Friday, August 3, 2012

Miami-Dade County Public Schools Switch to CIGNA, The Lesser of Two Evils

Last year, the Miami-Dade County School Board, faced with a 13% increase in premiums from United Healthcare (who offered larger discounts than any other insurer in exchange for the district using them to cover all health plans offered to employees), tried to pass off a large chunk of those costs onto employees. Backlash from employees was swift and indignant; after all, getting the promised raise would be meaningless if all of it went to cover health insurance costs that had not previously been paid out-of-pocket. As a result, employees kept their health insurance plans at no extra out-of-pocket cost, and were denied their promised raises.

This year, the situation looks even worse. United Healthcare is raising premiums by 22% over last year--making last year's 13% increase look like small potatoes. The only other insurance company willing to negotiate anything less is CIGNA. Going with CIGNA is no bargain, mind you; it will still cost the district 16% more than the current rates.

But, forced to choose between the lesser of two evils (two evils being the only choices at all for the district), M-DCPS is, understandably, opting for the 16%-increase evil over the 22%-increase evil.

While details are still being ironed out, the teachers' union, United Teachers of Dade (UTD) assures its members that they are working their hardest to make sure that employees will not be forced to shoulder any of the increased cost of health care...for now. They warn that the district covering 100% of the costs of employees' health insurance has a limited lifespan, and that if premiums continue to increase as they have been doing for years, that sooner or later--and probably sooner rather than later--employees will have to start paying out-of-pocket for their own insurance.

The plan with CIGNA will operate on a "self-insured" model, meaning that, essentially, the district will cover its employees' health care costs, rather than paying premiums to United and then having United keep the profits made by what is left over of those premiums after paying out claims. CIGNA will process the claims, but the district will cover the cost of the claims, and will be required by insurance regulators to have a sufficient amount of money in the bank to cover claims.

Since CIGNA is, of course, a for-profit insurance company, they will be taking their cut from the deals. Taxpayers will be picking up the tab, since, of course, employees of Miami-Dade County Public Schools are paid with taxpayer money.

As the health care debate continues to rage on in Congress and across America, health insurance companies continue to raise their rates. Competition remains nearly nonexistent in the insurance market in most areas of the country, including here in South Florida. Although 65% of Americans, according to the latest New York Times/CBS poll, favor offering a Medicare-like government health insurance option to all Americans, for some reason (more often than not that "some reason" relating to huge donations from the health care industry) all Republicans and even quite a few Democrats remain opposed to any government insurance option.

They claim that government needs to "stay out of their health care"; that the government "can't do anything right" (though they would tar and feather anyone who suggested that our military--the foremost government operation--was anything less than the best in the world, and despite the fact that those on Medicare and VA health plans are the most satisfied insurance customers in the country); that offering such a plan would be "too expensive" (though those on the right making that claim are the first to support huge increased deficit spending to fund unnecessary wars in the Middle East to protect powerful American oil interests).

What they (often willfully) ignore is how expensive the status quo is. We already spend 17% of our GDP on health care, more than any other industrialized nation in the world--yet we are the only one that does not provide health insurance coverage for all its citizens. And we see concrete examples every day of taxpayers directly funding profits for large insurance companies. United Healthcare boasted a second-quarter increase in profits of 155% over the same period last year, but nonetheless chose to impose a 22% increase in premiums on a taxpayer-funded school system. By moving to CIGNA, the district can watch health care costs rise by 16% instead. What are the options in such a situation?

Well, there are not too many. One is that the district could pass the skyrocketing costs on to their employees, which essentially equals a pay cut in a field that already barely covers the cost of living for most South Florida residents. This would certainly be unlikely to help attract qualified teachers to South Florida, nor would it help persuade qualified teachers to stay in the profession instead of leaving in the first five years, as over half of new teachers do. Another option would involve the district continuing to pony up and pay the ever-increasing costs, but probably never in the near future agree to any sort of raise for teachers...again, a move unlikely to help attract or retain good teachers. Yet another option is one that is almost laughable, to the extent that Florida politicians would probably never even consider it: that one would mean raising taxes to cover both the exorbitant cost of providing decent health care to school district employees AND still paying them a living wage. The constant that remains across the board, in all of these "options," if you can call them that, is that the health insurance companies continue to make astronomical profits (and pay staggering executive salaries) off raising premiums and denying claims, all funded by the taxpayers.

The for-profit health insurance industry do not hesitate to thumb their nose not only at the working stiffs paying their premiums out of pocket, or the small business owners who cannot afford to cover their employees at all, or the large corporations who watch their health care costs increase steadily even amidst the worst economic crisis since the Great Depression--but also at local, state and federal governments, and, consequently, taxpayers. This constant applies not only to school districts, but also to city, state and federal government employees, and the military.

Stagnant salaries are not likely to go up in any significant way--not even to keep up with inflation--as long as health care costs continue to rise. And it is neither an accident nor a coincidence that the rise in health insurance premiums over the past ten years dwarfs the rise in salaries and wages...for average working Americans, that is; not for insurance company CEOs.

Yet despite the unsustainable cost of our current system on employers, individuals, families and taxpayers, hardly anyone in our government is advocating for the real solution to the problem: a single-payer system, where health insurance would be divorced once and for all from employers (thus allowing wages to keep up with inflation, reducing the part-time culture created in part by the astronomical and ever-growing cost of providing health insurance to full-time employees, AND allowing the United States to be competitive in world markets once again without putting workers on starvation wages or leaving them uninsured), where no one would have to worry about being denied because of pre-existing conditions, being dropped by their insurance when they need it most, being denied medical treatments they need by their insurance companies, or losing their insurance because of losing a job or changing jobs. For all the right's fear-mongering, 85% of Canadians are happy with their health care--a far higher percentage than the U.S. could claim. And Canada is not the best example of a single-payer system that works: France has an excellent system, as do Italy and the United Kingdom. No system is without its flaws, but other industrialized countries with universal health care do have better outcomes, spend less of their GDP and have higher rates of satisfaction.

Until all political campaigns are publicly financed, and politicians' "electability" no longer depends on how much money is in their coffers (which can be had in abundance from powerful industries), it is doubtful that America will achieve any such efficient system.

But in the meantime, the public option is the best tool that has been seriously proposed in legislation. And regardless of how it works for those in the private sector or unemployed, it not only should exist, but all employees of local, state and federal governments should be on it.

Taxpayers do not need to fund insurance companies' profits or executive salaries any longer.

And teachers badly need those raises they were promised back in 2006.

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