Written and edited by Norm Scott:
EDUCATE! ORGANIZE!! MOBILIZE!!!
Three pillars of The Resistance – providing information on current ed issues, organizing activities around fighting for public education in NYC and beyond and exposing the motives behind the education deformers. We link up with bands of resisters. Nothing will change unless WE ALL GET INVOLVED IN THE STRUGGLE!
The photo above is what I picked up in my mailbox on Monday. Last night I got a message from my building saying my mailbox was full and mail had to be moved to the front desk. I'm heading in early to pick it up before going to the healthcare rally at City Hall at noon.
In case you hadn't hear, there is a petition which is scaring the hell out of the leadership despite the fact we need 20,000 signatures to force a referendum on health care changes, a seeming impossible number unless it goes viral. And yesterday, in an attempt to suppress the petition, Unity Caucus operatives only helped spread the word, as James pointed out.
Even some of our people who were skeptical at first, are signing on. The other day some New Action retirees went to a middle school and spoke at 4 lunch hours and got a great response.
In the meantime, Unity and the UFT high-priced leadership has gone nuts attacking the opposition and making accusations. Arthur has a reponse
An Update as Educators of NYC reports: Day 10 of the@UFT healthcare referendum petition drive & we are at ~ 2300-2400 signees. The petitions continue to pour in
Let’s let
leadership know we are union strong and that we are the union.
Please share the petition with your colleagues in your chapter.
http://hcpetition.educators.nyc
Municipal
Workers to Hold Emergency Rally to Express outrage at Mayor Adams’
decision to force
250,000 Retirees into Medicare Advantage
The
rally is April Fools Day-themed: “Mayor Adams, Don’t Try to Fool
Municipal Retirees”
What:
Municipal
workers from across the city will rally at City Hall the day after
Mayor Adams’ signed
a
contract that
sold
out 250,000 retired city employees and their dependents by
forcing them into an inferior Medicare Advantage Plan.Retireesare
here to tell Mayor Adams that
theywant
Medicare Not Profitcare.
The
theme of the rally, which takes place the day before April Fool’s
Day, is “Mayor
Adams, don’t try to fool municipal retirees!"
The rally is organized by the Cross-Union Retirees Organizing
Committee (CROC) and the Professional Staff Congress, the union
representing active and retired faculty and professional staff at
CUNY.
Visuals
Will Include:
Speaking
program of retirees, municipal workers, union leaders and elected
city officials including Council Members
Christopher Marte, Alexa Aviles, Kristin Richardson Jordan.
A
chanting crowd of retired and active workers with music, noise
makers, signs, crutches, walkers, and canes.
April
Fool’s Day themed signage, “We’re Not Fools” hats, and
slogans.
When:
Friday, March 31st
at 12pm
Where:
Outside City Hall Park on Broadway and Murray Street
Rally at City Hall
WE ARE NOT FOOLS, MAYOR ADAMS!
We Want Medicare, Not Money Care! Friday, March 31, 12 Noon - Broadway & Murray St.
No to Medicare Advantage
NYC retirees do not want to be forced onto Aetna’s for-profit Medicare Advantage plan! NYC retirees demand to keep our traditional Medicare & premium free Medi-gap insurance.
Yes to “Option C”
The Mayor has a choice to make by April 1st. Tell the Mayor to Choose “Option C” in the Aetna contract which would let us keep what we already have. Retirees & Active Municipal Workers: We Need You There
Bring your signs, noise makers, wheelchairs, crutches, walkers, canes, your sense of humor and sense of outrage!
Here is the
article that was behind a Paywall. Please come to tomorrows Rally at
city Hall at 12 Noon to tell the Mayorf Not to Try to Fool Municipal
Retirees.
Retireesare
here to tell Mayor Adams that
theywant
Medicare Not Profitcare.The fight will continue.
