Saturday, June 25, 2022

Dems and UFT want everyone in Privatized Medicare Advantage (MulgrewCare)- Machinist Retirees Resist, Threats to Working Member HealthCare


Our leadership is willing to sacrifice our health care needs for their own narrow political ends.
 
 
That may not be such an easy sell as:
...it looks like Mulgrewcare might eventually be coming to active people. Only a judge stopped a healthcare plan that would have denied a choice of free plans for retirees. We called the inferior plan Mulgrewcare.--- James Eterno, ICEUFT Blog
This is not only a local but a national issue as a project of the Dem party since the Clinton days:
A Biden administration official in charge of the program has said they intend to have all the traditional Medicare beneficiaries in such for-profit programs by 2030..... Daily Kos
And the UFT/AFT/NYSUT anti progressive agenda is tied to Dem Center right corporatists where the health care industry pores millions of lobbying dollars.

Saturday, June 25, 2022
 
There's a lot on this plate for you to chew on. Retiree Advocate continues to work toward fighting the attempt by the city and our own beloved union to remove us from Medicare and into a higher expense MedAdv plan to save money. Someone explain how much higher expenses save money unless it comes out of services.   
 
June 30 will be a year since our big march and rally to protest MulgrewCare. Posts from June/July 2021:
Last week we had another rally at city hall. I've been trying to keep up with the story:
And James has an update:
  • ICEUFT Blog ACTIVE CITY WORKERS NEED TO WATCH OUT FOR UNIONS DISCUSSING HEALTHCARE SAVINGS - UFT Chapter Leader Update: Efforts begin to rein in health care costs. The Municipal Labor Committee, the umbrella group of nearly 100 municipal labor unions including the UFT, negotiates the health care benefits of all city workers. The top priority of the MLC and the UFT is to maintain high-quality, premium-free health care for all city workers even as costs increase year after year. The city, with the MLC’s support, issued a request for information on June 16 to let the health care industry know that the city is seeking a 10% decrease in health care costs without sacrificing any of its employees’ existing benefits
This cutout from the article on the Machinists resistance sums up the situation:
the Medicare direct contracting pilot program that Trump initiated where equity firms and insurance companies could come in and basically buy up clinics and medical facilities and move people over to that private system without having to really notify them or explain to Medicare recipients that they were now in a different system,” Lux told the members.....  there is about $1.6 trillion in the Medicare Trust Fund that these private equity firms and insurance companies are just waiting to get at—to make a profit 
While we know it's impossible that we will see Medicare for All nationally, there is the NY Health Act which both the UFT and DC 37 oppose. Why? One answer is they employ many people to handle our healthcare and those, often patronage, jobs would disappear. The other is that they can claim to members that the leadership has delivered health care and once that's out of their hands, what else can they deliver? Bupkus. So our leadership is willing to sacrifice our health care needs for their own narrow political ends.
 
It is important to connect what's happening locally with the national trend which is privatization to save money on the backs of the patients while insuring massive profits to industry. I posted a story from The Lever on how Biden is pushing privatization:
BTW - Biden has appointed a guy who wants to privatize social security too.
Reality check -- 2024 will be a disaster and will have the even more awful Rep a trifecta and a DeSantis will be a smart Trump and give us our own Viktor Orban. For me the only Dem who could have a chance is John Fetterman but given his health etc that is a dim chance. Pete or Harris? OY! We're dead.

Here are two more stories to check out: An update from the lawsuit that has stopped MulgrewCare so far and  -- this union is fighting back:

Thursday, June 23, 2022

VOTE NO on Whatever Contract Unity Negotiates/ Resist UFT Cone of Silence, Calls for Open Bargaining

We simply cannot surrender our right to share with our coworkers information that affects their livelihood. We were elected to the Executive Board to amplify the needs of our members, not to make decisions unilaterally behind their backs....
Alex Jallot and Ronnie Almonte, UFT Ex Bd High School (as of July 1, 2022)
The cone of silence descends on the UFT negotiating committee. Some UFT Ex Bd members refuse to sign the Non Disclosure Agreement. 

I believe just about all contract issues have been pre-decided by the leadership already - including what they will accept. Don't hold your breath for inflation matching raises. Any hint of preventing this farce by open bargaining has been disparaged by Unity -- you don't bargain in public.

