There was a time when hospital and health insurance costs were controlled - public and non-profit but the neo-liberal deregulation craze since the late 70s has created a monster. Last week I attended a film and panel discussion exposing these issues and pointing out that the only way to control costs and deliver better healthcare is a single payer system where the government regulates prices, similar to what Medicare does today. On the panel was former NYSNA president Judy Sheridan Gonzalez, whose husband Angel was a close associate for a few years in organizing in the UFT - and one of the co-founders of the Grassroots Education Movement (GEM). Judy who still works in a hospital pointed out all the scams they are using to drive profit over health. Watch this sort video of a few of her comments: see her summary here.
Here is the email they sent out:
Dear Norm,
On Tuesday night, Physicians for a
National Health Program - NY Metro, Center
for Independence of the Disabled - New York, and New
York State Nurses Association hosted a screening of the new
documentary American
Hospitals, followed by a
panel discussion. Our panel of experts discussed how the issues
raised in the film manifest in New York state, systemic solutions to
the failings of our profit-centered current system, and modest
improvements that would bring some immediate relief. We had a full
house with lots of great questions. Due to technical difficulties, we
are unfortunately unable to share a full recording of the panel. See
below for a few highlights and ways to take action!
Speaker
Judy Sharidan-Gonzalez succinctly captured how the current financing
of healthcare negatively impacts patient care - see her summary here.
Screening
attendees expressed the reasons they support single-payer healthcare:
the NY Health Act and Medicare for All - guaranteed, universal,
comprehensive healthcare that is paid for fairly, according to income,
with no out of pocket costs, surprise bills or medical debt. Systemic
inequities and injustices require systemic solutions!
Action Items
& Resources:
Featured
speakers:
Donald Moore, MD, MPH appears in American Hospitals as a featured expert. He earned
his degrees in 1981 from the Yale School of Medicine and the Yale
School of Public Health Clinical Assistant Professor at Weill Medical
College of Cornell University and SUNY-Downstate Medical School. He
has been an Attending Physician at New York Presbyterian Brooklyn
Methodist Hospital since 1990 where he currently serves as Chair of
the Medical Ethics and Professional Conduct Committee. Dr. Moore is
the past President of the Provident Clinical Society, the Brooklyn
affiliate of the National Medical Association (NMA) and he has served
as the President of the Association of Yale Alumni in Medicine (AYAM)
and President of the Medical Society of the County of Kings (MSCK). Dr
Moore is chair of the Committee on Physician Health of the Medical
Society of the State of New York (MSSNY), Chair of the Health
Information Technology (HIT) committee, and serves on the Board of
Directors for the NY Metro Chapter of Physicians for a National Health
Program.
Judy Sheridan-Gonzalez, RN has been a health care and social justice
activist for most of her life and an ER nurse at Montefiore Hospital,
in the Bronx for 40 years. Introducing Single Payer to the New York
State Nurses Association 30 years ago, she was instrumental in
engaging the legislature to generate such a bill.
After serving nearly a decade as NYSNA
president, Judy was a key leader in the January 2023 NYC Nurses Strike
of over 6,000 nurses.This historic strike won unprecedented victories
around racial and social equity for patients, enforceable nurse
patient ratios, accountability requirements for huge hospital systems
and served to inspire labor actions across the spectrum to continue
similar fights.
Barbara Caress has
over 40 years of experience as a non-profit, union and public agency
manager, consultant and administrator. She served as Director of
Strategic Policy and Planning for the SEIU Local 32BJ Health, Pension,
Legal and Training Funds, which provide benefits to 250,000 people
living in seven states where she oversaw the substantial redesign
effort dedicated to developing incentives for members to use, and
providers to offer, patient centered medical homes and other certified
quality providers. Most recently she has been assisting the
Professional Staff Congress in their campaign opposing the
privatization of City retiree Medicare benefits.
Ms Caress has spent many years as a
healthcare consultant working for such clients as the New York City
and State Health Departments, the Community Service Society, Local
1199, SEIU, NYSNA, the Freelancers Union, and the United Hospital
Fund. She was a member of NCQA’s Standards Committee, NQF Hospital
MAP, and the NYC Primary Care Improvement Project Advisory Board.
Author of a wide range of health policy articles, reports and reviews,
Ms Caress received her undergraduate and graduate education at the
University of Chicago and is currently an adjunct faculty member in
the Program in Health Administration at the Zicklin School of
Business, Baruch College, CUNY.
Moderated by:
Heidi Siegfried, MSW, JD is CIDNY’s Director of Health Policy. She monitors and analyzes
trends and initiatives asthey affect people with disabilities in the
city and state to help CIDNY develop its health policy agenda,
testimony, bill memos, and action alerts. She represents people with
disabilities in a variety of healthcare coalitions.
