Archive for June 2nd, 2009

by jhwygirl

I’ve mentioned this before in comments and it has been met with agreement, but it bears worthy of repeating: The self-insured nature of both the city and the county’s health care coverage is a huge huge disaster-in-waiting.

Missoula Red Tape’s post is what is prompting this, although I was tempted with this post from Ward 3’s Bob Jaffe’s listserve from back in May.

And so I’m clear, when I’m speaking about the city and the county being self-insured, I’m talking about the city and the county taking what they contribute towards each employee and putting into their own bank account, essentially, and then paying the bills as they come in. In this case – just so I’m clear – the city and the county’s ‘pool’ of money are separate. They are not merged together for that slightly larger pool of members….which is pretty ridiculous, in and off itself, but more on that below.

From Jaffe’s post, the city contributes about $680 per month per employee. From Missoula Red Tape’s post, the city gets $10 per month in employee contribution. Now – I don’t know the amount of insurance, specifically, that people are getting, but a direct cost of $680/person is pretty steep. Employees should be getting 4-diamond health care for that price, and more (dental, eye, life, enhanced disability, etc.,…. but I strongly suspect that isn’t the case (although I’m not insinuating that it is horrible insurance, either.)

The thing is, a city employee could take that kind of money and buy a considerable amount of insurance under a ‘normal’ policy for that kind of money. The self-insured nature of the city’s operation means that they need to bank that money, and then pay some agency to manage the policy as the city has written it. That agency reviews claims and pays them out as requested. T-r-o-u-b-l-e. What about a catastrophic accident where a St. Pat’s helicopter, life support and several surgeries are needed? Say two of those in one year? Big trouble.

And don’t think that hasn’t happened to either the city or the county – where they’ve had to adjust their policy, cutting coverage just to make ends meet – just to keep their own self-insured pool upright.

Self-insure is a self-perpetuating nightmare. It’s very hard to transition over to a ‘normal’ insurance pool (say Blue Cross/Blue Shield Montana or NewWest or Allegiance) because of the ‘pre-existing condition’ clause that would interface, likely, for a year. But failure to act might be far more costly than trying to continue to maintain this self-insured policy.

U.S. is talking health care. It doesn’t taken an Einstein to know that the more people in the pool, the less costly the insurance. I don’t know how many people the city insures, but it sure isn’t the number like those that are employed at the University or for the State of Montana – and why the city wouldn’t negotiate to join in with that pool of providers…well, I can’t see how it wouldn’t make sense.

A smart person (and a good negotiator) – instead of wanting $10 more a month from each employee – might find far greater savings in seeking to transition from self-insured to some larger insurance pool. Because any year can be that next bad year. Let’s just hope it isn’t FY2010.

Hell – I bet there’s a savings to be accomplished just joining together both the city and the county health insurance as one pool.

Now that’s some crazy talk, no?

by jhwygirl

Tomorrow’s regular Wednesday public hearing of the Missoula County Board of County Commissioners contains a few things that might be of interest to county citizens – but don’t look to the county webpage for information on what it is they’re doing.

For example – we’ve got a family-exempted subdivision for George Denman. Don’t know where – don’t know how many lots. Don’t know if he has legal access…don’t know if it’s on a hillside or in a wetland. And because of this lack of information, people won’t know 5 years from now whether that lot that sells down the street was part of what was supposed to be a lot created for a member of Denman’s family.

Maybe that’s the idea…everyone knows those family-exempted subdivisions are just away to evade regular subdivision laws. Ravalli and Powell and Flathead counties are all contemplating reeling these things in a bit…and maybe even more counties.

But we get a link for some pathway.

There’s a 2-lot subdivision on 2.4 acres somewhere in Orchard Homes on 7th Street, west of Clements. Anyone ever heard of a legal description up there? Is it zoned? Isn’t there a staff report for this?

How can they give us a link for some pathway, but they can’t seem to get out a staff report to the website 5 days (on Friday) before the hearing. Don’t tell me the County Commissioners don’t have it – and if they aren’t getting the staff report 5 days before the hearing, it isn’t just the administrative staff in the BCC that are slipping.

Seriously. Look at this weeks city council hearing – and compare that to the BCC public hearing. Rarely does the BCC have much more than 1 or 2 subdivisions and 1 or 2 family transfers….yet information (i.e., links to staff reports) are sooooo hard to do for the county. .

Even though they do seem to do them selectively.


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