A Chevy or a Cadillac?
Despite the political optimism, small business owners in the valley say providing health insurance – while critical to keeping top-caliber employees – remains tough financially.
Mark Weinreich, co-owner of Venture Sports in Avon, says health insurance can be crucial in the mountains, where folks spend a lot of time skiing, mountain-biking and doing other potentially dangerous sports.
“We live in a high-risk environment with the sports we do,” Weinreich says. “Certainly an ACL or a fall off mountain bike can be catastrophic if you don’t have health insurance.”
Weinreich says retail shops with just one location, like Venture Sports, don’t typically offer their employees health insurance. Weinreich does, however, in an effort to keep from losing his best employees to larger companies with more resources, such as Vail Resorts. That competition, however, also means Venture Sports can’t skimp on salaries when providing health insurance, either, Weinreich says.
“We want to keep high-caliber people around,” he says. “Even for a healthy young man – we employee a lot of young guys who are 20- to 35-years-old – it’s more than $200 bucks a month and we absorb 50 percent of that. It’s tough for the employee and the employers.”
Local insurance providers, like Michael Neff at American Family Insurance in Eagle-Vail, also say health insurance is a financial dilemma for many in the valley.
“They cannot afford what they need to have,” Neff says. “The biggest problem is people don’t understand health insurance and people who are selling them health insurance are just selling them health insurance – not educating them.”
Neff says he’s worked with people in the valley who’ve bought the cheapest policy they can find and realize later the nearest doctor they can see is in Canon City.
“When somebody’s making a premiums lower, that company is also dramatically restricting coverage, dramatically restricting what doctors you can use and more than likely making it difficult to even use the policy,” Neff says.
The key to fixing health insurance, says Eagle County’s representative in the state Senate, is to get rid of the some of the rules and regulations that dictate the type of plans employers have to offer.
These rules and regulations are called “mandates,” says state Sen. Jack Taylor, R-Steamboat Springs.
“Men are covered for pregnancy and women are covered for prostate tests,” says. “Tell me where that makes sense. There will be an effort cut the mandates.”
State Rep. Carl Miller, D-Leadville, whose 56th District now includes Eagle, Lake and Summit Counties, blames lawmakers for passing many of these mandates into law.
These mandates are responsible for both high costs and the inflexibility of the plans employers can provide, Miller says.
“It’s been a real burden on employers,” Miller says. “Business people want to take care of their employees, they want to offer health insurance – but it gets cost prohibitive.
“I think we’ll make some major steps,” he adds.
Freedom and flexibilty
Taylor says the mandates began as good intentions to expand coverage. The result, however, has been giving people what they don’t want or need. A comparison many have made is that mandates force people to drive Cadillacs when all they need to get around is a Chevy.
“The mandates, they’re warm and fuzzy things when they come through here, whether it’s mandatory mammography or prostate tests,” he says. “But they require a Cadillac policy instead of a Chevy policy. You can’t pick and choose the things you want, whether you employer is paying for it or you’re paying for it.”
A goal, therefore, is to provide health plans that allow working people to only pay for the type of coverage they want, Miller says.
“We’ve got make it more accessible and more affordable and I think there will be a sincere effort to do that this year,” Miller says. “But we need to have cafeteria plan so people have a choice of the coverage they want.”
“We clearly need to get it down to where more people can get covered,” Taylor says. “I get calls all the time from people saying, “My insurance has gone up 30 percent this year and it went up 40 percent last year.'”
Meanwhile, says Neff, people looking for better health insurance coverage shouldn’t be scared off by high deductibles. A deductible is how much a person must pay before the insurance policy kicks in. Neff says many people wrongly think high deductible means they won’t get covered if they’re injured or get sick.
In truth, while a person with a high deductible will wind up paying for cheaper treatment – say for an ear infection – they will be covered for a serious, costly injuries, such as blowing out a knee.
“A high deductible means paying for medical care as you need it, but you’re protected from something that costs $25,000, $30,000,” Neff says.
Weinreich says medical costs are sometimes the most onerous for middle-class workers like his employees. People in such a salary range are neither wealthy enough not to worry about medical expenses nor poor enough to qualify to public assistance.
“The middle class is getting the shaft,” Weinreich says.
Matt Zalaznick can be reached at 949-0555, ext. 606, or via e-mail at firstname.lastname@example.org.
Editor’s note: This is the second part of a five-part series examining issues affecting residents of the Vail Valley that are being considered in the 2003 Colorado Legislature this year.
With a pitched battle brewing in the state legislature over his signature “public option” health insurance bill (HB19-1004) from last session, state Rep. Dylan Roberts, D-Avon, is urging calm before the coming storm.