Prior to her position at CIDNY, Ms.
Siegfried was a Supervising Attorney at The Partnership for the
Homeless and was Executive Director at the Capital Region and Genesee
Valley Chapters of the New York Civil Liberties Union. She has a
Master of Social Work from the University of Nebraska and a Juris
Doctorate from SUNY at Buffalo School of Law.
Thank you for being with us in
struggle and for taking action today!
Morgan Moore
Physicians for a National Health Program –
New York Metro
Follow us on Twitter, Facebook, and Instagram or the hashtags #PassNYHealth #NYHealthAct
#MedicareForAll!
Donate to support our work! www.pnhpnymetro.org/contribute
Wear
your support with our Medicare for All face masks and
t-shirts!
Amy Rowe commentary
Below my signature are notes taken during the American Hospitals
documentary Tuesday night and the panel discussion afterward. Forgive
the rough nature of my notes, for time reasons.
Here's
a quick introduction and summary, including the documentary's relevance
for those fighting a forced transfer to Medicare Advantage.
Big takeaways from documentary:
-
Private insurance companies pay much higher rates to hospitals than
traditional Medicare. If you have a percentage copay, you're paying a
percentage of a much higher price for a service or procedure. I assume
private Medicare Advantage companies have no more protection for
patients from this practice than do workplace group private health
insurance policies.
- Private insurance
companies' prices for hospital procedures and stays are negotiated
behind closed doors and basically invisible to consumers -
unpredictable, variable, and nontransparent - as well as being very
high. Traditional Medicare rates are low, transparent, public, and
standardized for each procedure.
- The quality
of hospital procedures is as high when traditional Medicare is billed
as it is when expensive insurance is billed. Either the documentary or
the panelists, or both, noted that for routine procedures like knee
replacements, your community hospital's outcomes are as high-quality as
academic-center hospitals (although for exotic procedures, you want the
academic-center hospitals).
- Panelists noted
after the documentary that the hospital medical error rate is just as
high for fancy insurance as for traditional Medicare: "We [nurses and
doctors] see what's going on." Fancy or high-priced workplace group
insurance doesn't protect you, they said. Conversely, traditional
Medicare's lower reimbursement rates to hospitals don't boost your
medical risk.
- Rural hospitals are closing
because they're small and less able to negotiate aggressively with
insurance companies for better reimbursement rates for procedures. When
they get less money than it costs to perform procedures, they can't go
on and they close. This threatens both the health of people in the area
and the health of the local economy, because businesses and people don't
want to live where they can't get health care, where if you have a
heart attack the nearest medical care is an hour away.
Despite
their huge profits - which have different names due to the nominally
nonprofit hospital structure - hospitals pay no taxes due to being
nominally nonprofit. That loads up the community with higher taxes, such
as on real estate, in addition to the burden of high insurance costs
and high medical costs.
Thoughts from me - skip this section, friends, if you've heard this before, and scroll straight to the NOTES section
below my signature - about how the documentary relates to the fight
against a forced transfer to Medicare Advantage (the documentary focused
more on group health insurance for employees than on Medicare):
-
Medicare Advantage companies will not fail to learn and use every
technique perfected by group insurance plans (often owned by the same
companies) for employees, which shift more and more costs from the
insurance company onto the insured sick person and their families. Many
people in medical bankruptcy in the U.S. have medical insurance.
-
The requirement for sick patients to fight private insurance companies,
such as Medicare Advantage companies, to access necessary medical care
is particularly dangerous and inappropriate for retirees, who are older
and sicker and have NO human resources department or union to negotiate
or fight for them.
- The injustice of a
forced transfer to Medicare Advantage and a foreseeable, unwinnable war
for essential medical care is magnified for those whose jobs made them
sick, such as 9/11 first responders and civilian employees forced to
continue to work near the toxic smoke, or whose jobs cause physical
danger, wear and tear, high stress, and high fatigue, including police,
firefighters, educators, medical professionals, and others whose jobs
forced them into public contact during Covid.
-
No self-respecting New York City taxpayer (who has a degree of good
luck to have enough income to pay taxes) would wish suffering, including
that caused medical neglect / denial of care / inferior, restricted,
unpredictably accessible care, on any human being, least of all NYC
retirees, to save money in a city and state with alternate ways to save
and take in money. That is a morally depraved and unnecessary path to
more money for the city or for some union leaders.
Amy Rowe
Brooklyn, NY
NOTES - American Hospitals documentary and panel discussion, Tuesday, April 11, 2023, 7:10 pm, Quad Cinema, New York City
