Healthcare has been on a collision course nationwide. But in Colorado, the runaway train that let loose in 2001continues on its wayward path. According to the Colorado Department of Personnel, about 1,300 state employees did not re-enroll for continuing health coverage during open enrollment in October 2002. They likely joined the ranks of the 600,000 uninsured Coloradans.

Meanwhile, Gov. Bill Owens has stated that he wants to reform insurance and get rid of the mandates that are so costly. He wants Coloradans to purchase "Chevrolet" plans instead of "Cadillac" plans. We call it the "Yugo" plan--you go deal with your health on your own dime.

Like other public employees around the country who do not enjoy collective bargaining rights, Colorado state employees have had to absorb a huge portion of the premiums. The state pays up to 45 percent of the total cost of employees' insurance, which pales next to the 75 percent to 80 percent paid by other employers in the state. In 2002, employee premiums rose from 43 percent to 172 percent--the hikes largely determined by where the employee lives.

When our runaway train began speeding up, the Department of Personnel worked with the insurance carriers to "redesign" the plans in an attempt to bring down the employee's portion of the premium. Colorado's redesign, which was nothing more than cost shifting, sharply contrasts with solutions that have been implemented in states where public employees have collective bargaining rights. For example, when Indiana announced an enormous jump in the employee cost for healthcare, Unity Team president Fuzz LeMay negotiated a $1,092 annual pay increase to offset the rise in premiums.

Under Colorado's redesign, however, premiums were reduced insignificantly, while co-payments, co-insurance and deductibles were doubled or more. Hospital admission costs became obscene. Kaiser Permanente increased hospital admission costs from $100 to $1,000. Other carriers went as high as $3,000.

In 2003, our state's answer to the crisis is legislation that would meld three appropriation bills into a "total compensation" bill that would fund salary survey increases, health insurance benefits and pay-for-performance awards. Under the proposal, the director of personnel would have sole authority for deciding how to divide the single appropriation.

Colorado Federation of Public Employees leadership has met with the director of personnel to discuss our concerns with the total compensation plan, including the problems it raises with continuance of paying prevailing wages. We also will be meeting with the sponsor of the legislation to express our concerns.

Meanwhile, the CFPE is researching ways to lower the cost of prescription drugs. Because none of our carriers is strong enough to negotiate good purchasing plans, one option to reduce costs would be creation of a single purchasing pool for state employees. Another solution would be formation of a coalition with other states to purchase prescription drugs for Medicaid recipients and state employees through a pharmacy benefits management company. This has been done in the Northeast where Vermont, New Hampshire and Maine initially formed the Northern New England Tri-State Coalition. Now these states are joining Massachusetts, Connecticut, Rhode Island, Pennsylvania, Hawaii, New York and the District of Columbia to form an even larger coalition. West Virginia--a member of a purchasing coalition with Louisiana, Mississippi, Missouri, New Mexico and South Carolina-- expects to save $25 million over the next three years in purchasing for its public employees alone.

For the problem to be resolved, elected officials at all levels of government must address the healthcare crisis. It is, after all, a universal need and a national necessity if we want to continue to provide quality government services to the public.