It’s a good bet that if Columbia City Council had the power to reform the U.S. health care system the challenge of doing so, albeit herculean, would be accomplished.

True, given the council’s record on spending, homelessness and other issues, the end result of the seven-member elected body retooling health care could be worse than the current system.

Still, one word would make reform probable — money.

The city doesn’t have any, extra at least. And runaway health care costs are hammering the city’s budget.

BlueCross BlueShield of South Carolina administers Columbia’s health insurance for about 2,150 employees and some 550 retirees of the city.

As it stands, they pay nothing for it except for co-payments and coverage for their dependents. But that seems likely to change based on the prevailing sentiment among council members.

Famous, or infamous depending on one’s perspective, for tasking staff with “finding” dollars for one pet project or another, City Council is facing what it is generally averse to doing — making difficult decisions — because of the escalating health care costs.

They rise every year and will reach unsustainable levels if not addressed, city officials say. It is the same exacting dynamic confronting many if not most American companies and their workers.

Likewise, city employees are in line for a fate similar to that which their private-sector counterparts have been dealing with for years: paying more for health care and getting less of it.

That’s how Councilman Kirkman Finlay described the inevitable bottom-line outcome of an in-the-works overhaul of city health and dental insurance benefits.

Finlay offered his assessment during an Oct. 29 meeting in which the council discussed options for stabilizing and cutting costs.

The city paid $9,500 to Towers Perrin, a global professional services consulting firm with offices in Charlotte and Atlanta, to assess Columbia’s health care offerings. Jo Stewart, a principal with Towers Perrin, led the council through the nearly two-hour discussion.

The city is working up a contract with Towers Perrin for the company to finish the job of helping the local government reconfigure its benefits to make them more cost effective.
Missy Caughman, the city’s budget director and interim finance chief, declined to say how much the contract might cost.

The city’s projected health care expenses in the current fiscal year will near $19 million, Caughman says.

To save money long term, the city is looking to wellness opportunities for its employees. “I think we have the beginnings of a comprehensive program,” said Allison Baker, an assistant city manager.

Short term, council members expressed a consensus desire to begin making changes as early as January, with full implementation coinciding with the start of the 2009-2010 budget year July 1.

Council members similarly agreed on some guiding principles for the overhaul. They ranked curbing costs first but also emphasized a choice of benefits plans, equal quality of care, employees contributing based on their pay, covering child dependents and stressing prevention tied to incentives and penalties.

Stewart said Towers Perrin plans to present its recommendations to the council at its final meeting of the year in December. — EW

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