Public Employee Medical Benefits

For all of you who want to cut medical benefits of public school teachers in New Jersey, here is what the real problem is.

I am a public school teacher. I am a middle-aged man. I am in decent shape. I have a few extra pounds, but I exercise regularly. I do not smoke, etc.

I have one ailment: I have poor ears. Much like children, my ears do not drain fluids well. My ears also create excessive wax. It’s been an ongoing battle since childhood. Every so often I get fluid behind the ear drum that will not drain and just like children, my drum is punctured and a tube is inserted. The fluid drains and I can once again hear.

I have had this procedure done more than a dozen times . . . probably closer to two dozen times. It’s the price of being me.

My ears have had a lot more fluid in the past two years than ever before. I am pretty certain it is due to mold in the workplace. That’s another issue altogether. I have had three tubes inserted in a little more than a year. I have been back to my otolaryngologist recently with more fluid in the ear.

We discussed why the fluid is there and the remedy. I was told that adults expel the tube during healing much more quickly than children do. My doctor thinks a tube with a larger flange will do the trick. Once during high school, I had such a tube inserted.

I knew the routine for the “special” tube. It cannot be inserted in the office, but rather in an operating room. Twenty-five years ago that was a hospital in Wilmington with the nurse whose sole job was to hold my hand (I am certain she needed surgery afterwards). Today it is in an outpatient facility.

But then it happened . . . I was asked a question that puzzled me. “How old are you?” I was incredulous. What does that have to with it? Well, since I am now considered old, the tube that needs to be inserted requires me to get bloodwork, chest X-rays, and an EKG before they’ll stick the stupid tube in my ear.

Sigh . . .

I am a public school teacher and I do have medical insurance. Trust me, I will be using that insurance. A regular visit to my otolaryngologist is billed at $185 to clean my ears. At least once a year I am required to have a hearing exam that documents the loss of hearing I am experiencing and that is at least a $500 charge. What do you think all these tests (totally unnecessary if you ask me) are going to cost?

So, cut my medical benefits folks. But that doesn’t solve the problem. The problem isn’t that folks need medical attention, it is that the medical profession racks up the billables. Billables just like the urine test that was required of my wife two days before the birth of our daughter. The test results were not going to be back before the birth of Beetle. I pointed that out and was told they would be. They weren’t and the delivering doctor never saw the report. Those billables!

Yes, the taxpayers are footing this. And no, they shouldn’t have to. But I can’t get the damn tube I need unless I jump through these hoops.

Now, how is cutting these benefits solving the problem? It doesn’t. That is what is wrong with the shallow approach to cutting the benefits of the state workers. Folks trot out that their employers do not provide these kinds of benefits. Folks have easy access to the cost to the taxpayer. And superficially, it sounds horrible. But the problem is not that school teachers have good medical benefits. The problem is that the medical profession is out of control. An EKG for a normal guy who needs a routine procedure that children have every day of the year?

Keep blaming school teachers . . .

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8 thoughts on “Public Employee Medical Benefits”

  1. Bob, we don’t blame teachers for the high cost of health care. We blame lawyers, who have sued doctors and hospitals so often that the doctors feel compelled to conduct every test known to man before making a diagnosis and prescribing a treatment.

    I would, however, like to see teachers accept responsibility for some of the cost for their health care. In private industry, an insurance plan with no employee contribution to premiums is a very rare thing. Among union-represented government employees, no contribution is the rule rather than the exception.

    I pay a relatively small fee, amounting to 1.7% of each weekly paycheck, plus a $20 copay for each visit to the doctor. I think that’s pretty reasonable. What would be the reaction of the union leadership if your school district were to propose such a plan in contract negotiations?

  2. I would, however, like to see teachers accept responsibility for some of the cost for their health care.

    Ah, it sounds so reasonable, Ken. But unfortunately, it is not as simple as that. The day that I am compensated in my paycheck equally to what I would be in the private sector is the day I will agree to the same benefit package.

