For the last four decades, Tom Tomczyk's part-time job as a college football referee has meant he's on the road almost every weekend from late August until early December. If he's assigned to a bowl game, he might be away during the holidays as well.

On Friday afternoons during football season, he travels to the site of a Big East conference game, officiates on Saturday and returns home late that night or Sunday.

Monday morning he's still making calls, but this time at his job Downtown as a consultant who offers advice to businesses about employee benefits.

Mr. Tomczyk got his start in health care at Blue Cross of Western Pennsylvania where he spent 15 years becoming an expert in helping businesses select employee insurance packages. He then worked for 20 years at Mercer Consulting before leaving last month to join the Pittsburgh office of Buck Consultants, a New York-based firm with 90 employees here and clients including H.J. Heinz Co., Alcoa and Westinghouse Electric.

His career as a referee goes back even further. He loved sports as a boy growing up in Mt. Lebanon but could only play one -- basketball -- while earning a math degree at Westminster College.

To earn pocket money in the fall before the basketball season started, he officiated grade school and high school football games and stayed with it as a weekend job while he launched a professional career. He started officiating Division I football in 1985 and joined the Big East when that conference was created in 1991.

During an interview last week at his office on the 29th floor of BNY Mellon Center, Mr. Tomczyk had lots to say about the federal government's health-care reform proposals but little to say about the outcome of the University of Pittsburgh-West Virginia University Backyard Brawl rivalry that was set to be played Friday night. "I wish them well. I've worked that game a number of times."

Q: Much of your early career was spent as an actuary. What exactly does an actuary do?

A: We're involved in a number of different jobs for the government, insurance companies, consulting firms and large corporations. There are two sides to the actuarial field: employee benefits; and property/casualty, which includes worker's compensation, home and auto insurance.

When I started at Blue Cross, I chose benefits. The job itself is essentially trying to figure out the best way for my clients to spend their health-care dollars. It requires a lot of analysis, a lot of projections. It's extremely complicated. Our clients look to us and say, "Am I doing the right thing with my health-care dollars? Should I provide this plan or that plan? How can I get the most benefits to my employees with the budget I have this year or next year or the next three to five years? How do I stay in business and still offer health care?"

Q: So obviously you're watching closely to see if the government comes up with a health-care reform package. Who is getting hit harder right now -- large or small companies?

A:I think all of them are facing the issue, "How do I continue to be able to afford to offer benefits to my employees?" They differ by their ability to pay for that and the cash they have to pay for that. Obviously, for the small employer the cash flow at times is limited and so their biggest expense is usually health care. Everybody's solution has been let's just pass more on to the employees. A lot of large employers are even struggling with that. You have an employee making $50,000 or $70,000 a year and if they've got to pay $400 or $500 a month for family coverage, that's a big chunk out of their take-home pay. Do they buy the coat they really need that month for their child or do they struggle to pay for health care?

Q: What is your take on the federal government's reform proposals?

A:In reading both the Senate's and House of Representatives' versions, I don't see them getting at the root of the problem, which is controlling health-care costs.

President Obama's mantra was that we are going to bend the curve. I think he's going to bend it in the wrong direction. There are so many unanswered questions. From an employer's standpoint, it may be better if they get out of the game altogether. For some employers, it may be what they're looking for. For some employers who get out of offering health care and let their employees enroll in some type of exchange, the employees won't be eligible for a subsidy [because they'll earn too much] ... and they'll be left to pay for all of their health care on their own.

Q: Is there anything the federal government could do effectively?

A:Health-care reform doesn't seem to be addressing the waste we have in the system and the quality of care we have today. I think if the federal government really wanted to play an extensive role, it could collect data from the providers. There is some legislation for a national clearinghouse, but I don't know what's going to come of that.

It doesn't have to be done by the federal government: set up a non-profit organization so there's no issue of whether the government is trying to gerrymander the data to foster its agenda. That could address the quality of care issue.

Another area is malpractice insurance. As long as somebody has this huge possibility of malpractice hanging over their head, they'll do whatever they can to avoid it. Those types of burdens really have an impact on the ability to deliver quality health care.

And I think the reimbursement system is one where the federal government could do something. You get paid for the more that you do -- a physician or a hospital. A lot of it is a result of the patient who walks in the door and says, "I want an MRI." The doctor says we could an X-ray and the patient says, "No. I want an MRI." The doctor will eventually order an MRI.

Q: Do you think the reform bill will pass?

A:Back in March I was asked if we were going to have health -care reform passed this year, and my answer was no and I still think the answer is no. I think there's going to be debate in the Senate just like there was in the House, and I think there may be tougher debate. What would worry me is if it does [pass]. I would be worried they didn't put enough thought into it just to get it passed. It seems more about politics than policy and that really scares me.

Q: When you entered this field in the 1970s did you ever imagine health care would become such a hotly debated political issue?

A:Health care has been a political issue since the 1930s. When I got into it in the 1970s, there was a big push for national health insurance. At Blue Cross we were trying to figure out what it would do to the carriers. There were months and months of meetings then it went away.

Then in the 1990s, President Clinton brought it up. Here we are at the end of the first decade of the 2000s and we're dealing with the same issue. I think this is the closest we've ever come to it. And I think something going to be passed. And I think the employers will be shocked with the impact on some of them.

Q: What games stand out in your career on the football field?

A:Notre Dame vs. Penn State in South Bend, Ind., in 1986. That was the year Penn State ended up being the national champion, and it was Lou Holtz's first year as coach at Notre Dame. Penn State won the game. Notre Dame had the ball, and the tight end dropped a pass in the end zone, which would've won the game for them. It was really exciting. It was not the national championship game, but it could have been.

Q: Is officiating a tougher job since you started?

A:Instant replay came in and answered or dealt with some issues and concerns of coaches. But it opened up other issues. Now coaches are questioning whether the replay is getting it right. College football has become such a big enterprise and there's so much at stake: coaches' jobs, big paydays if you're in a Bowl Championship Series game.

A lot of times I don't blame the coaches. They get paid a lot of money, and they're expected to win; if they feel we somehow missed something, they let you know and rightfully so. But I still enjoy it. I think the challenge is part of what you go out there and try to deal with every Saturday. Are you really that good that you get it right every time? You can't. I just hope I don't get it wrong in the last two minutes of a nationally televised game.

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