THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING
Kevin Cullen

A system that hurts us all

By Kevin Cullen
Globe Columnist / March 7, 2010

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If you read Sean Murphy’s marvelous, maddening stories in this newspaper about how skyrocketing health care costs for municipal employees are destined to bankrupt many cities and towns in the Commonwealth and your head didn’t explode, consider yourself lucky.

How’s this for irony: the only reason Murphy was around to write those stories, and there was a newspaper around to publish them, is because the union Murphy and I belong to agreed to the very kind of givebacks the public sector unions are balking at.

Like a lot of other companies, the Globe’s owner, The New York Times Co., needed to cut costs in a lousy economy. So last year it put a gun to our head, telling the unions, “Give us $20 million or we’ll close the paper.’’

It might have been a bluff. But faced with the prospect of not having a job in the middle of a recession that might as well be a depression if you’re unemployed, people at the Globe held their noses and took the pay and benefits cuts.

In the case of cities and towns, we taxpayers are the owners, and we’ve got no gun. Taxes come out of a spigot we can’t shut off. And if we don’t pay taxes, we’ll be escorted to jail by some guy whose health plan we’re paying for. The idea that taxpayers are forced to underwrite health care plans that the vast majority of us can only dream about is more than galling.

But aside from being good doobies, and in some cases averting layoffs, what’s the incentive for the unions to give up their benefits?

Before you go bashing the unions, which is irresistible in this case, would you, short of having that gun to your head, give up benefits?

After Murphy’s stories ran, the Boston Foundation put out a report saying that the only way we can stave off the financial ruin of many cities and towns is for the Legislature to stand up to the vested interests and change the law, forcing municipal employees to shoulder more of their health care costs. The report also urged mayors and other municipal executives to force retirees onto Medicare at 65.

So the financial solvency of many cities and towns rests on the premise that politicians will do the right, as opposed to the expedient, thing by going after two of the most politically active demographic groups in the state, the unions and retirees.

God help us.

Murphy’s stories have caused understandable anger. But they should also cause everybody to pick up the phone and tell the pols in Washington they have to put aside the ridiculous charade that has passed for debate and produce something that will improve the way health care gets doled out and, just as important, rein in runaway costs.

And if you’re looking for one more good reason for health care reform, take Liz Beebe’s left index finger.

They almost had to, with a scalpel, after Beebe was shuffled around like a deck of cards when her finger got badly infected from a dog bite.

Liz Beebe, 28, lived in Los Angeles, where she works as an actress and in TV production. She was in between jobs and had to choose between paying for rent or health insurance. Having seen the accommodations on Skid Row, she opted to pay the rent. After she got bit, she went to a series of clinics and doctors in LA and paid $2,000 out of pocket for care that didn’t fix her finger but left her broke. So broke she moved back with her parents in New Hampshire. The bright side was access to Boston’s great hospitals.

She went to the emergency room at Massachusetts General Hospital, and the staff couldn’t have been nicer. They were appalled at the treatment she got on the Left Coast, and she was quickly scheduled for surgery. But the surgery got canceled when the hospital questioned her ability to pay. She was hoping to set up a payment plan, something like $200 a month, but was offered only two options.

“I was told I could pay for the whole thing up front, $5,500,’’ she said. “That didn’t include the $3,000 for the doctor. I said I didn’t have that kind of money, so they said I could pay $7,500 on a payment plan but that would include 80 percent up front. I said, that doesn’t make any sense, because that would be $6,000, which is more than the $5,500.’’

First lesson in paying for health care: Nothing makes sense. Everything’s arbitrary.

Liz Beebe shopped around, as her finger throbbed, and was able to negotiate a plan she could afford at Portsmouth Regional Hospital.

Joe Ianelli, the financial services manager at Mass. General, said his staff bent over backward to help Liz Beebe. But he said they were limited by what they could do for her as an uninsured patient because she wasn’t a Massachusetts resident.

“In New Hampshire,’’ he said, “they have more flexibility.’’

Unfortunately, Liz Beebe’s finger doesn’t. She’ll never be able to fully bend it. She’ll never have full use of her finger because, from coast to coast, we have reduced access to health care to something like buying a car. She was dealing with one of the greatest hospitals in the world, but Liz Beebe had to haggle to save her finger as if she were trying to have a sunroof or chrome wheels thrown in.

Is this a great country, or what?

Kevin Cullen is a Globe columnist. He can be reached at cullen@globe.com