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JULY 2002 - Retirees Decry HMO Option - An attempt by the city of Worcester to drop Blue Cross / Blue Shield of Massachusetts has been defeated. This news marks a significant victory for retirees and active employees in Worcester.

This Association, along with the active employee unions within Worcester, vehemently opposed a move by the city to no longer offer coverage under BC/BS, thereby forcing retirees and active employees to join an HMO. At one point, the city reportedly considered offering Fallon Health Plan as the sole provider of health insurance.

"As soon as news got out as to what the city was considering, our phones never stopped ringing. Thankfully we had folks in Worcester, retirees and active employees, who refused to give in to the city's scare tactics," said Association Legislative Liaison Shawn Duhamel.

Those Worcester allies ranged from retirement board member and Executive Director Elizabeth Early, to the Mass Teachers Association, the International Brotherhood of Police and the Professional Firefighters of Massachusetts. However, it was Early who kept in constant contact with the Association.

"I can't say enough about the job Betsy Early did on this issue. She was our go-to person in Worcester throughout this ordeal," continued Duhamel. "Betsy was in this for the retirees. She knew what it would have meant to our members had they been forced into an HMO."

It was that fear of being "forced" into an HMO, that motivated members to lobby city hall. After receiving a letter from the Association in early April explaining the situation, hundreds of retirees contacted Worcester City Hall to decry the proposed change.

Cost Is Factor

Like many communities, Worcester is faced with escalating insurance costs. With the prior three-year contract with BC/BS set to expire July 1, Worcester placed the health insurance contracts out for bid late in 2001.

The original proposal submitted by the Blues increased the annual insurance cost by 43% over the previous year. This represents an increase of over $11 million dollars to the city.

With the threat of layoffs circulating, Worcester City Manager Thomas Hoover proposed reducing health care costs by not renewing the BC/BS contract. The city then began negotiations with Fallon, Harvard Pilgrim, and Tufts.

However, standing in the way of the city's plan were not only vocal retirees and employees, but also several collective bargaining agreements that mandate BC/BS insurance coverage. With Worcester firefighters refusing to open their contract and allow Blue Cross to be replaced, the city had to find other means to save money.

After intense negotiations with the IAC, city officials announced in early May that the contract with BC/BS would be extended for another year.

Members Speak Out

Here's what our members had to say about Fallon and their experiences with the provider.

Retired police custodian Roger Larochelle switched from Fallon to BC/BS in 2000. After having been enrolled in Fallon for much of his 23-year career, he began to feel mysteriously ill in the late 90s.

Despite his desire to "seek out a specialist," Fallon sent Larochelle from test to test within their own network, without arriving at a concrete diagnosis. When attention began to focus on his liver he was informed that if he required a transplant he would have to undergo the procedure, far away from his Auburn home, in either Cincinnati or Pittsburgh.

"I got fed up with Fallon and switched over to Blue Cross. There I could see any doctor I wanted and within months the problem was identified," recalls Larochelle. "I had a liver transplant on June 5, 2001. Not at some far away place either, but right here (Worcester) at U-Mass Memorial Hospital.

"I really believe that if I had stayed with Fallon, I would not be here today. It was not the doctors that were the problem...it was the system. They always seemed to be pressing the doctors to save money."

Marie Lanaua, who retired as the senior clerk in the city treasurer's office, also feels strongly about keeping BC/BS. "I would not go to Fallon even if it were free," states Lanaua. "They remind me of the cast of characters from the movie Blazing Saddles. I stand by Blue Cross 100%."

Disabled Worcester firefighter Pasquale Bisceglia, who retired in 1994 after breaking his back in a house fire, also expressed his great concerns over being forced into Fallon. Along with his back, Bisceglia, who has never smoked, is battling tongue cancer.

"I was not getting any better under the care I was receiving with Fallon. After several major surgeries, I demanded to see a specialist in Boston, but was denied," said Biscelglia. "I finally switched out of Fallon during the open enrollment in 2001. After joining BC/BS, I started seeing a cancer specialist at Dana Farber.

"I think I can speak for most retirees when I tell you that I do not want to be forced into an inferior health insurance plan, just so the city can save a few bucks. There may be budget problems right now, but what about my condition and the fact that I risked my life for the city. I'm sick because of the job I did. The least they can do is make sure we have the best care available...I do not think I am asking for too much."

Neither do we Pasquale.

 
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