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SURVEY FINDS UNION FUNDS
UNDER SEVERE STRESS FROM RISING HEALTH CARE COSTS
“Health care has become the most difficult part of
any negotiation.”
“The cost of health care is the biggest issue in
negotiations by 100%.”
“We’ve begun dipping into our reserves – we are never able to keep
up with the increasing cost of health care.”
These are typical findings from a survey-in-progress of
the current state of union health benefits. The survey is being conducted by the Five Borough
Institute in collaboration with the New York City Central Labor Council.
The union responses stress the soaring costs of health
care and the difficulty of maintaining benefits in contract negotiations.
One respondent said, “There are the same difficulties in all our
negotiations, increased cost contributions from employers, reductions of
benefits, and increased contributions by employees.” One union’s benefit
fund went bankrupt “because the premiums are going up faster than the money
from the employers.” Another union plan’s losses have been nearly $500,000
each year for the last three years.
Many respondents
cited more specific difficulties as well, especially prescription drug
coverage and insurance coverage for retirees. Two reported that “retirees
have been the biggest issue with health care coverage,” while another says
that “many active employees otherwise eligible for early retirement will
not be able to retire prior to Medicare eligibility.” Another noted that
“to fund current benefits and add prescription coverage for pre-Medicare
retirees is the #1 member demand and enormously expensive.”
Negotiating Pressures
Twenty-five of the City’s major unions are included in
the survey. Faced with an average cost increase last year of 13%, their
benefit plans adopted a variety of strategies. Most drew on increased employer
contributions and drew down plan reserves, while some changed coverage or
access rules, and several increased member deductibles and/or co-payments.
In its last negotiation, one union said that work-week minimums rose and
employer contributions nearly doubled. Several others reported that rising
costs to employees were major concerns. The pressure continues: Most unions
predicted sharp rises in health care costs for the next year, with an average
prediction of 13%.
Most respondents reported that health benefits were a
major issue in the last contract, and all but two said that health care
benefits would be a big issue in current or project negotiations. Fourteen
said these contract pressures were initiated by management. The most common
contract issues included deductibles and/or co-pays, and contributions by employers;
other issues were “network” access rules, the scope of covered services,
and the use of limited prescription formularies.
Coverage for retirees is a major issue as well, with
most unions expecting cost or coverage pressures regarding retiree benefits.
The pressures cited included prescription drug costs, overall cost of
retiree benefits, coverage of retirees before age 65, and long term care
costs.
Who—and
what—is Covered, and Who Pays?
All
responding unions cover their members and full-time members’ families. Half
of them cover part-time members as well, with most of these including
part-time members’ families. More than half cover retirees, and almost all
of those cover retirees’ spouses or families.
Most unions provide hospitalization, general medical
care, prescription drug, dental, and optical coverage. Most do not,
however, provide long term care or disability coverage.
More than half of the responding unions had no member
contribution to insurance premium costs for either members or member
families. To fund retiree benefits, about half used employer contributions
on behalf of each eligible retiree, and about half used employer contribution
on behalf of active employees.
Plans for the Future
Almost every responding union expressed concern about
soaring health care costs and the pressures on negotiations and union
health plans. Several offered solutions as well. One union noted the
“overriding importance to the labor movement of national health care.” It
called for a “Labor Health Alliance” solution, which it said “would clearly
save money, but requires New York’s major unions to take a leap of faith
and commit to such a plan.” Another union suggested a law in New York State
requiring minimum medical coverage, much like Workers Compensation. A third
asked, “What are we doing about a national single payer—Canadian-style
system. It works better than ours – costs are lower, life expectancy is
higher. Let’s start with regulating drug cost
June 2003
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