By Alexander Vazquez, on June 17, 2015

A couple weeks ago, as I walked back to my office from a meeting, I saw 50 plus people wearing “Made in Durham” t-shirts assembled in the City’s committee conference room. Needless to say, this caught my attention. When I asked a fellow staff member what was going on, she gave me the inside scoop on the situation: Durham was considering switching health insurance providers – from Blue Cross Blue Shield (BCBS) to Aetna – and the people with the “Made in Durham” t-shirts were BCBS employees looking to sway councilmembers’ decision on the matter. As my colleague mentioned, the stakes were high – the insurance provider the council decided to move forward with was going to receive a contract worth millions of dollars.

Over the next two weeks, I attended three meetings where the BCBS and Aetna proposals were discussed in detail. The major pros and cons noted regarding the BCBS proposal were the following:

• PROS: BCBS has a long-standing relationship with Durham. The company employs about 1,300 Durham residents and will be moving their headquarters from Chapel Hill to Durham early next year. BCBS has a large philanthropic footprint in Durham.
• CONS: BCBS made numerous revisions to their proposal, which seemed unprofessional to several councilmembers. The proposed savings were lower than that of Aetna, even after “unprecedented” guarantees (i.e., BCBS promised to pay the City for not reaching certain goals). BCBS failed to disclose details about their network.

The major pros and cons discussed regarding Aetna’s proposal were the following

• PROS: Aetna’s proposal never changed throughout the bidding process. Aetna offered a larger network, which would be supported by the Duke University Health system. The overall savings, over three years, would be worth over $7.5 million.
• CONS: Aetna is based out of Connecticut. A couple councilmembers were worried about Aetna’s history (i.e., in the mid 1800’s, Aetna issued life insurance policies to slave owners that covered their slaves). Moving employees to Aetna would take time and money.

In weighing these pros and cons, the Human Resources and Finance departments made the recommendation to move forward with Aetna. According to them, the overall savings and the non-monetary qualities of Aetna’s plan were better than those offered by BCBS.

However, in a split (4-3) vote, the Council decided to move forward with BCBS. I was perplexed by their decision. Staff had spent months figuring out the best option for the City and the extra $700,000 in savings the Aetna plan promised seemed like a good chunk of change, yet the council members decided to move in a direction different from what staff recommended. As I sat in the committee conference room, I expected to see signs of frustration on staff members’ faces, as their recommendation was ignored. Instead, I saw elation on their faces. This too confused me.

As I reflected on what had just occurred, I remembered that a staff member’s role is to provide elected officials the most objective recommendation possible. How elected officials choose to use staff members’ recommendations is out of their control and in no way an indictment on the quality of their work. The elation I saw on staff members’ faces stemmed from the fact that, after months of working with multiple providers, they could begin hashing out contract details with the winning provider, bringing them one step closer to completing their work on this project.

When I graduate and begin working in local government, I will make sure to recall this experience. Not all decisions can be based on a dollar-to-dollar comparison. Sometimes, decisions are primed to be made solely based on politics, as was the case with the decision to move forward with BCBS.

In the next post, you can expect a recap of the four ride-alongs I’ve done in the last couple weeks! Until then…

Innovation in Durham Number 2

The City of Durham has developed a website called Neighborhood Compass that integrates local public records with other data sources, such as the US Census and American Community Survey, to allow “all local stakeholders to track quality of life and provision of services throughout Durham.” Specifically, through a very user-friendly interface, website visitors can currently access about 50 demographic, infrastructure, economic, housing, environmental, and safety dimensions. Users are can also create reports and/or download data using the website. With this amount of information and these capabilities, many would call the development of Neighborhood Compass a success. However, the current state of Neighborhood Compass is just the tip of the iceberg. The City has plans to add even more dimensions and to translate the website material in Spanish. I’m eager to see what comes next!