My parents, still residents of the great Commonwealth of Massachusetts, are consistent kvetchers about their ever-expanding property tax burden; money required to pay for brilliant boondoggles like the Big Dig, state employees receiving payment for unused sick days, rising public sector pay and unsustainable municipal health care costs. An investigation by The Boston Globe found that "that municipal health plans, which cover employees, retirees, and elected officials, provide benefit levels largely unheard of in the private sector." A (longish) sample of their findings:
Copays are much lower. Some communities do not force retirees onto Medicare at age 65. Many citizens on elected boards—some after serving as few as six years—receive coverage for life, too.
As medical costs across the board rose over the past decade, municipal health care expenses exploded, draining local budgets and forcing major cuts in services, higher property tax bills, and billions in new debt.
"It has got to be dealt with," said Richard Fortucci , the chief financial officer in Lynn. "Or we will all go bankrupt."
The cost of municipal health care more than doubled from fiscal 2001 to 2008, adding more than $1 billion in all to city and town budgets, according to state Department of Revenue data. A Globe survey of 25 communities found that they now devote, on average, 14 percent of their budgets to health care, up from 8 percent a decade ago. Somerville, for one, spends $20 million more annually than it did 10 years ago, now devoting almost 20 percent of its budget to health care.
So far, with powerful labor unions resistant to giving away hard-won benefits and a lack of political will in the state Legislature to force changes, efforts to overhaul the system have fallen short.
To be sure, many municipal employees, elected officials, and retirees are paying a greater percentage of their health premiums than ever. Still, almost all of the increase in municipal health care costs in the past 10 years has been shouldered by taxpayers, who are subsidizing plans that are often superior to their own.
"It's a nice deal," said Debski, now a part-time planner in Malden.
She could get insurance through her husband's employer but doesn't, for a simple reason: The municipal plan is far more generous and costs less….
The consequences of failing to face this crisis are on display in many cities and towns, nowhere more vividly than in Lawrence.
In that city, on Feb. 1, children were momentarily trapped in a burning apartment building, down the street from a fire station. But the city had recently shuttered the station, to help close a $24 million budget gap, and firefighters had to race from another location. The children escaped, but the fire chief warned the city it may not be so lucky next time.
Meanwhile, Lawrence, one of the poorest municipalities in Massachusetts, continues to pay among the highest rates in the state for health care benefits. The city's health care kitty, which it uses to pay for coverage, is currently $4 million in the red.
Health care costs are not the only budget-buster for cities and towns, of course, but their rise has led not just to fewer firefighters in Lawrence but diminished services across the state.
Library hours have been cut in Wayland and Hull. Wakefield has deferred road and sidewalk repairs. Malden has introduced fees for trash pickup. Class sizes have increased in Chelsea. Major layoffs have hit, among others, Boston, New Bedford, Worcester, and Brockton—with officials in all those communities citing rising health care costs as a major factor. Revere last year closed City Hall on Fridays, to save cash.
"What am I going to do next, put a padlock on the police station and tell people to call the State Police instead?" asked Mayor Thomas G. Ambrosino of Revere, who, like other mayors, is covered by municipal insurance.