    Unlike many folks in education, I actually worked in the private sector. I earned a salary as a 22 year-old that I earned only after several years as a teacher a decade later. To become a teacher I also added a little thing called a graduate degree to the resume. A few years later I now have a second.

    There are some in the NJ blogosphere who state that NJ teachers earn a far higher rate of compensation than those in the private sector. I am not familiar enough with the studies to know if that is true. I do know that for me, however, it is not. I am confident that with my two advanced degrees I would make far more than the salary I earn as a public school teacher. Extremely confident.

    For taking fewer dollars in the paycheck, public employees are compensated with a benefits package that, as you point out, most private industries do not offer. Washington Mutual does not give a hoot about my medical benefits. They want US dollars every month for the mortgage.

    I pay a relatively small fee, amounting to 1.7% of each weekly paycheck

    I suspect that the budget that determines your compensation is not put up to a public vote nor is it made available to anyone who wishes to see it. I suspect that your industry is not put in the position as the very last place that the public gets to voice its opinion on at the ballot box. One and seven-tenths percent may not seem like a lot now, but I guarantee that three years from now when our contract is re-negotiated that one and seven-tenths percent is a lot higher. It’s just like when the state reduced the amount they pay into my pension. No one recalls that little maneuvering.

    Let’s see, my pension has been sold off and used to prop up general spending in the late 1990s. I bet your company makes regular payments into your pension. I think the state is about $7 billion in arrears to mine.

    Too many folks think the public employee is to blame for what is going on. He is not. Government has run amok for far too long. To balance the budget on the public employee is dishonest and more important, it does not rectify the problem.

    What would be the reaction of the union leadership if your school district were to propose such a plan in contract negotiations?

    Union and leadership do not belong in the same sentence let alone having one describe the other. But I will answer in the way I have shared with the union I am forced to join despite my protestations (and they use my dues to support political action that I loathe, but it is legal to do so in the Garden State): I am willing to take fewer dollars each contract to preserve my benefits. Because Ken, once my benefits are taken, there is nothing other than that “good feeling” to draw someone to public service. My co-pay is more than what it used to cost my parents to pay in full at the doctor’s office and I have a vivid memory of my mother being stunned at the bill to take her sick boy in.

    Outraged at what I was going to have to do just to get a tube, I saved all New Jersey taxpayers money today. I went into the doctor’s office and consulted with the doctor. I explained my hesitation at all the pre-work that needed to be done. She explained that it wasn’t her, but the anesthesiologist who required all this. I asked why I was going to have an anesthesiologist for a metal tube. When she explained I was going to be put out, dear taxpayer, I refused the procedure. That’s right. I stated that I could not in good conscience go through all this for a tube that children have inserted all the time with far less hassle. I stated I would endure the increased pain that this tube will give me if inserted in the office without the anesthesiologist.

    So Ken, how is that? I saved you thousands of dollars today. Do I get any credit for that?

    We aren’t all trying to suck the tank dry . . .

  3. Don’t let your frustration with the system affect your health/hearing. You are no longer a child and the medical folks are trained to provide you the best, comprehensive care possible. Let them do their job.

  4. Bob,
    I feel your pain, but can’t really support your position on this. You’re smart enough to know that your experience would be more valued in the private sector, yet choose to trade immediate compensation for a more secure government job. That’s a rational decision.

    Demanding that the taxpayer make up the difference, when he has already given you a practically lifetime position, strikes me as a bit much. If you want a total package with a higher value (i.e., more in line with your self-worth), then you’ve got to be willing to accept a higher level of risk.

  5. choose to trade immediate compensation for a more secure government job.

    That includes health benefits.

    I am surprised.

    You suggest a quick fix. Let’s say you get what you want. You slash medical benefits to all state workers this year. I now pay 5% (or whatever) of the package. Now what?

