Health Care:
The Bits and Pieces

Most likely, we’re going to have a lot of disagreements about health care. This actually makes pretty good sense: the issues are tangled and confusing, we all have somewhat different needs, and the politics of health care go on forever.

But maybe we can more or less agree about what the bits and pieces are. That is, we can at least figure out what the facts and the issues are--and then, maybe we can even sort of agree on what the possible, “solutions,” are, even if we don’t agree about which solution we should try out.

So, here are the bits and pieces--here’s what we know pretty much for sure.

1. Health care is a national issue, and nobody’s got a perfect solution.
2. We have no national health care plans, except for Medicare/Medicaid/the VA.
3. Mostly, health care in America is driven by money.
4. Most of our health care comes from some, “employer-paid,” system.
5. There are a few different ways to pay for health care: a) you can buy it yourself, if you’re rich; b) the Government can buy it for you; c) you can pay an insurance company; d) your employer can pay an insurance company; e) you and your employer can cut a deal to pay for your health care together.
6. The kinds of insurance plans we have available in Blythe are: PPO (Preferred Provider: you choose an independent doctor from a list given to you by a company like Blue Cross), HMO (but only out of town: you choose a doc who is employed by a Health Maintenance Organization, like Kaiser), and Trimark (used by members of the military and vets).
7. PPOs are expensive; many Americans prefer them because they like the idea of, “free choice.”
8. HMOs are cheaper; some prefer them because of their cost, and their focus on preventative care.
9. The costs for health insurance were relatively low until the late 1990s, and then they started zooming.
10. The rate increases in health care were pretty low until the late 1990s, and then they started zooming.
11. Employers like PVC committed to paying for health care because it was a cheap benefit back in the 1990s.
12. At present, PVC spends around 11% of their annual budget on insurances.
13. Nearly all the costs of health insurance, and nearly all of the cost increases, are for Blue Cross: dental, vision, life, go up maybe a couple of percent every year, and BC went up around 14% in 2004, around 10. 9% in 2005, and 8.2% in ‘06.
14. Costs for HMOs are rising, but Kaiser only went up around 5% in 2006.
15. HMOs are cheaper because they a) have their own doctors, pharmacies, hospitals; b) push prevention, which costs less in the long run; c) control drug costs; d) sometimes limit experimental treatments.
16. We do not have an available HMO in Blythe, though Kaiser is available in Indio.
17. Currently, total costs for our health insurance are around $12, 900/yr.
18. Everybody gets the same rate: we’re on a “supercomposite,” structure.
19. The College probably wouldn’t save any money if we went to a “3-tier.”
20. The doctors in town all seem to be signed up with Blue Cross.
21. PVC appears to have the best health benefits in town.
22. There does not seem to be cheaper insurance out there, if we want to keep the same level of benefits.
23. We belong to REEP.
24. We could get cheaper Blue Cross, just like you get cheaper car insurance: accept higher deductibles, higher co-pays, or lesser benefits.
25. A “single-payer,” system would ensure that everybody in California was covered. It would eliminate co-pays and deductibles.
26. A single-payer system would be paid for the same way STRS is paid for: employer contributions, and payroll deductions. The deductions would be on the order of 2-3%.
27. We do not have IRS 125 accounts set up, which would allow you to set aside pre-tax dollars to pay for the following year’s health care costs and some dependent care costs.
28. We have no insurance benefits available for PT and adjunct faculty.
29. In 2003, we turned down a Contract that would have meant deductions capped at $300 for the first year, $700 for the nest year, and $1000 for this year, while the District would have paid everything else to a cap of $11, 900 this year.
30. In 2003, faculty got control of about a third of the PVC “self-insurance fund,” a total of around $185, 000.
31. After 2003, we met a set of deals that worked out to this: a) in 03-04, the District cap was $10, 800 and faculty paid zero; b) in 04-05, the District cap was $9880 and faculty each paid $2200; c) this year, the District cap is $10, 996 and the faculty will pay around $1900/yr.
32. The reason for this deal was that a majority of faculty did not wish to pay for their health care, believing that the District should pay.
33. An outsider might have trouble seeing how paying $4100 from the Benefits Fund is better than paying $2000 in payroll deductions.
34. The Benefits Fund is essentially gone, as we have put no money into it.
35. Our current demand is that the District increase the cap to $15,000.
36. If we assume that BC costs go up 8-10% for each of the next three years, $15, 000 would cover 07-08 and maybe 09-10. It would not cover 2010-2011.
37. We are going to run into serious District resistance to increasing the cap.
38. The union is not prepared for impasse and mediation, let alone fact-finding and strike.
39. The CTAs/Alan Frey’s recommendations on health care are, a) don’t start paying, you’ll never get it “for free,” again; b) don’t consider paying until the District’s paying $13,000-$14,000.
40. The current District cap for the CSEA is $12, 100. They traded part of their COLA.
41. We, “double cover,” a few employees.
42. The CSEA has a “me too clause,” especially on health care.

