Maggi Cook

Maggi Cook is a Green Township resident.

The dispute between Rachel Dovel and her employer, the Public Library of Cincinnati and Hamilton County, is not a political one but an economic one.

Dovel asked the library board to change its insurance policy, apparently in the middle of a plan year, to cover surgery that she wanted to schedule. Insurance costs, under the best of circumstances, are a significant of any organization’s budget and a line item that all organizations closely manage. It’s not unusual that surgery which could be considered elective is not covered by an employer provided insurance policy.

A friend lost nearly 250 pounds over the course of two years through hard work and a radically changed lifestyle. One consequence of the weight loss was extra skin that needed to be surgically removed. His employer provided medical insurance did not cover the surgery. Like Dovel, his body was “not lined up with his head” and “caused depression.” My friend used crowd funding to pay for the nearly $20,000 surgery.

Several years ago a co-worker elected to have a double mastectomy due to her family’s medical history. A few months later she had reconstructive surgery that was considered by her insurance carrier to be not medically necessary. For her it was necessary, and she made the financial commitment have the surgery. Dovel’s situation is not as unusual as she might think.

The library board certainly has a duty to provide the best possible benefits to its employees, including comprehensive medical coverage. But the board has an equal duty to use its limited financial resources, which are provided by tax money collected from Hamilton County taxpayers, in the best and most efficient manner possible. Changing the terms and conditions of an insurance contract in the middle of the contract year is neither efficient, likely nor affordable, and certainly not the best use of the library’s limited resources.

If there is a conservative point of view on the human resource issue, it is to ask what is the best and most equitable use of limited public funds. At my day job we manage ACA compliance, changes to overtime-eligible employees' pay scale imposed by the Department of Labor and negotiations with insurance carriers. Insurance is expensive. However much we want to offer Mercedes-level coverage to our employees, the budget says Kia. I imagine the members of the library board have the same concerns. Fiscal responsibility is the conservative position.