Okay… if you say so:
Elizabeth Debski spent eight years as Everett’s city planner, before losing her job in 2006 when a newly elected mayor installed his own team.
But Debski did not leave City Hall empty-handed. In addition to her pension, Debski, at 42, walked away with city-subsidized health care insurance for life. If she lives into her 80s, as actuarial charts predict, taxpayers could pay more than $1 million in all for her family’s health care benefits.
That’s not to say Debski manipulated the system. She simply took what she was owed under a municipal health care system whose generous benefits and colossal inefficiencies are crippling cities and towns across Massachusetts.
A six-month review by the Globe found that municipal health plans, which cover employees, retirees, and elected officials, provide benefit levels largely unheard of in the private sector. Copays are much lower. Some communities do not force retirees onto Medicare at age 65. Many citizens on elected boards – some after serving as few as six years – receive coverage for life, too.
As medical costs across the board rose over the past decade, municipal health care expenses exploded, draining local budgets and forcing major cuts in services, higher property tax bills, and billions in new debt.
“It has got to be dealt with,’’ said Richard Fortucci , the chief financial officer in Lynn. “Or we will all go bankrupt.’’
Municipal health costs in the state more than doubled from 2001 to 2008. The town of Somerville spends almost one-fifth of its annual budget on those costs alone.
How did we get to this state of affairs?
So far, with powerful labor unions resistant to giving away hard-won benefits and a lack of political will in the state Legislature to force changes, efforts to overhaul the system have fallen short.
To be sure, many municipal employees, elected officials, and retirees are paying a greater percentage of their health premiums than ever. Still, almost all of the increase in municipal health care costs in the past 10 years has been shouldered by taxpayers, who are subsidizing plans that are often superior to their own.
“It’s a nice deal,’’ said Debski, now a part-time planner in Malden.
She could get insurance through her husband’s employer but doesn’t, for a simple reason: The municipal plan is far more generous and costs less.
“The system was there,’’ she said. “I find it hard to believe that anyone wouldn’t take what the system offered.”
Quite right, Debski. Eight years as a state hack (hell, six will do), and you earn benefits unimaginable (not to mention unaffordable) by anyone who, you know, actually works for a living. Who wouldn’t take that deal? We may be dumb here in Massachusetts, but ain’t stupid.
So what if costs are divorced from ability to pay? If it’s such an emergency, just call 911:
Health care costs are not the only budget-buster for cities and towns, of course, but their rise has led not just to fewer firefighters in Lawrence but diminished services across the state.
Library hours have been cut in Wayland and Hull. Wakefield has deferred road and sidewalk repairs. Malden has introduced fees for trash pickup. Class sizes have increased in Chelsea. Major layoffs have hit, among others, Boston, New Bedford, Worcester, and Brockton – with officials in all those communities citing rising health care costs as a major factor. Revere last year closed City Hall on Fridays, to save cash.
“What am I going to do next, put a padlock on the police station and tell people to call the State Police instead?’’ asked Mayor Thomas G. Ambrosino of Revere, who, like other mayors, is covered by municipal insurance.
Don’t forget the wildly successful state Medicare program, MassHealth:
While health care reform has brought the state closer to universal coverage, the unintended consequence of that success is most disproportionate share hospitals are losing more money as they treat additional patients whose insurance doesn’t cover the cost of care.
It’s not just people with public insurance who are hurt by poor government reimbursement, but the entire community that depends on its local hospital. There is a risk community hospitals will disappear unless the state pays them for the care they deliver.
Bringing suit is not the option we prefer, but leaving a lopsided reimbursement system in place is not an option. The current system will inevitably lead to more hospital closings, ravaged local economies, and reduced access to care.
Some or all of the following consequences seem inevitable: cuts in municipal services (fire, police, sanitation, schools, etc.); cuts in municipal health plans themselves; enormous tax hikes; default on bonds. I can hear the objections to all of them in my head (to accompany all the other voices I hear).
Publicly funded universal health care is an unfunded mandate, a liability that only metastasizes.
Let’s take it national!