Saving on healthcare

Employers are coming to the bargaining table insisting that workers shoulder the soaring costs of healthcare and insurance. What's a union to do? Here are some of the suggestions the AFT research department gives to locals seeking alternatives to premium hikes.

• Audit all plans for eligibility, coverage and claims payments to make sure you are only paying for contracted items and covered beneficiaries.

• Institute disease management programs for pregnancy, heart attacks, stroke, substance abuse and auto accidents to provide patients with alternatives to long-term in-patient care.

• Consolidate all health plan options (e.g., PPO, HMO, Point-of-Service) with one carrier.

• Pay people to select the low-cost plan. Monitor it to ensure for quality, access and service.

• Discourage double dipping--i.e., your members' dependents choosing to opt out of their own employers' health plans and using yours instead. Reserve the dependent coverage option for those who have no other source of insurance.

• Get prescription costs under control.

--Audit prescription plan and pinpoint problem areas. Make sure members understand why overall costs for the group are going up and tell them how to reduce their use.

--Seek prior authorization on specialty drugs and all drugs prescribed for children. Because pharmaceutical companies are marketing directly to consumers, more drug prescriptions are being written than may be necessary.

--Encourage use of generic drugs--especially for brands that go off patent.

--Don't allow prescription drug co-pays for any member who volunteers to participate in a disease management program.

• Take wellness programs seriously. Encourage members to get regular tests for glaucoma, high blood pressure, diabetes, colon cancer and so on. Of course they need to give up smoking, wear their seat belts and exercise, too!

• Employers use brokers to purchase insurance. Make sure the broker isn't paid through increases in members' premiums.