Until you do:

Turning the Tables: Transparent, Big, and Open Bargaining ...

Feb 8, 2022from Jane McAlevey ... How unions negotiate is a strategic choice. Seldom do union members experience the actual process of collective ...

Seven Steps to Opening Up Bargaining | Labor Notes

Open- versus Closed-Door Negotiations - JSTOR

UFT will put a giant version of the cone of silence over contract meetings.
 

 

 

 





 
 
 
Thursday, June 23, 2022

I've been mocking the UFT/Unity leadership over its faux negotiating committee farce for years.

Saturday, August 8, 2009
UFT Contract UFT Cast of Thousands Contract Committee
I raised some questions on the then 350 member Neg Comm, now expanded to as many as can fit in the cone of silence dome.

Questions on the Negotiation Committee: How are people chosen to be on this committee? Of the 350 committee members how many are in Unity Caucus? Does secrecy mean that Unity Caucus members don’t discuss the issues brought up for discussion among themselves? Are we to believe that the only discussion that takes place among Unity Caucus members is in the committee room?

If you think top level Unity don't discuss the issues beforehand, take a walk on the bridge you just bought.

In fact, I believe just about all contract issues have been pre-decided by the leadership and their main problem is how to filter the info out to the negotiating committee and how to do it to make it look democratic. Every committee will echo the election committee with a Unity majority. I like that there are people who want to be on the neg Comm even if having to sign the NDA and also that there are people who won't sign.
 
 
We know the contract will suck and many in the opposition will call for a Vote No campaign - in fact I'm starting the campaign right now -- oh, shit, retirees don't get to vote on the contract. You working stiffs have my proxy.

Some Unity slug will stop by to comment on how dumb I am.
 
 I urge people to accept the reality and just call for a NO VOTE NOW.

But most people connected to United for Change who are on the committee are signing the NDA - but we do have some newly elected Ex Bd people who were added to the negotiating committee but are refusing to sign and therefore will not be on the committee -- and they came under attack by ubber Unity Hack Richard Skibbens.  But who cares?
 
 
Here is the statement by these two members of MORE:
 

WE believe our union's contract should be open and transparent to all members and stakeholders (see the work of Jane McAlvey). 
 
Under the duress of our union leadership's decision to keep talks with management confidential. I am compelled to sign today's agreement because the interests of my chapter must still be represented in these negotiations.

As newly elected Executive Board members, we have been invited to join the union’s contract negotiating committee. In a time of pandemic and budget cuts, it’s critical that we bargain for better salaries, benefits, and working conditions.

As workplace leaders, we also believe that our union’s strength depends on making decisions collectively with openness and transparency. Unfortunately, the UFT has a long practice of requiring members (who are hand-picked) to sign a non-disclosure agreement (NDA) as a condition for serving on the negotiating committee. We oppose this policy because it prevents the membership from holding the committee accountable, puts pressure on the UFT to broker backroom deals with politicians rather than rely on the strength of the union membership, and thus undermines the union’s ability to win a strong contract. For this reason we oppose the NDA, and refuse to sign it as much as we would like to join the committee. We simply cannot surrender our right to share with our coworkers information that affects their livelihood. We were elected to the Executive Board to amplify the needs of our members, not to make decisions unilaterally behind their backs.

The upcoming negotiations with the city must be open and transparent. In this way the membership can be made aware of what’s at stake, can follow the progress of negotiations, and can be mobilized in moments where the city refuses to compromise. Our members are the union, and their activity is the source of its power. Open bargaining is the path to securing the working conditions we deserve, and the schools our students need.

Signed,

Alex Jallot, Ronnie Almonte

Ex Bd meetings will be fun again next year. 

 

Tuesday, June 21, 2022

Join the June 23 People’s Panel for Educational Policy!- Make your voices heard

Shades of the Bloomberg era - it's time to go back to the PEP - except they got an emergency reprieve from having to face the public in person through the July meeting -- so this is zoom only. 

I have little doubt that Adams etc are privatizers of public schools. Cut the budget deeply and create demand for the charter school cap to be lifted. The class size law? Hochul hasn't signed it yet. Adams doesn't want it. Watch the primary outcome to get a clue to see if she signs it.
Norm Scott
 

Calling all Parents, Students, Educators, and School Staff

Make your voices heard – In Unity There is Strength!