Mayor Adams signs controversial
contract that
eliminates traditional Medicare for retired NYC workers
Mayor
Adams signed off on a contract Thursday that will eliminate
traditional
Medicare coverage for retired city government workers and shift
them into a
privatized version of the program instead — a highly
controversial move that
immediately drew a lawsuit threat from a grassroots retiree
group.
The
contract with private health insurance giant Aetna is the
culmination of a years-long
effort by
the city to enroll its roughly 250,000 municipal retirees in a
Medicare
Advantage Plan.
Under
the deal inked by Adams, the city’s retirees — most of whom are
on a
traditional Medicare benefits structure that includes a Senior
Care supplement
— will lose their current coverage
and be automatically
enrolled in an Advantage plan administered by Aetna, effective
Sept. 1.
The
Advantage setup will save the city some $600 million annually
thanks to
increased federal subsidies, an allocation Adams described as
critical at a
time that the municipal government is staring down a $10 billion
budget deficit by
2026. In a statement, Adams also argued the
Advantage plan will
improve health care coverage for city retirees.
“This
plan improves upon retirees’ current plans, including offering a
lower
deductible, a cap on out-of-pocket expenses, and new benefits,
like
transportation, fitness programs, and wellness incentives,” said
the mayor.
“This Medicare Advantage plan is in the best interests of both
our city’s
retirees and its taxpayers.”
Tens
of thousands of retired teachers, cops, firefighters and other
city workers say
Adams is wrong.
Citing
federal studies that show Advantage plans can deny beneficiaries
“medically
necessary” care,
retirees have called on Adams since he took office to let them
stay on
traditional Medicare, contending that the switch would put them
at risk of
losing access to certain doctors, medical procedures and drugs.
A
group called the NYC Organization of Public Service Retirees
successfully
convinced courts last
year to block the
first iteration of the Adams administration’s
Advantage plan — and
Jake Gardener, a lawyer for the group, told the Daily News on
Thursday that
they will file another lawsuit in hopes of derailing the new
plan as well.
“We
will be challenging this violation of the retirees’ health care
rights in
court,” Gardener said. “This is just the latest example of the
city trying to
save money on the backs of retired and disabled city workers.
What this would
do is to jeopardize the health of a quarter million elderly and
disabled city
workers.”
Retirees
are resisting the Advantage switch, in part, because Aetna will
require
pre-authorizations for some forms of care, a protocol that does
not exist under
traditional Medicare. They fear this will result in diluted
coverage, and have
depicted it as a life and death issue.
“Retired
firefighters, police, EMT workers and teachers will be forced
into a
privatized, managed care plan that has strict in-network,
pre-authorization and
referral requirements that will cause potentially
life-threatening delays and
denials of care,” said Marianne Pizzitola, a retired FDNY EMT
who leads the NYC
Organization of Public Service Retirees.
“Many
of the quarter-million respected public servants, and all the
current NYC
public employees, will be harmed by this damaging decision by
Mayor Adams.”
In
his statement, Adams said he sympathizes with the angry
retirees.
“We
also heard the concerns of retirees and worked to significantly
limit the
number of procedures subject to prior authorization under this
plan,” he said.
The
reason courts blocked
Adams’ first plan
was because it would’ve levied a $191 monthly premium on
retirees who wanted to
opt out of Advantage and stay on traditional Medicare. The
courts found that
penalty violated a local law requiring the city to provide its
retirees with
premium-free coverage for life.
Adams’
administration, with support from
the city’s
Municipal Labor Committee, says the new plan
structure complies with
the court rulings because there will no longer be a $191 penalty
on the table
as the premium-free Advantage coverage is the only insurance
option available
to retirees.
Gardener
disagreed and claimed the new plan is also illegal.
“Forcing
them into Medicare Advantage by not even giving them the option
of keeping
their existing health insurance is far more damning and just as
illegal,” he
said.
Gardener
declined to say exactly on what grounds his group will challenge
the new plan,
but added: “We have a number of grounds that we will be relying
on to ensure
that the savings the city is looking to achieve is not obtained
solely on the
backs of retirees.”
