By Daniel C. Bryant, M.D.
Portland (Maine) Press Herald, November 19, 2020
In the United States, health care has been tied to employment since World War II, when employers compensated for wage controls by offering health care coverage to help them recruit and retain workers. However, an arrangement that may have made sense in the 1940s may not still make sense today. Three examples of the problems that employer-based health insurance can cause – all here in Maine and in just the last few months – bring home that point.
• The contract talks at Bath Iron Works in June: BIW’s June 13 “last, best and final offer” to workers included an increase in deductibles, prescription drug co-pay and out-of-pocket maximums in 2022, and a 5 percent annual increase in employee contributions in 2021-2023. Local S6 District Lodge 4’s June 11 negotiations update told members: “Depending on your medical plan and specific medical conditions that you or your family may have, the changes in health care could eat up the proposed wage increase.” Deciding the pros and cons of these details is far beyond me, but what isn’t is that neither BIW nor the union should have had to be mired down in them, a strike looming, when there were other, more pressing workplace issues to negotiate.
• The threatened strike at Calais Regional Hospital: Having worked without a contract since the last one expired in 2018, staff gave notice Nov. 10 that they would strike Nov. 18 and 19. The hospital’s September 2019 filing for bankruptcy protection had delayed negotiations, but employees and the Maine State Nurses Association sent to the hospital board of directors a petition of no confidence, including their concern with their employer-based health care: “In the most recent bargaining session, CRH management threatened to double (and in some cases triple) employees’ health care deductibles and out-of-pocket expenses, causing a net pay decrease for many hospital employees. Employees report that their insurance bills are sometimes not being paid in a timely manner, resulting in multiple billings from providers over months; and even some bills progressing to collection.”
To avoid a strike, the union requested, among other things, that the board “immediately ensure that none of the hard-working employees (who have kept this hospital running through these very difficult times) incur a pay decrease because of exorbitant increases in their benefit costs.” On Nov. 11 the strike was averted when agreement was reached on health insurance and paid time off, though the proposed contract, set to last two years, still needs to be ratified by the bargaining unit. Rural hospitals have enough problems these days without having to deal with the minutiae of their own employees’ health care coverage.
• Changes to University of Maine System retirees’ health coverage: UMaine System retirees have voiced opposition to the decision to move them from a group plan to a health care exchange where they would be required to pay for medical expenses up front and then be reimbursed. “The Maine Education Association and unions representing faculty and staff have filed grievances and said the changes were done against signed contracts between the system and retired employees,” the Press Herald reported Wednesday. “Jim McClymer, president of the Associated Faculties of the Universities of Maine, said Monday the system has denied the grievances filed by the three unions representing employees and they will now head to arbitration.”
Replacing antiquated, employer-based health insurance arrangements with a publicly funded, privately provided universal health care system would be liberating to these three Maine employers, and indeed to all businesses, hospitals, academic centers, municipalities, etc., allowing them to focus all their attention on more relevant concerns.
Few people drive Nash 600s (made 1941-49) anymore.