Join the June 23 People’s Panel for Educational Policy!

Budget Cuts? Layoffs? School Closings? Class size? Charter School Takeovers? High Stakes Testing?  Homeless Families?

Defend Our NYC Public School Communities

Whose Schools?  Our Schools!

Hosted by the Coalition to End Mayoral Control https://www.nycmayoralcontrolnot.org/

Thursday June 23, 2022.  6:00 -7:30 PM

Register for the zoom call below.   If you wish to speak sign up  when the meeting begins

You are invited to a Zoom meeting. 

When: Jun 23, 2022 06:00 PM Eastern Time (US and Canada) 

Register in advance for this meeting:

https://us04web.zoom.us/meeting/register/upIpdumrrjwpGtRwUNpm6YT8jecxeg06wVfS


After registering, you will receive a confirmation email containing information about joining the meeting.


 

Monday, June 20, 2022

Support Class Size Matters: "Skinny award" dinner June 27, 2022

I've been to almost every one and was a proud recipient a few years ago. There is no more consistent fighter for the public education community than Leonie Haimson.
See you there!
 
 
lso news update on city budget
Dear folks-

Class Size Matters would like to invite you to our “Skinny Award” dinner to be held Monday, June 27 at 6 PM. This our first fundraiser in three years, and especially important this year as we have something really momentous to celebrate: the passage of a new state law that will require NYC schools to lower class size to much smaller levels.

We are honoring the groups and individuals who made this happen, and thus gave us the real “Skinny” on NYC schools:

  • The Alliance for Quality Education, for leading the successful battle to provide full Foundation aid to NYC schools at last;
  • State Senator Robert Jackson and Assemblymember Jo Anne Simon, for introducing the original bills requiring our schools to lower class size;
  • Assembly Education Chair Michael Benedetto and NYC Senate Education Chair John Liu, for shepherding the class size bill to passage this session;
  • A special "Parent Visionary" award to Johanna Garcia, education advocate and Chief of Staff to Sen. Jackson, for her persistent and passionate advocacy over many years to achieve the goal of fully equitable class sizes for NYC children.

Wine and light food will be served!

For more information and to purchase tickets to attend either in person or remotely, please click here. If you’d like to contribute to the organization without attending, you can do so here.

2. Sadly, despite all our advocacy, briefings and testimony, and all your emails and calls, the City Council agreed to a budget deal with the Mayor that did not restore any of the $215 million cuts to school budgets for next year; a deal that will be voted on tomorrow night. It is likely that in many schools, this will force class sizes higher and/or cause the loss of critical services, and I urge you to work with your School Leadership Teams to try to ensure that your school's core teaching staff is protected as much as possible.

Clearly, Mayor Adams and Chancellor Banks have no intention of obeying the will of the Legislature to require them to lower class size, and instead are thumbing their nose at them, as I say here. Which makes it even more critical that Governor Hochul to sign the class size bill as soon as possible, which will give us legal leverage to stop these cuts or at least minimize their damage.

So please, call the Governor at 518-474-8390 , and message her here. Tell her: Please sign the class size bill as soon as possible so that NYC class sizes do not increase and instead, our students are provided with the same smaller classes that kids in the rest of the state already receive. We have also posted a petition that you can sign here.

I’ll be in Albany on Thursday, and if we get enough signatures, I’ll try to deliver it personally to her and/or her staff.

Hope to see you on June 27!

Leonie Haimson
Executive Director
Class Size Matters
124 Waverly Pl.
New York, NY 10011
leonie@classsizematters.org
www.classsizematters.org
Follow on twitter @leoniehaimson
Subscribe to the Class Size Matters newsletter for regular updates at http://tinyurl.com/kj5y5co
Subscribe to the NYC Education list serv by emailing NYCeducationnews+subscribe@groups.io

Sunday, June 19, 2022

Christina Gavin Defends Her Reputation Against False Claims by Unity Hierarchy and District Rep Woodruff


You have to listen to these podcasts and the recordings of the interactions between Christina Gavin and Bill Woodruff to get the full picture of what happened at a s0-called UFT District "social" event; just a week before UFT ballots went out.
 
