier that legislators are considering adding another buck onto the existing tobacco tax, raising it to something like $2.15 - but its For The Children™.

Seems to me that they should have been dumping some of that settlement cash into prevention/cessation.

But if they did that, and were successful, whatever would they do without the tax money?