There is still time to register for tonight's Retiree Advocate-UFT's meeting at 7pm on Zoom. Register Here: https://bit.ly/3yr6M8K (Close to 250 people are already registered.)
DONATE TO THE UFT PETITION CAMPAIGN FOR A HEALTHCARE VOTE - IT IS COSTING MONEY TO MAKE SURE EACH ELECTRONIC SIGNATURE WILL NOT BE TOSSED OUT BY THE UFT LEADERSHIP.
A Tale of 3 city teacher unions - and UFT/Unity are the losers
Sunday, March 26, 2023 - This post is loaded, so sit back or just ignore and go out and get some sun
No matter the liberal blather from the UFT (we support the LA teachers for not crossing picket line but would jump off the roof of 52 Broadway of NYC did the same), we have an ineffective right-center UFT leadership compared to the left wing leadership in Chicago and Los Angeles and the compilation I've gathered below proves it, not only ideologically, but in terms of actual political and economic accomplishments. My comment above about changing the leadership does not mean dumping Mulgrew for another Unity Caucus hack but removing Unity from leadership. Note these articles.
In the UFT we have decreased militancy - actually no militancy. Well, if you consider "wear certain colors certain days" as militancy.
The increasingly militant autoworkers had their first direct election of a national president and an insurgent won - barely. He said:
“This is the end
of company unionism, where the companies and the union work together in a
friendly way, because it hasn’t been good for our members ---- President Is Ousted in United Auto Workers Election --
"Company union" increasingly strikes a chord when talking about the Unity crowd. When Marianne appeared on Brian Lehrer the other day, his first comment was how surprised he was that the UFT was teaming up with the Adams administration against its own members.
We are not surprised.
A long-time UFT activist asked: What would happen if we had direct elections for presidents of the AFT and NYSUT? Right now only winner take all Unity delegates (750) vote in those elections.
There is actually a new petition campaign in the UFT to bring a level of democracy with a petition campaign based on the UFT constitution calling for a member vote on healthcare changes (as opposed to Mulgrew backroom deals through the MLC).
Sign the petition for a democratic vote on healthcare.
Attend the Retiree Advocate Zoom Sunday, March 26 at 7PM. Register: https://bit.ly/3yr6M8K
Are
you fed up with our union leadership making bad decisions for us
without our input? We never got a chance to vote about our Medicare with
Seniorcare being taken away from us. RA has no representation in the
DA, ExBd or RTC despite receiving 30% of vote in last Chapter election.
Time to build our caucus and get ready for next year's Chapter Election.
Find out how by coming to the Retiree Advocate's meeting on March 26
at 7pm on Zoom.
This morning, the Municipal Labor Committee, a group of approximately
100 NYC public sector unions, voted to ratify an agreement with the
city and Aetna to transition Medicare-eligible retirees to a Medicare
Advantage plan.
CSA voted “no” on behalf of our membership.
Throughout this entire process, we have been committed to fighting
for the highest quality of healthcare possible for every retiree. Our
retiree members have consistently asked that we advocate for an option
for Medicare-eligible retirees to keep their current plan. For a variety
of reasons, city retirees will not be allowed that choice at this time,
and too many retirees have limited options.
To be clear, our vote was not a referendum on the process nor the
Aetna proposal itself. The MLC has been diligent in fighting to protect
Medicare-eligible NYC retirees during these complex negotiations, and
Aetna has customized their proposal to try and mirror our current Senior
Care plan. Aetna representatives have been collaborative and
responsive; we greatly appreciate that they addressed our members
directly on a Zoom yesterday afternoon. They have committed to returning
to speak with our members again now that the agreement has been
ratified. Thankfully, many CSA members have had their most critical
questions and concerns addressed, and we are pleased that we were able
to support these retirees and advocate on their behalf.