(If the player doesn't work try clicking the URL.)
This is not the first time we've heard of bizarre behavior from Woodruff, but I will get into that at another time. In fact, the Unity defense of Woodruff itself constitutes bizarre behavior.
 
Here are some previous posts:
But let's put things into context. Christina took the lead in compiling election complaints against Unity which is the cause of the persecution of Christina by elements of the UFT leadership. (I'm not sure there's unanimity inside the leadership in this crusade against Christina.) Ok, she is relentless and willing to go to the mat for her beliefs, a much needed elements all too often missing from the usual suspects (me included) in the opposition. And make no mistake about it, Christina is not one of the usual suspects.
 
You really can't  make this stuff up. A must listen 2 part series by our fave podcaster, Noah Teachey exposes the entire rotten process. Note Christina's point by point take down of the UFT leadership case. She should be the lawyer for the UFT, not Beth (nicknamed Rude Beth by Christina) Norton.
 
In Part 2 (Ep. 46) take particular note of the actual recording of Leroy Barr and UFT attorney Beth Norton subjecting Christina to the third degree on when she eats lunch. Bizzaro-land. The Woodruff stuff is pretty funny too.
 
Here are Noah Teachey's notes:
 
 This week, Christina Gavin (school librarian, MORE UFT caucus member, and UFC candidate) makes an appearance on the show to tell us her story from the UFTwilight Zone, where the bureaucracy of a union meant to support educator-members sometimes turns on these very educators if they dare to identify the majority caucus's breeches of UFT election policy and national labor law. This is part 1, which sets the stage for the story and establishes how Christina first became known to Unity's higher-ups. Be sure to tune in next week for some pretty serious evidence of Unity deceit and the thrilling conclusion of the story.

https://lnns.co/a1ipI3JXKEC 

 Ep 46: The UFTwilight Zone pt. 2, feat. Christina Gavin

In today's episode I'm joined once again by Christina Gavin, a librarian, unionist, and self-proclaimed smart-aleck. This is part two of a two-part episode exploring the UF Twilight Zone, a land governed by a single caucus in which the line between fact and fiction is blurry at best. If you haven't heard part 1, which is episode 45 of the show, be sure to go have a listen so we're all on the same page.

>>Christina's conversation with Bill Woodruff: bit.ly/inappropriatebillwoodruffreadalong

>>Play "spot the contradictions" in this false complaint: bit.ly/inappropriatebillwoodruffcomplaint

>>Read and sign an open letter to UFT leadership on Christina's behalf: bit.ly/openuft

>>If you're enjoying what you're hearing, and want to hear more, check out patreon.com/professionaldevelopment

https://lnns.co/fRwSrFs9Be2

Woodruff apologizes to her for a half hour, saying she did nothing wrong at the UFT event and then goes on to file charges against her, along with two other Unity candidates, also on the union payroll. And the UFT gang defends him to the hilt.
 
https://www.listennotes.com/e/64c196a127fb4870ba2eb2e768fb4efc/ ====
After Burn

Note this comment by a Unity hack on one of my posts on the Christina situation.

Really, Norm, first you go on about Christian Glavin without noting that she was the person who filed the charges against Janella Hinds falsely accusing her of electioneering on union time. And now you are telling us that Unity candidates shouldn't be able to use their personal Twitter and Facebook accounts to campaign for election -- for some reason. What were you and all the UFCUFT candidates doing? Were all of your personal Twiiter and Facebook accounts that campaigned for election hijacked?

Hi Saturday Anonymous,

My name is Christina; not Christian.

If you were more informed, you might know that no “charge” was filed against Janella Hinds. An inquiry was made and a follow-up inquiry was made too, based on the fact that Mr. Cambria and Ms. Norton had at several junctures in the election provided misinformation, even when asked repeatedly.

Seven times over the course of 37 days Mr. Cambria (informed by Ms. Norton) adamantly told UFC candidates that the UFT was not a nonprofit organization, for example. They also informed representatives of all candidates & Marie Wausnock that the UFT’s Communications and Accounting departments have said that it costs $11 to send each email when asked about the cost to send an email to a portion of membership.

Asking twice was no reflection on Ms. Hinds’ character but was based solely on the repeated instances of off-the-cuff wrong answers from Mr. Cambria and Ms. Norton, as I later told Ms. Hinds myself in a phone conversation about this topic.

