Scottsdale employees face insurance hike - East Valley Tribune: News

Scottsdale employees face insurance hike

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Posted: Saturday, March 18, 2006 5:09 am

In the three years since Tom Houk’s wife felt a tumor snarled around her left shoulder, her body has been cut into, poisoned and burned to defeat the growth.

Houk, a Scottsdale police officer, has relied on his city health insurance to provide his wife specialists for what was diagnosed a desmoid tumor, a rare condition. “It’s like a nasty vine. It just grows and continues to grow, and whatever it touches it destroys,” he said.

But the level of health care the Houks — and many other Scottsdale employees — have become accustomed to might not be affordable come July.

The city is proposing dramatic increases in its employees’ health insurance premiums and out-of-pocket costs, some rising as much as 600 percent. With medical expenses spiking nationwide, Scottsdale is looking to lessen the burden from taxpayers and place it on those receiving the benefit, said Pat Dodds, a city spokesman.

The city’s insurance premiums have been the same for more than two years, he said.

“It’s a proven strategy in the health field that, in order to control medical costs, employees who participate more in those costs are going to help hold down costs,” Dodds said. “They make better choices.”

The City Council is to consider the proposal on Tuesday. Councilman Ron McCullagh has argued that employees should pick up more of the tab for Scottsdale’s health benefits, historically less expensive for employees than those in neighboring cities.

“Relative to the private sector, we have an extremely generous health plan,” he said.

Scottsdale finance officials project a $5.4 million jump in employee medical expenses next budget year, city records show. As a result, the cost of monthly insurance premiums for the vast majority of employees are slated to more than double.

However, the most significant changes would affect employees enrolled in MMSI Health Tradition plans, which include 27 percent of the city’s roughly 2,100 workers. These plans offer a network including Mayo Clinic physicians.

It is also Scottsdale’s most expensive plan, with the cost doubling from this budget year to $1,439 a month, records show. The city plans to pay $928 of the premium.

The city’s main insurance provider is Aetna.

Employees enrolled in the MMSI plan — commonly known as the Mayo plan — would go from paying $105 to $511 a month after July.

Scottsdale’s two police unions have bristled at the proposed cost increases and accuse the city of attempting to drive employees to the cheaper Aetna plans.

Employees who have health problems, or whose family members do, have often chosen Mayo over Aetna, said Chet Anderson, president of Scottsdale’s Fraternal Order of Police.

“Sometimes I think the city looks more at actual dollars and cents than actually looking at the bigger issues of why these things are going on,” Anderson said.

Once Houk’s wife was diagnosed with a desmoid tumor, the Mayo plan was the key to their finding a specialist. In the Valley, only two physicians had seen that type of growth, he said.

The first doctor did not accept private insurance, but the second — Dr. Christopher P. Beauchamp — is with the Mayo Clinic, Houk said. Beauchamp shepherded Houk’s wife through chemotherapy and radiation.

Ultimately, he said, she had to have the rotator cuff and deltoid muscles removed from her left shoulder. There remains a 40 percent chance the tumor will recur and the radiation treatments make it more likely she will develop breast cancer, he said.

Beauchamp and all of the benefits they now receive are not available under the Aetna plan, Houk said.

Should they switch plans, seeing Beauchamp could cost them as much as $20,000 — the proposed deductible under Aetna for out-of-network doctors.

“So what do you do? Do you take your chances and tell your wife, ‘If you get another tumor you’re basically dead?’ ” Houk said. “Or do you leave the city of Scottsdale?”

The $511 premiums are more than a fourth of Houk’s paycheck, he said.

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