    Medical costs still rise. Next year, even though I am paying 5% of the bill, the cost to you the taxpayer is rising. And it is rising far greater than the cost of living. The following year? Another 12% increase. And the year after? 15%. What have you done?

    Absolutely nothing.

    Cutting medical benefits hasn’t done anything other than save a couple dollars this year.

    You aren’t against public employees having good benefits. If we all could get full benefits for $100 per year, there would be no outcry. The issue is that the price is out of control and there appears to be no stop. Why punish the worker?

    I am really surprised that you would take such an approach to this issue. By your own admission, the lawyers are responsible for that. So, what does cutting benefits to the workers do to curtail the source of the issue?

  6. It doesn’t. All I said is that I believe public employees should share some of the cost of their health benefits, just as most private employees do. Asking you and your fellow teachers to take a financial stake in your own health care is not unreasonable. From a taxpayer’s point of view, it is completely rational. Any school board would be failing in its fiduciary responsibility to the taxpayers in not considering such a proposal during contract negotiations.

    But this is all beside the point. Health care costs go up at the rates they do because 90% of the effort expended in the medical profession goes towards keeping the lawyers at bay. If the teachers unions understood that opposing (and rolling back) the actions of the lawyers would free up funding to hire more teachers, maybe they would use their considerable political muscle toward that end.

  7. Bob,
    Here’s a 2006 report on Press of Atlantic City that gets into many of the issues being discussed here, including NJ public employee salaries vs. those in the state’s private sector.

    No one is talking about taking away medical benefits for you or your family. We are asking for public employee contributions (co-pays, deductibles and premiums) to be brought into line with the private sector. In many private sector companies, co-pays and deductibles are based upon a sliding scale tied to salary. If adopted, in the public sector lower than average pay would result in lower than average private sector contributions, but in-line with private sector practices.

    There are some groups of public employees in this state who pay nothing toward their medical insurance premiums. if you don’t mind answering, do the teachers in your school district contribute to their health insurance premiums? Please don’t take that question as a dig, it’s not – just a request for information to give us all a better understanding of what we’re talking about.

    No one blames you or any other public sector employee for fighting to maximize their salary and benefits package. You want to improve your income in order to provide for yourself and your family. But, don’t blame us for wanting the same thing. You know all about the outrageously high taxes we pay in this state – if we don’t get the big ticket items under control, the tax situation will further cut into our incomes.

    The current public employee packages in New Jersey are not stainable and they are more generous than benefits provided to public employees in just about every other state. Something has to give to keep the system solvent.

    One last thing – Bob, you’re one of the good guys and we’re not looking to balance the state’s budget on you back. You obviously need to have the medical procedure, get it done.

  8. I pay nothing yet toward the premium on my primary healthcare in the sense you are asking. I pay for it in taking a lower salary as a public employee. I do have a co-pay.

    I’ll point out that my wife who is also a teacher does not take her medical insurance. She is paid a stipend at the end of the year because of it. That stipend is nowhere close to the cost of a healthcare plan. So, the eCache household is already saving thousands of dollars off of the public payroll already. We are doing our part. Coming back and asking for more is what is getting the dander up.

    And by everyone’s admissions, having teachers pay toward the premium does not solve the problem. Yet, for these very real people, it lowers their compensation even further.

    if we don’t get the big ticket items under control

    This is the crux of it, Enlighten. This item doesn’t get under control by having teachers pay into the premium. The entire system is out-of-whack. Having teachers pay doesn’t bring it under control. All that does is begin the slippery slope of increasing the premium pay-ins the public employee is obligated to.

    Get the system under control. Then if having the public employee pay towards it is warranted, we’ll re-visit the issue.

    We are all reasonable people here. If every public employee paid into the premiums this year, next year the public’s tab for healthcare would still rise 12% or more. You have controlled nothing but have effectively screwed every public employee.

    Certainly you can see the issue here. You don’t take from your workers before you’ve cleaned house upstairs.

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