However, there are currently too many CSA retirees who still believe
this plan is not right for them and their families. In January, I took
an oath to represent all CSA members to the best of my ability, and it
is my belief, along with our leadership team, that voting “no” today was
the right decision for our union.
Other union leaders within the MLC also did what they felt was right
for their members, resulting in enough votes to ratify the agreement.
Aetna has pledged to begin communicating immediately providing further
details and answering your questions. The MLC and the city will work to
ensure that the plan is implemented as promised. The dedicated staff and
leadership of the CSA Welfare Fund will begin to immerse themselves in
the new plan which include many additional, unique benefits.
We will continue to communicate regularly with you in the coming
weeks and months. Please be reminded to contact CSA Headquarters or the
Retiree Chapter with any questions or feedback about the negotiation
process. If you have specific questions regarding the transition to the
Aetna plan, please contact the CSA Welfare Fund directly.
As always, I thank you for your honest feedback, patience, and support.
Jenny
Brown reports on the vote by New York City’s Municipal Labor Committee
to scrap some of the best retiree health care coverage in the country
and push retirees onto the for-profit Medicare Advantage plan.
Protesters
in New York City against the mayor’s and the
Municipal Labor
Committee’s effort to change a city law protecting
their health care
benefits, photo undated. (Cross-Union Retirees Organizing Committee)
Defying
two years of protests and lawsuits by union retirees, New York City’s
Municipal Labor Committee voted March 9 to scrap some of the best
retiree health care coverage in the country. The change would put
250,000 city retirees into a for-profit Medicare Advantage plan run by
Aetna.
Twenty-six
unions in the MLC voted no, while others abstained. But their votes
were swamped by the votes of the largest unions on the committee, AFSCME
District Council 37 and the New York United Federation of Teachers.
Retirees
and active members protested during the MLC vote and marched to City
Hall. They are asking the city council to strengthen the law protecting
retiree health care. The NYC Organization of Public Service Retirees
promises to sue.
In traditional Medicare, available when you turn 65, you present your card, get care, and the government pays for it.
With
Medicare Advantage, a for-profit insurance company gets money from the
government to cover you. But they get to take a fat cut — Medicare
Advantage is now the most lucrative sector of an already-lucrative
health insurance industry. And they get to say what care you can get.
Medicare
Advantage plans negotiated by employers and unions provide worse
coverage than traditional Medicare. But they are generally better than
the individual Medicare Advantage plans that seniors may sign up for
themselves and which are advertised on late-night TV.
Medicare
Advantage plans that individuals buy on the private insurance market
may work out to have cheaper premiums than traditional Medicare because
they wrap in a drug benefit and may cap out-of-pocket expenses. But they
are notorious for denying expensive care, imposing narrow networks of
doctors and hospitals and ripping off the government.
On
the other hand, union-negotiated Medicare Advantage plans are the
result of insurance companies having to negotiate with unions and
employers to sign up large groups of retirees, and that may restrain the
most egregious abuses. Still, some retirees in negotiated plans report that they were denied care at the most difficult time in their lives.
Department of Health & Human Services, Washington, D.C. (Sarah Stierch, CC BY 4.0, Wikimedia Commons)
In
both cases, the for-profit insurance companies that run the plans have a
strong incentive to deny care. Every dollar they don’t pay for your
care is a dollar earned by shareholders and CEOs, who often take most of
their compensation in stock. Stock prices are based on how little care
the company can pay for.
Traditional
Medicare (part A & B) costs $164.90 a month and covers hospital
costs and 80 percent of non-hospital costs. But medical costs are such
that the 20 percent gap in coverage can quickly become ruinous. So, the
government set up a regulated market of Medigap supplements.
Retirees can pay additional premiums to private insurance companies to
cover the final 20 percent, and cap out-of-pocket costs.
Medigap
plans can cost as little as $75 a month, but can cost hundreds more,
depending on the plan, your age, gender and whether you smoke. Unlike
Medicare Advantage, however, these Medigap plans are heavily regulated.
