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Health insurance decision includes many side questions

It sounds like a simple business decision, but this being local government and local politics, it gets a lot more complicated. Throw in one of the first public tests of how the consolidation of the two largest hospitals in this part of the state will affect health care costs, and it could get interesting.

Some answers could come Thursday when the three members of the Cabell County Commission — Nancy Cartmill, Jim Morgan and Kelli Sobonya — hear presentations from two entities wanting to provide health insurance for the county's employees.

Cabell County Sheriff Chuck Zerkle had asked the commissioners to switch the county's self-insured health coverage to PEIA, the state's public employee health plan. That is a proposal before the county commission.

Switching from Highmark Blue Cross Blue Shield to the PEIA Health Plan would save the county an estimated $3.7 million a year, which could be passed on to employees as pay raises, Zerkle said.

On the other side is Angie Swearingen, St. Mary's chief financial officer. Swearingen oversees managed care for Mountain Health Network, the corporate entity that controls Cabell Huntington Hospital and St. Mary's Medical Center. The two hospitals joined Huntington Internal Medicine Group and Marshall Health to form an accountable care organization (ACO). An ACO is a group of health care providers that come together voluntarily to coordinate care for the patients they serve.

Swearingen has told the commissioners that if the county will agree to work with the ACO, the providers would work to negotiate lower health care costs between the county and Highmark. Let's hope that Thursday's presentation from the ACO representative provides some solid evidence of how that would work and what the specific costs to the county would be.

Assuming representatives of both plans present their offers Thursday, the competing proposals would force the commissioners to face several questions.

First, the commissioners have a responsibility to manage public money wisely. This responsibility is not to be taken lightly, as every dollar spent on one insurance plan when another is less expensive is a dollar that does not go directly to providing public services.

But the commissioners must also consider what is best for employees. If PEIA costs them more than Blue Cross when out-of-pocket expenses are included, that could deter people from working for Cabell County and instead find similar jobs with a neighboring county or in a private industry that provides similar services. Employee turnover could increase.

Thursday's presentation also will give the public an idea of how the consolidation of Cabell Huntington and St. Mary's will affect health care costs. One selling point for the consolidation was cost savings through elimination of redundant expenses. If Mountain Health Network can provide better service at lower cost than PEIA, the commission's decision will be easy. If the ACO is more expensive, that does not bode well for the future of that plan.

This also is a test for PEIA. Can the state agency compete against a private insurance plan? If so, would other agencies of local government consider switching?

And there is a more personal point to consider. Sobonya's daughter works in the administration at Cabell Huntington. Any decision or vote Sobonya makes will necessarily be watched to see if there is a conflict of interest.

Without hearing the presentations, it's impossible to tell which of the two competing plans is better. The commission could make a decision Thursday, or it may need time to crunch the numbers. There could be a lot of pluses and minuses to consider, but the decision can't be put off for long, as the current fiscal year ends in less than three weeks.

Government control of choices breeds conflict

We are living in a time of increasing domestic tension. Some of it stems from the presidency of Donald Trump. Another part of it is various advocacy groups on both ends of the political spectrum demanding one cause or another. But nearly totally ignored is how growing government control over our lives, along with the betrayal of constitutional principles, contributes the most to domestic tension. Let's look at a few examples.

Think about primary and secondary schooling. I think that every parent has the right to decide whether his child will recite a morning prayer in school. Similarly, every parent has the right to decide that his child will not recite a morning prayer. The same can be said about the Pledge of Allegiance to our flag, sex education and other hot-button issues in education. These become contentious issues because schools are owned by the government.

In the case of prayers, there will either be prayers or no prayers in school. It's a political decision whether prayers will be permitted or not, and parent groups with strong preferences will organize to fight one another. A win for one parent means a loss for another parent. The losing parent will be forced to either concede or muster up private school tuition while continuing to pay taxes for a school for which he has no use. Such a conflict would not arise if education were not government-produced but only government-financed, say through education vouchers.

People also have strong preferences for goods and services. Some of us have strong preferences for white wine and distaste for reds while others have the opposite preference — strong preferences for red wine. Some of us love classical music while others love rock and roll music. Some of us love Mercedes-Benz while others love Lincoln Continentals. When's the last time you heard red wine drinkers in conflict with white wine drinkers? Have you ever seen classical music lovers organizing against rock and roll lovers or Mercedes-Benz lovers in conflict with Lincoln Continental lovers?

People have strong preferences for these goods just as much as they may have strong preference for schooling. It's a rare occasion, if ever, that one sees the kind of conflict between wine, music and automobile lovers that we see about schooling issues. Why? While government allocation of resources is a zero-sum game — one person's win is another's loss — market allocation is not. Market allocation is a positive-sum game where everybody wins.

It would be easy to create conflict among these people. Instead of market allocation, have government, through a democratic majority-rule process, decide what wines, music and cars would be produced. If that were done, I guarantee that red wine lovers would organize against white wine lovers, classical music lovers against rock and roll lovers and Mercedes-Benz lovers against Lincoln Continental lovers.

Political allocation of resources enhances conflict while market allocation reduces conflict. The greater the number of decisions made in the political arena, the greater the potential for conflict. That's the main benefit of limited government.

