In the hole

| April 24, 1998

University faces insurance crisis

Workers to shoulder burden of $2.6 million shortfall

Blue Cross/Blue Shield's website, an airy bit of cyberspace dominated by peaceful white and baby blue, poses a rhetorical question: "What if you never had to worry about health care?"

A nice thought, maybe, but for 6,765 people working at or retired from Montana's state universities and colleges, there seems to be plenty to worry about.

After an unforeseen $2.6 million loss last spring and an increase in pharmaceutical costs that one official calls "astronomical," faculty and staff around the state-including those who work at the University of Montana-face a future of reduced benefits, higher premiums and uncertainty.

The committee that handles university employees' $21 million in Blue Cross/Blue Shield coverage met last Friday, and in the words of a memo addressed to UM's campus community Monday, "there were only unpleasant decisions to be made."

The committee wasn't shy in its recommendations. If its package of cutbacks and revisions is approved by the Commissioner of Higher Education and the Board of Regents, employees will lose all vision coverage and have to pay more for prescription drugs and treatment starting July 1, 1998.

While both the state and employees' share of the bill will increase next year, the workers will be hit harder. For example, a $350-deductible plan covering an employee and his or her spouse will cost $119 a year, up from $79 . The state's share will go up only by $25. A $500 plan for the same couple will cost employees $58 annually, rather than $17.80.

"I can't describe it in any other way than to say that benefits overall will decrease," says Mike Brown, a UM business professor who sits on the Inter-Unit Benefits Committee.

Brown and fellow committee member Kathy Crego, who co-authored Monday's memo explaining the changes, point to several reasons why health care benefits at UM must be made more austere.

Last year, a new "cafeteria-style" insurance program called Choices was implemented. Crego says the new plan, which allows employees to pick and choose which coverage areas they want, was implemented to stave off the money problems employees face now.

"Instead," she says, "those problems have worsened."

The new program held an open enrollment period last year, during which any dependent of a university employee could be added. About 400 new clients joined the plan at that time, many of whom had previously been denied coverage because of pre-existing medical problems or other reasons.

"That's pretty typical, for programs to have open enrollment periods," Crego says. "It's something the people on the campuses wanted. They said basically, well, if we're going to have to pay more, at least let us add some people."

The influx of dependents added to the $2.6 million loss between March and June of 1997, a loss Crego attributes to an unexpected surge in claims.

"Our consulting firm in Seattle told us to expect a 7 percent increase in claims, when in reality we had a 10 percent rise," she says.

That discrepancy, as Brown points out, creates a problem that's compounded each year as a 3 percent difference between expectation and reality becomes 6 percent and so on.

Besides this $2.6 million, the program must also come up with an additional $1 million surplus demanded by the 1997 Montana Legislature as a cushion designed to guarantee the plan's solvency into the future. On top of that, there's the 21 percent average annual increase in the price of prescription drugs to take into account.

"There are a number of reasons for drugs being so expensive," says Brown. "One of them is the so-called 'shadow pricing' of generic prescription drugs. Companies have discovered that they can still sell as much of their generic products and make more money if they increase the price. Now generics seem to cost almost as much as brand-name drugs.

"Then there's the prevalence of new 'miracle' drugs on the market today, and those are always very expensive. And usage is up as well."

As a result, university insurance will no longer start matching prescription bills over $10, as has been the case. Instead, employees will have to shell out $100 for drugs before insurance kicks in. Over $100, the client will pay 25 percent of the bill until out-of-pocket expenses reach a maximum of $500.

That cut-back will save the program $250,000, but will increase the financial burdens of higher ed employees who already rank on the low end of the national college pay scale.

"It's a difficult thing to do, given the way finances are on campuses now and the slow, slow rate of staff pay increases," Crego says.

William McBroom, a sociology professor who chairs the UM Teachers' Union, says these cuts are just a symptom of a wider health care crisis. He says the union, which isn't directly involved in the insurance committee, might consider trying to re-negotiate how benefits are handled in the next round of contract talks with the state.

"There's nothing unique to this campus here," he says. "This country simply needs health care reform and we won't see it, in my opinion, until the aging Baby Boomers demand it. As it is, we have a mess in this country and it'd be foolish to think it wouldn't affect the university system."


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