Indeed Ms. Norton herself stated that no complaint had been filed against Ms. Hinds, but “an inquiry that may lead to a complaint” had been sent to the UFT.

You write to Norm “you are telling us that Unity candidates shouldn't be able to use their personal Twitter and Facebook accounts to campaign for election -- **for some reason**”

UFC did not say this for **some or no reason,** as you falsely claim. On January 31, Mr. Cambria had emailed UFT employees “reminding” them that they were not permitted to use the same accounts to both communicate with members in their roles as representatives of the union and campaign for candidates/caucuses. Was this an unreasonable directive for him to give? Arguably. Was it a UFT directive given by the UFT Election Chair to UFT employees? Undeniably.

Perhaps you should spend less time making uninformed statements from behind anonymous accounts; it might help you to be less wrong in your future commentary.

My reply to the hack attack:
Obfuscation and distraction. Uft employees - people we pay out of our dues. District reps abused the process. They have power over teachers. One of them in essence threatened not to rep a teacher because of his association with me. As for the charge against Janella that was an admitted mistake, apology offered and accepted. It was unity people who claimed the mistake was racist by another black woman - and I do note the vehemence of attacks on Christina and Camille by Unity. A hint of racism at the so called angry black woman. Like the unity hack at that d 7 event who felt threatened by Christina being behind her. If Christina were white would she have felt threatened?
 
Look for follow-up commentary on the misbehavior of Woodruff (Arf)  and other UFT officials.
 

Saturday, June 18, 2022

Successful anti-MulgrewCare Rally - Politicians support including Jumaane Williams (for Gov) - Cross-union Retiree Organizing Committee (CROC)

Retiree Advocate/UFT is part of CROC --- a really good group of NYC union people -- one of the more successful broad union groups brought together by the attack on our Medicare by our own union leaders.

If you wander what UFT retiree activists do, we have noon rallies, followed by a trip to a bar. We had a great rally on Thursday outside the gates to City Hall - much bigger attendance than I expected. What surprised me the most was how many electeds support us. Jumaane Williams on the way to another event in his run for governor, lent some cheer.

Of course we went to a bar afterwards -- but our old fave on Murray St has closed down permanently but we found another.

Signatories on Open Letter to NY Elected Officials Public Advocate

Jumaane D. Williams

New York City Council Members

Kristin Richardson Jordan Christopher Marte
Sandy Nurse
Charles Barron

Kamillah Hanks Shahana Hanif Alexa Aviles Julie Won Althea Stevens Tiffany Caban Carlina Rivera Lincoln Restler

NYS Assemblymembers

Robert C. Carroll Peter J. Abbate Stacey Pheffer-Amato William Colton Demond Meeks

Jo Anne Simon Gina L. Sillitti Kenneth Zebrowski Harvey Epstein Yuh-Line Niou

NYS State Senators

Jabari Brisport

 

Old ICERs: Pat Dobosz, Sean Ahern, Ellen Fox


Bobby Greenberg on right - New Action and Retiree Advocate



 

For Immediate Release

June 16, 2022


Contact:

Sarah Shapiro, CROC

smshapiro@hotmail.com



Municipal Retirees and NYC Elected Officials Demand Mayor Adams Stop Plan to Privatize Their Medicare


Photos and Video from Rally Here 



NEW YORK- Scores of NYC retirees from diverse municipal unions of teachers, plumbers, sanitation workers, hospital workers, school staff, firefighters and others gathered at City Hall with New York City elected officials to deliver a letter to the mayor telling him to stop the “ bait and switch” with Medicare benefits – by pushing them into a for-profit Medicare Advantage plan that is more costly and more likely to delay and deny them care. 


The former city workers, members of the Cross-union Retirees Organizing Committee (CROC), shared their grave concerns about what the switch to “Medicare DisAdvantage” will have on their health as it cuts the quality of their care as private insurance companies skim off profits from the plan. 


“I have atrial fibrillation, which carries a high risk of stroke or worse. I’ve reached the limits of surgery, and the usual drugs prescribed for afib would probably kill me. I sometimes need cardioversions to stop the afib – nothing else works. My doctor, one of the top doctors in the field, knows all this. With Medicare Advantage, my fear is that decisions about my health would be made by a stranger, someone who is not an expert in the field, who doesn’t know my history, and whose main concern is cutting costs. This is genuinely life-threatening for me," said Martha Cameron, who gets Medicare through her husband, a retired computer programmer for the City for 25 years.