It
is this gap for which New York City union retirees over age 65 are
covered by the city’s Senior Care plan. The city also pays the monthly
premiums for traditional Medicare, so retirees get premium-free
coverage.
Numbers Don’t Add Up
States and municipalities have increasingly tried
to put retirees into Medicare Advantage plans once they reach age 65.
Where unions have fought the change, as in Washington state and Vermont,
they have been able to prevent the switch. But in New York City,
retirees have been fighting not just the city but also their own unions
to keep from being shunted into a for-profit plan.
Public
employees in New York City have given up a lot over the years to keep
their ironclad retiree health care coverage and it paid off until now.
Along with paying traditional Medicare premiums, the city pays for
Senior Care, the wrap-around supplement that picks up nearly all costs
not covered by Medicare, along with drug benefits.
Rally in Washington, D.C., February 2013. (Djembayz, CC BY-SA 3.0, Wikimedia Commons)
Leaders
of District Council 37 and the UFT claim the Medicare Advantage plan
will save money and provide the same coverage. But the numbers don’t add
up, said Len Rodberg, a retired City University of New York health
policy expert who will be affected by the change. “Medicare Advantage
starts out 20 percent below what Medicare does, in terms of actual money
available to spend on health care,” Rodberg said.
Traditional
Medicare pays 3 percent overhead. By contrast, Medicare Advantage plans
have to make a profit for shareholders, and they also pay huge
executive salaries and maintain enormous staffs to protect their profit
margins by delaying and denying care. In these for-profit plans, Rodberg
said, “basically anything that costs money would need pre-approval.”
Municipal
Labor Committee leaders said their consultants told them the difference
would be picked up by the federal government, Rodberg said. But while
the federal government used to subsidize for-profit Medicare Advantage
plans 20 percent over what they paid out for traditional Medicare
patients, that subsidy is now down to 2 percent.
Medicare
Advantage plans also cut costs by contracting with certain providers.
This means the insurance company will only pay for care provided by
certain doctors or hospitals. For retirees who move to states with
spotty coverage, Rodberg said, “suddenly their Medicare card won’t work,
cause they’re in Medicare Advantage, not Medicare.”
Quick Reaction
Retired
teacher Gloria Brandman heard about the change in 2021 from friends in
PSC-CUNY, the union of faculty and staff at the City University of New
York. She and other teacher retirees swung into action, holding a
webinar that drew 400 people. The recording of the webinar circulated
widely, leading to a whirlwind of protest which forced UFT’s president,
Michael Mulgrew, to hold a town hall where he tried to sell the change.
Retirees
from the teachers, AFSCME and several uniformed service unions formed a
Cross-Union Retirees Organizing Committee to fight. Brandman and other
CROC activists hounded newly elected Mayor Eric Adams at every
opportunity.
New YorkCity Mayor Eric Adams February, 2022. (Marc A. Hermann / MTA, CC BY 2.0, Wikimedia Commons)
They
rallied when the MLC met: “We marched on the hottest day of the year,”
Brandman recalled. They held a Valentine’s Day “Don’t Break Our Hearts,
Mayor Adams” event.
In
October they held a “Halloween Horror” press conference, saying “Mayor
Adams, You’re Scaring Us to Death.” (“Death masks optional,” said the
invitation flier).
A
city law requires that all the health care options the city provides be
premium-free. That law turned out to be an important backstop and the
NYC Organization of Public Service Retirees sued to get it enforced. A
judge agreed that it was against the law for the city to charge seniors
an extra $191 per month to stay in original Medicare.
So
Adams and the MLC leadership asked the City Council to change the law.
They walked into a buzz saw. After vigorous protests and reams of
testimony from retirees and active union members objecting to the change
— which could have undermined active members’ health care as well — the
City Council declined to alter the law.
