How RI’s State Employee Unions And Everyone Else Would Be Helped By a More Rational Healthcare System
If there are any union folks still reading this site, let me use the Council 94 situation as the basis for explaining to you how conservatives would like to reform healthcare. Non-union folks might be interested in this too!
1. Instead of negotiating a plan and spending money with a health insurer, your employer would take the thousands of dollars currently spent per employee on health insurance, and give that money directly to the employees. In operational terms, every employee gets a multi-thousand dollar bump in their paycheck.
2. The employee can then use that money to buy an insurance plan directly from an insurance company. The laws would be changed so that people would be free to purchase insurance plans from any insurer in any state, and so that other government-created factors that artificially increase the price of non-employer health insurance would be removed.
2A. Most importantly, the tax-code would be changed so that individuals who purchase health insurance would get the same tax-break that companies who purchase health insurance for their employees currently get. Right now, businesses that buy health insurance for their employees are allowed to deduct that money from their corporate income tax calculations, but individuals who spend money directly from their paychecks on the exact same plans are not allowed to deduct from their personal income taxes.
(I’m not sure how the current employer tax-break works in the case where the state is the employer, but that only helps make my point: In the reformed system, the self-employed, the corporate-employed, and the state-employed will all be treated the same, which makes sense, as people’s health needs don’t fundamentally vary based on who their employer is.)
3. Finally, in this new system, a union like AFSCME could still use its negotiating prowess to go out and secure a preferred deal from a health insurance company for its members. AFSCME would bargain directly with the health insurers, choosing whatever health insurer in the country offered them the best deal, and not having to rely on the Governor to negotiate the details of its deal.
The night that Council 94 rejected the current contract offer, WJAR-TV (NBC 10) reporter Bill Rappleye interviewed state employee Sharon Moreno, who expressed a reasonable position about what she would like from the new contract…
Leave me where I am right now [in salary, but] don’t touch my coverage.The strength of the plan outlined above is not only that the state wouldn’t have to touch health-coverage benefits during contract negotiations, but that the state would not be able to touch health-coverage benefits during negotiations. Unions and employees would talk salary with their employers, and talk health coverage with their health insurers.
I know it’s too late for this kind of plan to help with the current situation, but this is the system that makes the most economic sense, the most political sense, and that gives workers the most direct control over their futures. This is the kind of system we need to be looking at moving towards for everyone.