Wednesday, October 16, 2019

Health Care: Are union leaders giving us ALL the facts?

I am publishing this excerpt the hard copy of Ed Notes which I distribute at Delegate Assemblies and will be doing so today. Thanks to a former ICEUFT founder Julie Woodward who spent considerable time assisting with this article and clarified so much about the issue. Before working with her I was waffling on single-payer but she has made herself into an expert

and assists people with health care issues. Julie has brought back her blog and is focusing on the medicare debates. Here is her latest:
Is your union backing Medicare for All? Ours not so much

Health Care:
Are union leaders giving us ALL the facts?
By Norm Scott

I will be reporting on health care in what it means for UFT members in these special editions of Ed Notes for the delegate assembly, in addition to my blog, ednotesonline.com.



All sides of the political equation recognize that our health care system is a mess, with costs double and with poorer outcomes than other advanced nations. Yet, I’m still not clear on where our local and national unions actually stand. There is understandable confusion about various versions of “Medicare for all,” each with very different implications. “Medicare for all” is misleading because people think it means merely extending Medicare for those 65 and over to the entire population - a system that includes major roles for private insurance, co-pays and deductibles. Original Medicare has left over costs that must be paid out of pocket but there are a variety of supplemental plans available through mostly for-profit companies, with a variety of premiums depending on the type of coverage.



Bernie Sanders is talking about a very different system based on a simpler design, one that eliminates the ACA,  Medicare, and much of the private insurance industry (with is duplicative administrative costs, high salaries, and faulty incentives) and creates an entirely new tax structure. We’ve seen this kind of massive structural innovation before — with Social Security in 1935 and Medicare in 1965 — and most people would fight hard to keep these programs until something even more efficient, universal, and protective comes along. The Sanders (Senate)/Jayapal (House) 2019 legislation currently in Congress also includes long-term care and other benefits. 



Some unions have endorsed Bernie’s total restructuring bill (National Nurses United (NNU). Other union leaders (our own included) and politicians have raised red flags, claiming the elimination of private insurance would make us lose our “much-loved” union negotiated plans and have backed a range of so-called “medicare-for-all” situations, including for-profit insurance, employer coverage, and public options. What they’d leave us with are the same bad players, and a variety of compromises that continue to feed at the public trough.



People think they like their plans, but they really like their doctors and hospitals.  Most people 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 between what they DO pay and what they WOULD HAVE HAD to pay if they didn't have a plan.



We are told we have given  up salary for decades in exchange for health care benefits and won’t be able to negotiate on health care in the future. Is that what we want to do instead of focusing on salary and working conditions instead of having to make choices to divert funds for those purposes to health care? Remember our 2014 contract where we agreed to help save the city billions on costs which has led to some reductions in coverage, with possibly more to come?



President Mulgrew pointed to the AFT taking a position in favor of “Medicare for all,” but that has been muddled. An article in Jacobin asked:  Why Is Teachers Union President Randi Weingarten Attacking Medicare for All?... Weingarten pulls her bait and switch; different versions of medicare for all, including plans “that preserve a role for commercial insurance,” are actually all the same, she argues, and are just different paths to universal coverage. Weingarten, wrote a recent piece in Politico: The false choice over Medicare for All: We can have both private health insurance and an expanded role for government. She argued for pretty much every plan, obfuscation at best. A role for private insurance  (five times the administrative costs of public plans) leaves a lot of money on the table for profit with executives and investors making millions of dollars and with much higher turnover of employees with less knowledge, poor response times and poorer general service.



Here's the crux of Randi's waffling. She wrote. "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… 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? A single-payer plan eliminates the stranglehold instead of easing it. Randi says "Preserve the option to innovate," while single player doesn’t play footsie with corporations.  They want corporations out of the picture.



In fact the Sanders plan offered in 2017 (improved in the current bill) was analyzed by a team of economists from the University of Massachusetts Political Economy Research Institute (PERI). They found that it is not only economically viable, but could actually reduce health consumption expenditures by about 9.6 percent while also providing decent health care coverage for all Americans.



I was first convinced about single-payer by my wife who spent decades handling billing issues for a major hospital and dealt with every private and public insurance company. She maintained without a doubt that the most efficient and responsive people were those who worked for the Medicare system. There were long-term professionals while the private insurers were often clueless. It was her practical experience, not some ideology, that convinced her, and me, that only a single-payer government financed plan would create a much better healthcare for all.



Resources: UFT activist/blogger Julie Woodward, now retired, has specialized in assisting people with Medicare issues and her blog, Under Assault underassault.blogspot.com, has been brought back from dormancy to deal with the politics of Medicare for All. Last week I attended a presentation/debate on Medicare for all at The CUNY School of Labor and Urban Studies with a fabulous presentation by Robert Pollin (www.peri.umass.edu/economists/robert-pollin).

3 comments:

  1. I would like a little honesty from UFT and Municipal Labor Council on the annual reductions in our existing health benefits. If you require allergy shots, coverage for injections disappeared several years ago. If you have joint pain that requires relief you are forced to take cortisone even if that is contraindicated for you. Actually tapping PICA benefits seems to be impossible. Fifty year olds are out of luck. Slightly older folks are told to wait for Medicare. Or you are given drugs that ultimately damage kidneys or liver. It seems like they are more willing to pay for dialysis or transplants then get you moving and healthy. This is not a health care system...we do not support people to act in their own best (health) interests.

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  2. This is what happens when "for-profits" make decisions about the kind and amount of medical care you need. They do it in the ways you say, but also by their increased calls for prior authorizations (drugs, therapies, skilled nursing) and, according to Investopedia, how they discourage sick people through the way they structure their co-pays and deductibles. Whistleblower Wendell Potter also brings up the point that the federal gov't kept Advantage plans "in the game" of health care by overpaying them in the form of bonuses.

    https://underassault.blogspot.com/

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  3. Interesting article in the Guardian this morning (https://www.theguardian.com/us-news/2019/oct/20/bernie-sanders-pete-buttigieg-donald-trump-voters) showing a graph of individual Democratic donor preferences broken down by profession. Says: "When it comes to higher education, Sanders and his fellow progressive senator, Elizabeth Warren, are schooling the competition. More than 2,300 teachers have donated to Sanders ... And Warren, who used to teach at Harvard Law School, dominates among the university set." The Sanders/Warren side adds up to more than 50%. Biden didn't even make the chart.


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