In
her testimony before the council, Jen Gaboury, PSC chapter chair at
Hunter College said, “We know these ‘savings’ don’t come from some brand
of private business magic. If you get this money, you’ll be denying
care and/or delaying treatment to your own people, older city workers.”
Contracts Held Hostage
Part
of the problem is that the unions created a $600 million hole in the
last round of contracts and they’re trying to plug it now. They
negotiated to use a health care stabilization fund, designed to equalize
costs between health plans for active members, to bolster wage
increases. Now the fund is broke and that threatens to raise health care
costs for active members.
At the City Council hearings, PSC-CUNY proposed a way out of this mess. Retired professor James Perlstein described it in his testimony:
“(a)
Redirect funds the City holds in reserve to bridge the Municipal Labor
Committee Stabilization Fund for three years, (b) Create a stakeholders
commission charged with finding a path to control health care spending,
with hospital pricing as a priority, and (c) Develop a sustainable
mechanism for funding City health insurance.”
PSC also suggested that New York City’s very profitable non-profit hospitals contribute, since they don’t pay taxes.
None
of these steps have been taken, so far. Instead, city administrators
continue to push Medicare Advantage. “The city’s taken a hardball
position that it won’t negotiate new contracts until the unions save
them $600 million by moving forward with Medicare Advantage plan,” said
Rodberg in February. The city promises to replenish the stabilization
fund with the estimated $600 million it will save from the switch.
AFSCME
DC 37 members have been working for 18 months without a contract.
Recently the city and the union inked a tentative agreement with raises
that don’t even keep up with inflation. Other city unions object that
this low bar will harm their negotiations, since the city expects the
first agreement settled by a major city union to set a pattern which the
other municipal unions will largely follow.
And
while members will get to vote on the agreement, they won’t be able to
vote on the retiree health care concession their union agreed to behind
closed doors. It seems that as a condition for settling, the dominant
MLC unions agreed to impose what the retirees call “the nuclear option,”
deliberately misreading the city law they tried to change, and making
Medicare Advantage the only option for retirees.
Any
retiree who wants to stay in traditional Medicare would have to pay for
all of their coverage, as if they had no union at all.
The showdown
underscores just how important — and lucrative — Medicare Advantage has
become to insurers and doctors’ groups that are paid by the federal
government to care for older Americans. Roughly $400 billion in taxpayer
money went to these private plans last year. Profits on Medicare
Advantage plans are at least double what insurers earn from other kinds
of policies, according to a recent analysis by the Kaiser Family Foundation.
Without reforms, taxpayers will spend
about $25 billion next year in “excess” payments to the private plans,
according to the Medicare Payment Advisory Commission, a nonpartisan
research group that advises Congress.... NYT
One thing has become increasingly care - switching us out of traditional medicare to MedAdv will raise healthcare costs by billions. Thursday's NYT has an explosive article in the print section which I am reproducing below, with the charts that show how they make money by upcoding. Like my blood tests show some sugar escalation - they will take that and get more money from medicare by classifying me as pre-diabetic.
Some hints on enormous profits for MedAdv plans -- fraud, upcoding ----- How our union's move to MedAadv will raise not cut costs while reducing service for the sick.
It would
significantly lower payments — by billions of dollars a year — to
Medicare Advantage, the private plans that now cover about half of the
government’s health program for older Americans. The change
in payment formulas is an effort, Biden administration officials say,
to tackle widespread abuses and fraud in the increasingly popular
private program. In the last decade, reams of evidence uncovered in
lawsuits and audits revealed systematic overbilling of the government. A
final decision on the payments is expected shortly, and is one of a
series of tough new rules aimed at reining in the industry. The changes fit into a broader effort by the White House to shore up the Medicare trust fund.. NYT March 23, 2023
UNITYCAUCUS-CARE
Mulgrewcare does the opposite - weakens the Medicare trust fund. This was my theme when I spoke at the UFT Ex Bd on Monday, to mostly deaf Unity Caucus ears. I think we need to make it clear - this is a Unity Caucus, not a Mulgrew operation. Do we think if Mulgrew left Unity would not support this move?
