For retired Columbia police officer Joseph Ballentine, the assurance of free health care for life helped make up for the years of low-paying, body-beating work protecting the public.
Years after he joined the force in 1979, things changed and the health care wasn't free anymore. But it was still better than the benefits Ballentine and his first responder peers could find at many other agencies.
Now, things are about to change again, possibly drastically for some Columbia employees and retirees. And people who have given the better part of their lives to serve and protect the city are worried they'll be left with big insurance burdens in return.
"We took low pay for years and years and years, thinking we had this big benefit at the end, and now here's nothing when you're sick and you're starting to worry," said Ballentine, who retired in 2002 after more than two decades of service.
The rising cost of American health care is forcing Columbia leaders to make difficult decisions in coming weeks that will change the benefits plans that cover more than 5,000 employees, retirees, their spouses and dependents.
City leaders say if they don't make cost-saving changes now, health care costs eventually could rise to the point where the city couldn't afford to provide basic public services.
"This is an exercise in pure sustainability," Mayor Steve Benjamin said at a recent City Council work session. "If we could have universal coverage for everybody within our reach ... we'd do that. It's not sustainable."
Local governments everywhere — as well as businesses — are dealing with the same problem of rising health care costs. Most South Carolina cities participate in the state health insurance plan or another group plan — unlike Columbia, which is self-insured and pays all its own claims, as do a few other S.C. cities.
"These increases in health insurance premium rates and retirement costs are significant ... and there's no one answer to funding those increases" said Jeff Shacker, a field services manager for the S.C. Municipal Association. "To be competitive in the labor market, these benefits are necessary to recruit and retain quality employees. And quality employees are needed if you're going to provide quality public services."
Columbia leaders have yet to settle on exactly how to change the city's benefits plans, but some of the options being considered include:
▪ Increasing the amount employees will pay in premiums, deductibles and co-pays.
▪ Doubling the extra charge for tobacco users to $100 a month.
▪ Charging extra for employees' spouses who have other credible coverage, such as through their own employers, available to them.
▪ Setting a minimum eligibility age, possibly 50 or 55, for a retiring employee to able to receive continuous health care coverage.
The city also is weighing a number of options for retirees' coverage, including whether to set up health reimbursement accounts, whether to continue or adjust coverage of spouses and whether to hire a health care navigator to help retirees find options on the private insurance market. But the council has expressed an unwillingness to eliminate health benefits altogether for retired employees.
For some employees and retirees, the proposed changes might have relatively minor impacts.
But for Ballentine, a change in health insurance could mean choosing between critical medical treatments for himself or for his wife, he says. Both have serious health conditions that require ongoing treatment.
"I'm not going to let her die," Ballentine said.
On his $2,300 monthly retirement income, Ballentine worries he won't be able to afford the cost of premiums and other expenses on the private insurance market to cover both him and his wife. If he has to choose, he'll forgo his own lifesaving medications, he said.
"It's just a hard pill to swallow," Ballentine said.
Besides his own health care, Ballentine is concerned for the city's current first responders. If benefits decline, he believes many of them might leave the city to join other agencies. And, he said, weaker benefits could hurt recruitment of future employees.
Some first responders already are considering other employment options, depending on their benefits, said Jacob Eller, president of the Columbia chapter of the International Association of Firefighters.
He started working around age 20 as a volunteer firefighter in Beaufort. He's worked for 17 years now, including more than a decade in Columbia and Richland County.
"It was always told to me since I was a rookie firefighter, from my peers, that I would never be rich being a fireman, but I would be taken care of. I would have good benefits, and we would be taken care of," Eller said. "I love my job, and I love this career. And I'm going to be doing it until I can't physically do it anymore."
Eller said he understands the city's cost and difficult decisions leaders face, but he's worried about his fellow firefighters — many of whom experience serious injuries and health complications from their jobs — and their families.
"I've gone this long without any major debilitating injuries, but there's several people I've come across who can't say the same," Eller said. "That's what bothers me the most. ... What happens to me doesn't bother me as much as seeing one of my peers, seeing someone in trouble.
"I know that changes have to be made," he said. "But we have to work together on all of our options and find that middle ground that people can afford."