OPTIONS
Again, one assumes that we will disagree. The point here is to look at what the choices are fairly objectively. It’s to give our bargaining team better information on what the faculty wants, so that they don’t cut deals we can’t approve.

1. DO NOTHING. Advantages: no wrangling. We’d have what we have now: a District cap of $10, 996, and payments coming out of the Benefits Fund. We could probably get more on salary and other wages. Maybe the “single-payer,” would get done. Disadvantages: the BF would be dry by the end of September, 2007 at the latest, and our insurance would not be covered after that.

2. DEMAND A $15,000 DISTRICT CAP. Advantages: if we can get this, we’d be covered for around two years. Disadvantages: we’re probably going to have to fight for this one, and is the union ready to really really fight? Further, this will probably mean less sheer salary dollars, and may limit our ability to do anything for PT faculty and retirement benefits. Most likely, this would be the absolute end of District increases: can the District afford this?

3. DEMAND THE HIGHER CAP, AND TRADE PART OF COLA FOR IT. Advantages: would solve the problem for two years at least. Disadvantages: some faculty wouldn’t want to trade anything, believing that, “the District has the money.” We don’t know how much COLA will be. And this may be seen as encouraging the attitude of, “I don’t see the money, so it doesn’t cost anything.”

4. SETTLE FOR A CAP INCREASE OF LESS THAN 15,000, AND FIND CHEAPER HEALTH CARE OUTSIDE REEP. Advantages: Cheaper health care would be…well, cheaper. We wouldn’t have to pay anything for at least a couple years. Disadvantages: a) unrealism—no evidence of cheaper health care is available or has been produced by anyone; b) leaving REEP would mean that our small risk pool would have a lot less bargaining power; c) all the doctors in town seem to be signed up with Blue Cross.

5. HOPE THAT THE DEMOCRATS GET “SINGLE PAYER,” DONE. Advantages: everybody in California would be covered; no co-pays or deductibles; over time, rates might actually drop. Disadvantages: “Hoping,” isn’t a plan; single payer would cost us $200-300/month in payroll deductions, since the system would probably work like STRS contributions. (Note: a long-term approach might be to look at District savings, and negotiate for salary increases to offset deductions from pay, but this would mess up some of the tax advantages of payroll deductions.)

6. SHIFT TO HDHP/SAVINGS PLAN ON BLUE CROSS. Advantages: if we negotiated to have District pay deductibles, this would allow careful members to a) keep their Blue Cross PPO; b) control where their dollars went better; c) still stay with REEP; d) possibly accumulate savings, from unused deductible monies. Disadvantages: a) these plans demand a LOT of attention; b) anybody with kids or chronic health issues isn’t going to save anything; c) national surveys show a lot of dissatisfaction with HDHP plans.

7. SHIFT TO RADICALLY CHEAPER PLANS, LIKE HIGH-DEDUCTIBLE/HMO PLANS/BLUE CROSS WITH MUCH HIGHER CO-PAYS and DEDUCTIBLES. Advantages: probably would allow everybody coverage, without payroll deductions; would allow extension of benefits to PT and retirees; costs could be deferred with Sec. 125 plan; much cheaper rates and rate renewal costs; no changes in plan benefits. Disadvantages: faculty might object to paying the deductibles, particularly if they use a lot of health care. No HMO locally available.