Walter Williams is a syndicated columnist. To learn more about him, visit


Beware of Social Security scams

Social Security is committed to protecting your personal information. We urge you to always be cautious and to avoid providing sensitive information such as your Social Security number (SSN) or bank account information to unknown people over the phone or internet. Never reveal personal data to a stranger who called you.

There's a scam going around right now. You might receive a call from someone claiming to be from Social Security or another agency. Calls can even display 800-772-1213, Social Security's national customer service number or even a local SSA office number, as the incoming number on your caller ID. In some cases, the caller states that Social Security does not have all of your personal information, such as your SSN, on file. Other callers claim Social Security needs additional information so the agency can increase your benefit payment, or that Social Security will terminate your benefits if they do not confirm your information. This appears to be a widespread issue, as reports have come from people across the country. These calls are not from Social Security.

Callers sometimes state that your SSN is at risk of being deactivated or deleted. The caller then asks you to call a phone number to resolve the issue. People should be aware that the scheme's details may vary; however, you should avoid engaging with the caller or calling the number provided, as the caller might attempt to acquire personal information.

Social Security employees occasionally contact people by telephone for customer-service purposes. In only a very few special situations, such as when you have business pending with us, will a Social Security employee request that the person confirm personal information over the phone.

If you receive these calls, please report the information to the Office of the Inspector General at 1-800-269-0271 or online at

You can also share our new "SSA Phone Scam Alert" video at

Debra McComas

Social Security district manager Huntington


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President Trump plans a big Fourth shindig

WASHINGTON — For President Trump, every day is Presidents Day.

As Trump prepares to turn Independence Day into a political rally, the question is not why he has decided to crash the nation's birthday party on the Mall, but why he didn't do it sooner.

One by one, he has tried to remake our holidays to his benefit.

He issued a federal order declaring his Inauguration Day a "National Day of Patriotic Devotion." He claimed credit for saving Christmas, so that "everybody's very proud to be saying 'Merry Christmas' again."

On Thanksgiving, he proclaimed his gratitude for himself and "having made a tremendous difference."

He attempted a grand Veterans Day military parade — reviewed by him — and when he failed to make that happen, he skipped the traditional visit to Arlington National Cemetery because he was "extremely busy ... doing other things."

On Memorial Day, he said "those who died for our great country would be very happy and proud" of his leadership.

And on the 75th anniversary of D-Day in Normandy last week, he used the white crosses of fallen Americans as his backdrop for an interview condemning "Nervous Nancy" Pelosi and the "fool" Robert Mueller.

And now: "HOLD THE DATE! We will be having one of the biggest gatherings in the history of Washington, D.C., on July 4th ... at the Lincoln Memorial. Major fireworks display, entertainment and an address by your favorite President, me!"

Fireworks on the Fourth? It's a wonder nobody thought of it before. One can imagine how it will turn out ...

REMARKS BY THE PRESIDENT, Lincoln Memorial, July 4, 2019

My fellow Americans, welcome to the First Annual Trump International Independence Day and Casino on the Mall, brought to you by the Kingdom of Saudi Arabia and by the official hotel of Independence Day, the Trump International, preferred destination of discerning sheikhs.

Today, Americans celebrate what makes our country great, and that thing is your favorite President, me. We come together as one nation, even the haters and losers, the fake news, Low IQ Joe, Nervous Nancy, Cryin' Chuck — what a creep! — socialists, murderers, rapists and MS-13 animals. This is the largest crowd ever. I have all the records. I hold all the cards.

Martin Luther King Jr. spoke from this very spot, but I am hearing that my speech is already better than his — maybe the greatest ever. Abe Lincoln is also honored by my presence here. Abe was a good president, but he was never as popular as me. Ninety-four percent approval rating in the Republican Party! All-time record! Love records. Also, the White House physician says I am now 6-foot-5, which makes me taller than Abe and means my BMI is not in the obese category.

Thank you to those seated up front who contributed to my campaign at the Emolument Level. Before me tonight, I see the beautiful melting pot of America: people from Sweden, Norway and Denmark. It is almost as great as seeing my royal family on the balcony of Buckingham Palace.

The negative people in the District of Columbia objected to me taking over Independence Day, so I have declared July 4 a National Emergency, which allows me to pay for this party with money from the Pentagon. Instead of traditional fireworks, tonight we will be using tactical nuclear weapons. Why have them if you don't use them?

As part of my National Emergency, I also declare that:

This place will now be called Trump National Mall Golf Club; I am speaking to you from the ninth green.

I will be throwing out the first pitch at next week's All-Star Game in Cleveland; I will also be the starting pitcher.

I will be the halftime performer at next year's Super Bowl.

I will be declared the winner of the Masters golf tournament.

My picture will be on the new $20 bill, and the American flag. I will be replacing Adam Levine on "The Voice."

House Republican Leader Kevin McCarthy says I have constitutional authority to make all these changes.

Two-hundred-forty-three years ago, our forefathers put their John Hancocks on the Declaration of Independence, which under my emergency order will be displayed at Mara-Lago, with my signature added. The founders pledged to America their lives, fortunes and sacred honor, and tonight I inherit their fortunes. From the Trump International Redwood Forest to the Gulf Stream Waters and Spa by Ivanka, this land was made for me.

God bless America, and God bless me.

Dana Milbank is a syndicated columnist. You can follow him on Twitter, @Milbank.