There is a discussion on the Newton Tab blog on whether Newton should close our deficit through collective bargaining. I made a comment there that I think worth repeating here, based on what I learned at the Boston Foundation event yesterday.

What the report author, Bob Carey, said was that the reduction in rate of cost increase comes not simply from changing the employee/employer percentage split (though that is important) but rather the plan design details, such as “is there an incentive to use generics”, “is there an incentive to choose cheaper hospitals/doctors”, “is there an incentive not to use high tech imaging which is usually discretionary”, etc etc, basically that is there any incentive for the patient to choose a lower cost option – and in the case of most municipal plans, the answer is no. He pointed out that 90% of premiums go out the door to pay for medical services, so the key is to reduce the utilization of services and the cost of those services overall.

I also learned that the ability to collectively bargain plan design was never even written into state law, it is something that has just evolved over time. Rep Stephen Kulik has offered legislation to allow unions to bargain over the split, but to take plan design out of collective bargaining.

Another thing Bob Carey said is that compared to other states, ALL Mass. plans, whether municipal, state (GIC), federal or private, are more generous than plans in other states… his point being that if you have health insurance at all in Mass., you’re getting better coverage than most other people in this country.

Mike Widmer, who heads the Mass Taxpayers Foundation, pointed out that regular people in Mass are being hit 3 times:
- paying more for municipal employee health care coverage
- paying property taxes for someone to get way more generous health care coverage than they’re getting
- when those property taxes are not enough to cover the increased cost of health care, their government services go down as there are layoffs and cutbacks.

(Where do YOUR LEGISLATORS stand on this issue? Have you asked them? If not do so asap! Click here to find out who your legislators are, and click here to find out what to say to them!)


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