County struggles to keep cost of benefits in check

Clark County and its unionized workers say they’ve been trying every trick in the book to hold down their rocketing health care costs.

In 2008, employees who use HMOs saw non-generic prescription fees double to $20. New contracts include triggers: if premiums rise rapidly, annual deductibles might jump $200 per family to bring them down again. Unions say the county should look into contests rewarding workers for losing weight or quitting smoking.

“How do we cut the cost?” Joe Devlaeminck of the Association of Federal, State, County and Municipal Employees Local 307CO said last week. “Don’t take it out of workers’ hide.”

Health bills have soared at private firms, too — a big reason, economists say, why U.S. wages have barely moved in the last decade.

But for Clark County and local governments across the country, health bills and other benefits have soared faster and higher. In 2008, real benefit costs per full-time county position averaged $20,701, up 59 percent since 2001.

County managers and business interests both say the rising cost of employing a public worker is putting public safety and other services on the line.

The county and its deputies’ union have spent the winter negotiating over how benefit cuts or wage freezes might keep seven deputies on the street. But that’s just one of dozens of cuts around the county that wouldn’t be needed if health costs were rising less.

Some say it’s time for Clark County to stop covering its workers’ full health premiums. Others reply that workers have been making sacrifices for years to prevent that day from coming.

“It’s down the road,” said Mary Malicki, a supervisor in the sheriff’s office support branch and the president of her bargaining unit. “Everybody knows that.”

Workers feel pain

Clark County’s managers and workers say that to avoid employee-paid premiums, they’ve been hiking co-pays and deductibles — even though the new, higher fees might seem low to many private-sector workers.

When Malicki came to the county 19 years ago, she said, the co-pay for a doctor’s visit was $5 or $10. By 2007, it was $15.

Lots of such fees have gone up. It’s put the brunt on employees with the most health trouble.

“People who need health care a lot end up paying a ton of co-pays,” Deputy County Administrator Glenn Olson said.

Malicki, the sheriff’s office worker, says it’s a good system, because it gives people a reason to hit the brakes on their own costs.

That’s more than insurance companies seem to be doing, she said.

“Prevention hasn’t been high on the insurance companies’ list,” Malicki said. “We all know that obesity rates are rising in the United States, but there are no remedies. … If the insurance companies spent more attention and dollars on prevention, health care costs could probably go down.”

Services at risk?

Some say the problem is simple: public-sector workers are overcompensated.

“The days of the lowly paid public servant, I think, are past,” said Paul Guppy, research director of the business-funded Washington Policy Institute, a free-market think tank. “If you have a job, I think, in the public sector, you’re probably being paid pretty well, and I bet that you have excellent benefits.”

But even Guppy concedes that thanks to Washington’s property tax caps, local government budgets have been shrinking relative to the people they serve.

“The economy has certainly grown faster than the tax burden,” he said.

More expenses per government employee, less government money per resident — what’s it add up to?

Without wage or benefit cuts, Guppy said, public services are likely to suffer.

Devlaeminck, the local union representative, disagrees with Guppy that public sector workers are overpaid.

In general, he said, public workers do get better benefits. But they get worse wages.

“When we do salaries comparisons with private industry, we turn around and subtract 5 percent,” he said. “So all of our government salaries are 5 percent lower than private sector, with the idea that benefits will make up the difference.”

And in the end, Devlaeminck said, public services would also suffer if workers’ benefits are cut.

“If you take away the benefits,” he said, “you’re not going to have quality, capable people to run government.”

Michael Andersen: 360-735-4508 or michael.andersen@columbian.com.