UFT is acting like Republicans
Nick had a summary of my comments (which if not for him I wouldn't remember):
Norm Scott: UFT member since 67. Wearing a UFT logo and hope no lawyers
contact me. Healthcare: MAP isn’t Medicare. If I were to pay someone to
go to the grocery store for me, that’s kind of like what Aetna is going
to do with our healthcare. If you don’t understand that healthcare
hasn’t increased in cost because of profits and denial of benefits…I
hear some people say I don’t really care about it – it’s just politics.
I’m really disturbed by the fact that I may not have access to my
doctors. I’ve got doctors for every part of my body. I’m getting calls
from all over the country by people saying they might not get access to
doctors. 60% of people are now on MAP. But what happens when it’s 80 and
90%? I’m sorry to say but this union is acting like the Republicans –
the Republicans will end up killing Medicare. Mulgrew talks about
representational voting at MLC, but not in the UFT. Even though Retiree
Advocate got about 1/3 of the vote in the retiree chapter election, we
get no say at all – not a single delegate. We think there should be a
vote on questions of healthcare. We are starting a petition campaign,
where if we get 1/3 of this body, we can get a referendum to vote on any
healthcare changes. You might win that vote anyways – why not support
it. Give members a choice to vote.
I also said that Aetna is not doing this for charity but for enormous profits -- that is the cause of healthcare rise from insurance companies, hospitals, and doctor practice corporations. By joining in with MedAdv company lines, the UFT is helping undermine and bankrupt traditional medicare which is the only publicly run healthcare agency and instrumental in keeping healthcare costs down.
Another example of the UFT leadership Scam from Nick:
A few more highlights if you don't have time to read the whole thing:
The showdown
underscores just how important — and lucrative — Medicare Advantage has
become to insurers and doctors’ groups that are paid by the federal
government to care for older Americans. Roughly $400 billion in taxpayer
money went to these private plans last year. Profits on Medicare
Advantage plans are at least double what insurers earn from other kinds
of policies, according to a recent analysis by the Kaiser Family Foundation.
Older
Americans have flocked to Medicare Advantage, finding that many
policies offer lower premiums and more benefits than the traditional
government program. The insurers
receive a flat rate for every person they sign up — and get bonuses for
those with serious health conditions, because their medical care
typically costs more. But numerous studies from academicresearchers, governmentwatchdogagencies
and federal fraud prosecutions underscore how the insurers have
manipulated the system by attaching as many diagnosis codes as possible
to their patients’ records to harvest these bonus payments. Four of the largest five insurers have either settled or are currently facing lawsuits claiming fraudulent coding. Similar lawsuits have also been brought against an array of smaller health plans.
In 1975 the overwhelming majority of teachers (I was one of them) were
willing to accept two for one Taylor Law penalties to stand up for their
15,000 laid off colleagues. The UFT is a very different union from
those days.
The contrast between the NYC UFT and the LA UTLA teacher unions is beyond astounding. Our leaders emphasize our right not to strike and use their shills to claim we are in a post-teacher strike phase.
while the teacher union in Los Angelos is refusing to cross the picket lines for the next three days of the lowest paid school workers.
Note how our UFT leadership begged the city council (unsuccesfully) to create a two-tier healthcare system by allowing the wealthiest members to buy their way out of Medicare Advantage.
The union that represents 30,000 support
workers in the Los Angeles Unified School District is seeking a 30
percent pay increase, saying that many employees make little more than
the minimum wage and are struggling to afford the cost of living in
Southern California.
Security attempts to corral Medicare Advantage protesters inside the Conrad Hotel in New York City. Photos by Steve Wishnia
By Steve Wishnia
A
group of seven New York City municipal retirees protesting NYC’s plan
to privatize their Medicare coverage slipped into the Conrad Hilton
hotel today in Battery Park City where the Aetna insurance company was
about to hold a session to prepare union staff on how to tell retirees
about the company’s Medicare Advantage plan.
