New: Sex Change Surgery is Beside the Point (Reader Commentary)

By Barbara Gilbert
Thursday January 20, 2011 - 03:44:00 PM

Sex change surgery is beside the point when examining Berkeley’s budget and its employee health care program.  

The City has a Rolls-Royce plan that would astound and create envy in 99.9% of Americans—rich, poor or middle class. For the basic plan, employees pay nothing and receive these benefits tax-free. In some cases, employees actually receive cash in lieu of coverage. 

I refer interested and concerned readers to the City of Berkeley Consent Calendar Item #5 on November 16, 2010.  

For families of active employees, the City pays up to the Kaiser rate of $16,800 annually. For families of pre-Medicare retirees, the City pays $28,800 annually. For retiree families, the City pays $18,000 annually. The payments for single and two-party households are of course lower, but still astronomical. Beneficiaries who choose pricier Health Net coverage plans pay the difference out of pocket. For retirees, the City has paid, since 1988, premium increases of up to 4.5% annually (so for a 1988 retiree, the City’s premium cost has about doubled). 

The scope of employee Kaiser coverage is apparently limitless. For active employees and pre-Medicare retirees, there is $0 co-pay for office visits and $5 RX co-pay. For post-retirees the office visit co-pay rises to $5 and the RX co-pay stays at $5. 

My take on health care reform, shared by most other commentators, is that reasonable co-pays discourage abuse of the system by providers and patients, and of course promote sensible cost containment. 

We also know that physical fitness absolutely promotes good health. Berkeley employees receive free gym membership at the Downtown YMCA at a cost of almost $300,000 annually. Does the City even know how many employees use this valuable benefit? To my knowledge, there has been no serious effort to encourage or require at-risk employees to use this benefit. 

Then there is the cash-out issue. The point of health insurance is to address health issues, not to enrich employees. I briefly worked for the City about ten years ago and was amazed to learn that I could take my health benefits in cash since I was insured through my then-husband. I cannot recall whether this cash was tax-free but it may well have been. This wasteful policy is apparently still operative so that some number of otherwise-insured beneficiaries are literally cashing-in. Can the City provide this number and the dollar cost? Perhaps this “free” money should be used for borderline coverage in elective surgery and mental health. 

I really wish that the public and press would not get distracted by push-button issues such as sex-change surgeries, but would instead do the harder work of reading, thinking, and analysis of the very serious structural issues facing our communities.