Hundreds of Millions at Stake

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In the ongoing debate over municipal health care costs, there are now three competing proposals on the table, the Governor’s, the House, and the Senate.

The Governor’s effort is largely a bunt — signaling a desire to get communities into GIC or give them control over plan design, but pushing the details off onto the regulatory process.

The House is much clearer — communities can adjust plan design up to the equivalent of the biggest plan for state workers or enter GIC, so long as 10 percent of first-year savings is returned to workers.

The Senate takes a different approach — communities can negotiate their way to plan design changes or entering GIC, but they have to undergo an approval process by a three-person board (one appointee from the unions, one appointee by the municipality, and one by the Secretary of Administration and Finance). The committee can provide up to 33 percent of the savings to employees for a year.

From my seat, these plans are very different. The potential for mischief on the 3 member review panel is huge. Also, 10 percent of one year’s savings is materially less than 33 percent of savings for a year. So, the impulse for consensus from the business community is troubling. We are told that each plan gets us to “the exact same place” by their representative.

In a telling twist, it’s left to the Globe editorial page to clarify to our dear friends representing the business community that the House plan is clearly superior. Those who recall the modest results of the last consensus-driven municipal healthcare reform effort should also be skeptical of half measures. It’s time that we set aside our desire for good manners and choose to cut back on the hundreds of unnecessary millions spent by municipalities on health care rather than services.

Source URL: https://www.bostonmagazine.com/news/2011/05/26/hundreds-of-millions-at-stake/