“We
want to keep the care we have!” retired music teacher Trudy Silver
called out from one side of the room, where attendees were finishing
their lunches and mingling before the session. “We don’t want your Aetna
plan!” her compatriots — all of them women — responded from the other
side of the space.
Silver then swiveled through the crowd, around the small barstool-style tables, and past the buffet, as men in purple Aetna-logo T-shirts tried to push her out. One tried to block a news photographer’s camera angles. Eventually, all seven women were herded out by security guards.
Members of the Cross-Union Retirees Organizing Committee deliver their message despite attempts to shut them out.
“They’re
preparing the propaganda,” Sarah Shapiro of the Cross-Union Retirees
Organizing Committee [CROC] said before the March 20 action.
Earlier
this month, the Municipal Labor Committee [MLC], which includes 102
unions representing civil service workers, approved the city’s agreement
with Aetna to provide a privatized, profit-driven Medicare Advantage
plan for retirees, who now have traditional Medicare with city-funded
supplemental coverage. Mayor Eric Adams’ administration then announced
its intention to make the Aetna plan the only premium-free health
coverage available to retirees.
“We
want to keep the health care we have, and we’re not going to give up,”
Silver told Work-Bites afterwards. “Forty percent of the nation has been
boondoggled into accepting privatized Medicare. We’re not going to in
New York.”
Retired
United Federation of Teachers member and former special-education
teacher Denise Rickles said that she opposes the privatization of
Medicare and that “Aetna is a disreputable insurance company” that’s
under federal investigation.
In
2021, CVS Health, which acquired Aetna three years prior, revealed in a
financial filing that it was being audited by federal Department of
Health and Human Services inspectors to check for “diagnostic upcoding,”
in which patients’ diagnoses are written to list more serious
conditions than they actually have. Medicare pays insurers at a higher
rate if the people they cover are sicker.
These NYC municipal retirees successfully slipped into the Conrad Hotel on March 20, to protest the ongoing campaign to privatize traditional Medicare coverage.
Last
year, a Kaiser Health News review of 90 audits of Medicare Advantage
plans done by the Centers for Medicare & Medicaid Services between
2011 and 2013 — the most recent available, obtained after litigation —
found upcoding a common practice in the industry. The overpayments
averaged more than $1,000 per person at 23 plans, including 10 owned by
Humana. Overall, the companies had claimed excess payments for 20
percent of the patients in the audits.
In
October 2021, the Justice Department sued Kaiser Permanente, the
fifth-largest insurer in the Medicare Advantage market, charging that it
used algorithms to find ailments it could then pressure doctors to add
to diagnoses. It sought reimbursement and triple damages for more than
350 allegedly fraudulent diagnoses.
CVS
Health has 3.1 million people enrolled in its Medicare Advantage plans,
according to a study last year by the Kaiser Family Foundation. That
gave it 11 percent of the market, ranking fourth among U.S.
health-insurance companies after United Health, Humana, and Blue Cross
Blue Shield. New York City imposing Medicare Advantage on retirees would
add as many as 250,000 more enrollees.
“People put their trust in unions,” Rickles added. “But for the past
few decades, unions have not really represented their membership.”
The
UFT and District Council 37, the two largest unions in the Municipal
Labor Committee, have actively pushed for the switch to Medicare
Advantage, as has the Uniformed Sanitationmen’s Association. The
Professional Staff Congress [PSC], which represents City University of
New York faculty and staff, has opposed it. A PSC staffer attending the
session said he was sympathetic to the protesters, but wasn’t the right
person to comment.
“I’m on your side,” another union official told the protesters after they’d left the building. She quickly rushed inside.
Silver, a jazz singer, said she knew the attendees had heard their message.
Let’s let leadership know we are union strong and that we are the union.
Please share the petition with your colleagues in your chapter.
hcpetition.educators.nyc
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