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).