8. DEMAND SOME CAP INCREASE, AND GIVE UP SUPERCOMPOSITE RATES AND GO TO A THREE-TIER SYSTEM. Advantages: cheaper rates by far for singles, somewhat cheaper rates for two-party faculty plans. At least half of faculty would pay nothing. Disadvantages: Family rates would radically increase. Splitting of bargaining unit over costs. Would not save District money.

9. LEAVE REEP, AND USE CENTRAL VALLEY TRUST. Advantage: would make CTA very happy. Disadvantages: we’d lose local control in REEP; their rates are pretty much the same as ours, so we’d still have to worry about paying (San Joaquin Delta, Alan Frey’s old college, has agreed to payroll deductions); CVT doesn’t have doctors signed up closer than San Bernardino.

10. HOLD WHAT WE GOT, BUT ONLY NEGOTIATE HEALTH CARE FOR ONE YEAR, AND GO FROM THERE ON A YEAR-TO-YEAR BASIS. Advantage: might allow us to settle this year, and blow off the issue till 07-08 academic year; District might be more willing to increase to around $13, 900 for one year than commit to $15, 000/yr. for three years. Disadvantage: simply blows off issue again. District might demand to settle once and for all, NOW. Wouldn’t cut costs.

11. WORK OUT A COMPLEX DEAL FOR THREE YEARS THAT INCLUDED MORE PLANS, SEC. 125 ACCOUNTS, INCENTIVES FOR GETTING UNDER CAP, INCREASED CAP, PT PARITY, PAYROLL DEDUCTIONS, AND RETIREMENT BENEFITS. Advantages: would work out problems; would allow more options; would allow coverage for PT, retirees in Contract; would help control costs. Disadvantages: complexity; payroll deductions—are you insane?

Robert Robertson, CTA President

PALO VERDE COMMUNITY COLLEGE
CTA Meeting Minutes
Nov. 28,2006

I. Opening of Meeting:
The regular meeting of the CTA was called to order at 4:11PM.

II. Approval of Minutes: The Nov.14,2006 CTA minutes were moved, seconded, approved by voice.

III. Approval of Agenda: The Nov. 28,2006 agenda was moved, seconded, approved by voice.

IV. New Business:
1. Barbara Gaubeca was nominated and then elected as an at-large member to the Executive Board.
2. 2 documents were distributed entitled, “177 Day Full-Time Faculty” (7 pages) (let’s call it “177” for future reference in these minutes) and “Assessing Salary Schedule Integrity: A Brief Guide” (18 pages) (let’s call it “Integrity” for short). Some comments made by Robert Robertson and other CTA members relating to these 2 documents were:
a. Highest salary = twice the lowest faculty member’s salary.
b. Some of the numbers in the tables were questioned.
c. In 20-year earnings PVC has increased from 65th place to 51st place.
d. Salary and benefits should not be lumped together.
e. Overload pay is important.
f. Missing from these 2 documents is paperwork concerning retirement money,
salaries for part timers, and non-credit faculty pay.
g. Concerning “Integrity” – CTA members need to tell their opinions to
Negotiations Team members.
3. Sunshine benefits will be discussed at the next CTA meeting.
V. Adjournment: The meeting adjourned at 5:06PM. Ray Barney’s workshop concerning “Negotiations” will immediately follow this meeting.

____________________________________________________
Members in attendance: R.M.Robertson, Sandra Sher, Leticia Guilin, Joe Boire, Earl Turner, Sioux Stoeckle, Alejandro Garcia, T.M.Brown, Louise Gallan, Kevin Eoff, Bill Ponder, Joe Jondreau, Eric Wright, Henry Rinaldi, Bruce Wallace, Peter Martinez, David Silva, June Turner, Barbara Gaubeca, Doretha Jones.

Minutes submitted by: Sandra Sher, Dec.12, 2006