Dan's Papers -January 22, 2009 -

I read in the paper the other day that during the month of December in East Hampton, there was a huge surge of medical claims filed by the people who work for that town. Normal claims were around $400,000 a month. For December, the amount of the claims was more than double. Supervisor Bill McGintee, who has been supervisor for the last five years, was baffled.

"It is an enormous anomaly," he said. "I just want to figure out why this happened."

As a result of this, people might be fired, he said. He asked that the Town look into who was close to retirement and who was working overtime. This was a disaster, this sudden increase in claims. If this one-month surge continued, it could truly foul up the attempts to balance the budget for 2009.

I have thought about this. I think the surge happened for only one of two possible reasons. And I don't understand why McGintee didn't notice which one it was. He works in the building every day.

The first reason would be that there was a huge epidemic at Town Hall, with people collapsing and being rushed to the hospital by ambulance. It could have happened. I was around years ago when a whole hotel full of American Legion members having a convention in Philadelphia got sick one day and had to be hauled to the hospital. The doctors were baffled. But it was a pretty dramatic event. When they finally tracked down the bug that caused it, they named it Legionnaire's Disease. You have to be careful not to get it today.

Come to think of it, I recall that it was pretty dicey getting anything done at Town Hall in December. I called there several times. People were out sick. I could hear ambulance sirens in the background. Sounded like something was going on. Surely, McGintee would have noticed all that though.

The second possible reason is that on January 1, the Town allowed Blue Cross Blue Shield to take over the medical plan being offered to its employees. They did this because it was a delight to work at the Town. Because a few years before McGintee came into office, the Town decided to abandon its national insurance carrier and instead handle the medical insurance itself. There was a local fella who did it. The company was called Group Administration. If somebody got sick or needed a prescription, they went to the doctor or the drug store and did that and sent it in to Group Administration, who paid it, then marked up the bill a bit so they could make a profit, added it all up at the end of the year and that was the Town's insurance bill. It was a staggering $9 million in 2007, but until the budget crunch came along, the Town figured its employees deserved it, and surely they did. Oh, there were deductibles, of course, and there were co-pays and employee contributions and things the insurance wouldn't pay, but it was so much better than, say, Aetna or Blue Cross.

Well, in September, with the budget in East Hampton way out of whack, this insurance plan had to go. Instead, the Town would abandon this plan, and replace it with a lesser plan to be provided by Empire Blue Cross. The start day would be January 1, 2009. And the cost would be $7 million, a savings of $2 million.

So, I figured that either everybody working for the Town went out and got operations they'd needed between September and December 31, or they'd stocked up on prescription pills for the next six months, or they'd go to every doctor to take care of every ache and pain they'd been putting off, which sure would, for one month, drive insurance claims through the roof. Considering how long it takes to get a doctor's appointment, all this would have come down with a crash in December. McGintee might have done that too. He's a Town employee and he knows about the change in insurance.

So it was either the insurance changeover or Legionnaire's Disease.

I drove down there at high speed. I feared the worst. Ambulances, SWAT teams, mobile medical units, maybe a few MASH surgery units set up in tents on the front lawn with Alan Alda, who lives in Mecox, helping out inside. But no.

So it had to be the insurance switchover. There, Mr. McGintee, do not fear. It was a one-time thing. It will not be repeated in January. And I am here to report that you probably have the most shined up, healthiest, happiest and finest staff of Town employees full of bounce imaginable.