A Serious Problem Becomes Even Worse
When employees at a union health plans office in Camp Springs, Md. recently received a hospital bill for $1 million—for a serious but fairly routine case involving a single member—they quickly investigated the details while initially assuming the charges were a mistake by the health care provider.The health plan continues to dispute the bill, but one part of the answer they received from the hospital demonstrates how grave —indeed, unfathomable—the U.S. health care crisis has become. The patient was charged $430,000 for a pacemaker that should have cost a small fraction of that amount. The reason? Standard markup, according to the provider.
While the nationwide crisis isn’t new, the details have become more and more staggering. Unions are very much in the crosshairs, as health care costs routinely dominate contract negotiations. For instance, earlier this summer executives at General Electric wanted union employees to increase their share of health costs from 18 percent (the old level) to 30 percent. The company claimed its costs for insuring workers soared to $1.4 billion last year, up 45 percent from $965 million in 1999.
In mid-July, two unions at Verizon Communications announced that more than 75,000 workers had voted overwhelmingly to authorize a strike if a contract isn’t reached by Aug. 2. Health care is a factor in the negotiations.
Medical benefits also are at issue in Jefferson, Wis., where 470 workers are on strike at the Tyson Foods sausage and pepperoni plant—the first strike in the facility’s 128 years. In a familiar refrain, the company wants workers to pay more for their health benefits—in addition to scaling back the coverage.
Also, last month the California Public Employees’ Retirement System approved a major jump in premiums for its 900,000 members insured by health maintenance organizations. The increase is more than 18 percent, and it follows a 25 percent increase the prior year.
Unfortunately, such examples seem almost limitless.
New Prescription Discount Program for Seafarers Health and Benefits Plan
Editor’s note: Lou Delma, administrator of the Seafarers Health and Benefits Plan, recently delivered the following news to the membership concerning a new prescription discount program:The cost of health care in this country has been rising at an unforeseen rate in the last couple of years. We in the Seafarers Health and Benefits Plan have begun to battle the rising costs of health care. The first step in this process, which will be ongoing, has been to contract with the Eckerd Pharmacy chain, which includes Genovese and Thrift drug stores, in order to get some immediate relief in this ongoing struggle.
With this in mind, Eckerd has offered us a discount for prescriptions for any Seafarers or their dependent that is able to show a Seafarers Health and Benefits ID card. This will result in an immediate reduction of any out-of-pocket monies spent to fill prescriptions.
Once the discount has been given, eligible members and their dependents should submit their prescription claims to the Seafarers Health and Benefits Plan for reimbursement. This program goes into effect immediately.
You may use other pharmacies, but only Eckerd, Genovese and Thrift have agreed to the discount program.
This change will not affect pensioners, as they will continue to use Express Scripts. In fact, this new discount program is only an interim fix as the Plan is looking to expand on the national program that is currently in effect for pensioners which will enable participating pharmacies to bill the Plan directly for eligible active members and their dependents.
In the future, you will be advised of additional changes and adjustments that will be made in this ongoing battle.
Employer-Based Health Insurance Coverage Falls
Since the mid-1990s, employer coverage had been on the rise, thanks in large part to a strong economy. Now, a weaker economy coupled with double-digit health care cost increases are threatening these fragile gains in job-based coverage.Also, not everyone benefited equally from these prosperous years. Low-income families with at least one full-time worker are only half as likely to have job-based coverage as higher income working families. Workers in small businesses (under 200 employees) also fare worse—nearly 54 percent of these workers have no health coverage as compared to employed workers as a whole. Clearly, working does not guarantee coverage—56 percent of the uninsured in the U.S. are in families where one person in the household works full time.
Children and spouses are typically the first victims of a drop in coverage. Even during the recent strong economic times, family coverage was far less affordable than single coverage for the worker. In 2002, 23 percent of workers were in firms that paid the full cost of single coverage but only 9 percent were in firms that paid the full cost of family coverage, according to the Kaiser Family Foundation and Health Research and Educational Trust. Higher eligibility levels in state Medicaid programs and increased enrollment in state children’s health insurance programs have brought coverage to many more low income children.
But adults are not eligible for these programs in most states, causing 44 percent of poor adults in the U.S. to be uninsured as compared to almost 26 percent of poor children.
Source: AFL-CIO
Bargaining for Medical Care
Retaining affordable, quality health care is a top priority as workers in a wide range of industries head to the bargaining table this year. As health care costs skyrocket amid the current recession, many employers are trying to shift the rising cost of health care to employees. That means many workers who already are facing stagnating wages may also have to pay higher premiums, deductibles and co-payments.According to the Kaiser Family Foundation, corporations increased workers’ monthly health insurance premiums an average 27 percent for single coverage and 16 percent for family coverage from 2001 to 2002, despite hourly wage increases of only 3.8 percent in 2001 and 2.9 percent in 2002. At the same time, health care costs for employers increased 14.7 percent this past year, according to the Labor Research Association—while profits of HMOs and health insurers rose 25 percent in 2001.
Unions are meeting the challenge of rising health care costs by fighting hard in bargaining to keep workers’ responsibilities manageable and by building alliances with community groups to ensure employers who can afford to pay health care costs do not shift an unfair amount of the burden to their employees. When possible, unions also are seeking to negotiate cost-cutting measures that do not affect the quality of care.
Source: AFL-CIO
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