Health Scare
Recently, two related debates have caught our attention.
The first is a national one, where among other controversial conclusions, the bipartisan panel on deficit reduction recommended that the federal government should impose a cap on health-care expense increases.
That cap would be set at 1 percent above the rate of inflation. This would mean, in simple terms, less for everyone — whether it’s outright care or the options available — especially for those who enjoy the most generous benefits.
Is putting a hard cap on the growth of explosive health costs the right thing to do? Most certainly it is. Is this the right way to do it and will it have the political legs to ever see the legislative light of day? That’s much more doubtful.
We’ve advocated for some form of health care rationing on the state level, however draconian it sounds, as a means of controlling runaway costs that threaten to sink not only consumers, but the small businesses that help provide them with coverage. Doing so on the national level would set the tone for the whole country.
For a different lesson in how to approach the same problem as it affects the budgets of our cash-strapped municipal leaders, we need not look any farther than Boston Mayor Tom Menino.
A couple of weeks ago, Menino said he wanted permission from the state Legislature to circumvent collective bargaining over health insurance. The mayor’s goal seems to be to force savings on a runaway line item. The subplot of this confrontation reads as only the latest chapter in Menino’s longstanding feud with the Boston Fire Department.
And the fire department gives as good as it gets.
Rich Paris, president of the firefighters’ union told the Boston Herald: “We should sit down and negotiate and not let the city dictate what kind of health care we have. We will work together to get the best we can for our members. This is something that has always been bargained, and it should continue to be bargained.’’
So, there you have it. There is no secret that it's been near impossible to come to any kind of common sense agreement on health-care insurance for government employees.
His city budget in a mess, Menino wants to dictate health insurance terms to his department heads in order to stem the rising tide. Unions are unwilling to even sniff anything that isn’t collective bargaining even if it would help the city overall.
Frustratingly, there’s a vast middle ground that neither side is likely to find, let alone occupy, as this debate continues.
Friends And Neighbors
Since taking office, Lt. Gov. Timothy Murray has been a strong advocate for regionalization among the commonwealth’s cities and towns. We have a number of regional high schools, and such arrangements allow municipalities to share resources and realize collective savings.
There’s no reason the same can’t be made true for municipal health-care insurance.
Cities and towns should be keen to realize the collective savings that would come from banding together like any other group- buying organization. Instead, unions seem dead set on bargaining on their own.
What stubborn municipalities and shortsighted public-employee unions fail to realize is that time is quickly running out on the strategy of obstruction.
The increases in health-care premiums are simply unsustainable, and if agreements can’t be reached on something like the cost of health-care benefits for firefighters in Boston, the alternative will be fewer firefighters, or fewer school teachers or fewer snow plow operators or fewer people to serve in the public sector in general.
Unions and municipalities must realize that they’re going to have to pick their poison.
This will require both sides to break out of their traditionally narrow ways of thinking. Management isn’t going to run over employees' rights if unions operate outside the collective bargaining process to address the employee health-care line item. And towns won’t somehow lose whatever individual identity they’ve got left if they work with their neighbors to try to make the cost of health care more reasonable before budget season rolls around.
In the absence of a truly universal, single-payer health-care system, these are the types of decisions that await our towns, our advocates and our small businesses. The decision on how the needed savings will be extracted will come from on high, or at the negotiating table — but it will come. It’s not going to be easy, nor is it necessarily going to be fair, but there are solutions. They simply require the parties involved to think about the common good. In the long run, that’s good for more than just our health.
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