Randi Weingarten on Medicare for All and a Rebuttal

Abigail Shure, Ed Notes' Newark correspondent sends me Randi-isms. Randi justifies the union stance against the elimination of private insurance in Politico. Sometimes I wonder if unions are getting a slice of the action to keep them from going off the rails by calling for the end of for profit health insurance.

 

The false choice over “Medicare for All”

We can have both private health insurance and an expanded role for government.... https://www.politico.com/agenda/story/2019/09/23/medicare-for-all-000977

That our unions are supporting private health care companies and their profits as a better alternative is disconcerting. I believe it is Randi and the unions presenting a false choice. That somehow our medical plans are being taken away. In fact everyone who turns 65 has their medical plans taken away, mine 9 years ago. I haven't pined for my old UFT plan yet, though I do pay for the UFT supplemental plan.

I sent Randi's comments to a retired NYC teacher (who was a core ICEUFTer) who has focused her retirement on assisting people in health care choices and here is her very quick take on Randi's comments with more to come. She is very attuned to what is going on and raises issues of Warren beginning to make some compromises. I have no proof yet about Warren changing on medicare for all.

First - "people who like their current employer-based plan—which 7 in 10 Americans claim to (although it’s likely they like their doctor, not the plan itself"    ...  this is really true.  People think they like their plan, but they really like their doctors and hospitals.  Most people, instead, gripe consistently about the hoops they have to go through with their plans.  They hate their copays.  They hate their huge deductibles.  The only time they reach a true comfort zone with their plan is when they get a very expensive operation or hospital stay, when the contrast is so very obvious what they DO pay and what they WOULD HAVE HAD to pay if they didn't have a plan.

Second.   Here's the crux of Randi's waffling.."But easing the stranglehold private insurance companies have on the market and preserving the option for employers and unions to continue to innovate in health care is critically important, and there is support for public and private options to coexist. Unions can actually help navigate the transition to a health care system that works for more people, and we can help hold employers accountable for working with providers and employees to find cost savings without diminishing benefits."

     Easing the stranglehold -- Warren, Sanders and Medicare for All want to eliminate it, not ease it.

       "Preserve the option to innovate"....  Bernie and Medicare don't  want the option to innovate or play footsie with corporations.  They want corporations out of the picture.  Warren, I heard, is equivocating on this  now, trying to get the Dem leadership to swing her way with a more centrist stance.

       "support for private and public to coexist"... some people DO want to pay for a private plan outside gov. plans in England, Canada, etc.  My friends there sometimes have private plans on top of their govt insurance to help with wait times, etc.   But it is not as far as I know a competing system. It's more like a frill, if you have the money.  They can still walk into a doctor for normal things when they want to.

       "health plan that works for more people"....   Ay, there's the rub.  "More" people is not all people.   She is sugarcoating the union role in helping to"navigate" a "transition" -- but only to MORE people.  Not universal.   Not Bernie, not Medicare for All.   Warren, who is veering off the hard tack at this point,  I think might be starting to channel union-speak more than true Med for All advocates want her to.

She takes a strong position in favor of medicare for all with the elimination of private for profit insurance companies. Every dime of profit is an extra cost on health care.

Here are Randi's comments in full:

The false choice over “Medicare for All”

We can have both private health insurance and an expanded role for government.

By RANDI WEINGARTEN

09/23/2019 11:03 AM EDT

https://www.politico.com/agenda/story/2019/09/23/medicare-for-all-000977

Ask any voter in the country today and they’ll tell you that health care is top of mind. In other developed countries, health care is a basic human right, but in the United States, it’s a commodity—a highly profitable one for the health insurance industry. In the second quarter of last year alone, the top 85 publicly traded health insurance companies raked in a record $47 billion in profits. At the same time, the number of Americans covered by insurance is actually falling.

It shouldn’t be this way. A majority of Americans believe in guaranteed access to affordable, high-quality health insurance for everyone and want it to be a part of the basic social contract like Social Security. It’s likely that only the government can provide something on that scale; that’s the genesis for many of the 2020 Democratic candidates’ “Medicare for All” types of plans, which aim to phase out private health insurance in favor of a government-run plan that offers care to everyone. Some of the candidates argue for different versions of the plan that preserve a role for commercial insurance—plans people get through their jobs or the individual marketplace—but expand a public option, that is, a government-run plan to cover anyone who needs or wants it.

Pitting these ideas against each other is a false choice. It’s a fear tactic sowed by defenders of corporate greed meant to divide us and make us think that high-quality universal coverage—be it public, private or some combination thereof—is out of reach, even in the wealthiest nation on the planet.

Like many other labor leaders, I have sat across a bargaining table and negotiated many benefits packages for educators, nurses and public employees, so I know what is and isn’t true. Some working people have good health care plans through their jobs, many don’t. If we reduce this debate to a zero-sum trade-off between protecting people who like their insurance vs. expanding insurance to those who might want or need a public plan, we have handed a win directly to the corporate insurance giants before we even start.

The economics are simple: The more people who get covered, the lower the cost of insurance. The goal for all of us must be universal coverage. A broader public plan and employer-sponsored private insurance can coexist while still making universal coverage mandatory if we expand our sense of what’s possible.

One way to think about it is that Medicare could set the floor, not the ceiling. Employer-based insurance would be allowed to exist to the extent that plans met or exceeded the standards set by the Medicare plan. If not, employers and their employees would either be required to make their plans better, or transition to the expanded Medicare program.

This would allow people who like their current employer-based plan—which 7 in 10 Americans claim to (although it’s likely they like their doctor, not the plan itself)—to keep it, allow for a gradual transition from one plan to another when necessary, and effectively improve on the model originally created by the Affordable Care Act.

While many union members have made concessions on wages and other benefits in order to get better health care, the fact remains that no union negotiator in this country wants the continued pitting of health care versus everything else. The shifting of costs to employees must end. Indeed, many employer-based plans continue to fall short of the high-quality and affordable standard, and it’s gotten worse over time. According to the Kaiser Family Foundation, in 2013, 3 in 10 workers had coverage with a deductible of $1,000 or more, and in 2018, nearly half did. How can most Americans afford this, along with housing costs, student debt and other expenses, when 1 in 4 can’t put together $400 in an emergency?

But easing the stranglehold private insurance companies have on the market and preserving the option for employers and unions to continue to innovate in health care is critically important, and there is support for public and private options to coexist. Unions can actually help navigate the transition to a health care system that works for more people, and we can help hold employers accountable for working with providers and employees to find cost savings without diminishing benefits.

We see this happen every day, like in Dearborn, Mich., where the union set up a health care fund and took over administration of the city’s school employees’ health benefits, which had previously been administered by the school district. The union was able to improve coverage and find cost savings by having a more robust bidding and auditing process to determine which private insurance company could offer the best plan to workers; the city eventually adopted the plan for all school employees.

While some working people have good health care plans through their jobs, many do not. It's time we get closer to everyone in America having quality, affordable health care and a decent job on which they can raise a family and retire with dignity. There’s no reason government-sponsored health care can’t be one big part of this vision for America’s future.

Randi Weingarten is president of the American Federation of Teachers, a union that represents 1.7 million educators, health care professionals and public employees in the United States.