Retirees delivered an open letter to Mayor Adams, signed by two dozen city and state elected officials calling on him to drop his appeal in a lawsuit seeking to force the 250,000 retirees into Medicare Advantage or pay a fee to keep their traditional Medicare. 


City Council members Alexa Avilés, Christopher Marte and Kristin Richardson Jordan and Assembly members Robert C. Carroll, Harvey Epstein and Joanne Simon joined the rally with seniors to demand Mayor Adams end his court battle against the workers who had served the city for decades.


“As Medicare Advantage plans face increased scrutiny over fraudulent billing and coverage denials, now is not the time for New York City to force retirees into these privatized plans,” said Council Member Alexa Avilés. “The City is shirking their responsibility to retirees who have served it honorably and now want to live out with a sense of security and dignity.  Retirees rightfully earned their benefits through years of dedicated service. We should deliver for them, not private companies that we know put profits over people.”


In place of their trusted and excellent traditional Medicare with premium-free supplement, the mayor now wants to force them to pay $2300/year to keep the excellent Medicare they have always had and were always promised.


“Our City’s municipal retirees should not be forced onto private Medicare Advantage plans. It won’t improve their healthcare and won’t save the City money.  New York City should not be undermining Medicare and must keep its promise to City workers that they retire with dignity and security,” said Assemblymember Robert Carroll


“No one should have to choose between affording groceries, rent, other necessities,  or medical care but for thousands of workers, that is exactly the choice the City is forcing as it continues to pursue this bait and switch plan. After serving our City, municipal retirees deserve better,” said Assemblymember Harvey Epstein


“We should be expanding healthcare for New Yorkers, not making it harder to use and more expensive. Municipal retirees devoted their lives to running this city and planned on getting the Medicare plans they earned, not the inadequate substitutes that are being foisted on them,” said Assemblymember Jo Anne Simon. “I stand with the city's retirees and urge the Mayor to reject plans that provide less care but cost taxpayers more than traditional Medicare. Insurance companies siphoning off fees - money that should be used to provide care – to increase their profits is wrong-headed and just plain wrong.”


“Switching to the Medicare Advantage plan would leave our retirees overburdened and under-covered. They have spoken clearly against this change, the courts have supported them, and the Mayor ought to honor their request by dropping the appeal,” said Assemblymember Yuh-Line Niou. “Municipal retirees dedicated their lives to supporting this city, it is our duty to provide them the health care that they were promised.“


The retirees are fighting against the City’s plan to change their health benefits after years of service and dedication to this city. They say their traditional Medicare plan is much better.


“In May-- in ONE MONTH-- I had two emergency room visits and three CAT scans.  I am jumping for joy that all is well, and that I did not have to pay one cent for fantastic, immediate healthcare. WHY?  Because I have Medicare and a great supplement from the City of New York. I needed no prior authorizations and have no debt for incredibly expensive procedures.  I am lucky---but I'm here because I believe everyone should have this kind of care,” said Julie Schwartzberg, a retired staff trainer at the Health Department.

The for-profit Medicare Advantage plan is inferior, requires co-pays and dozens of prior authorizations and has a limited network of quality nationwide providers. It is also unfair to lower paid retirees with lower pensions– primarily women and retirees of color– who cannot afford to pay to keep their traditional Medicare.


Dana Simon, a retired librarian who is also visually and hearing impaired spoke of her nightmarish experience with a managed care insurance company in 2006 when her doctor recommended a 2nd cochlear implant surgery.


"The insurance company denied my surgery for almost 3 months. We had to appeal all the way to the NYS insurance commission, where three doctors finally ruled that my cochlear implant surgery was indeed necessary. But the whole ordeal took a real toll on me going through so many months of stress and heartache fighting for the medical care that I really needed. I'm afraid of the high rates of delays and denials these Medicare Advantage plans have. I don’t want to go through that again!” Simon said. 


Medicare Advantage plans are also a bad deal for taxpayers– as the profits private insurance companies siphon off raise their price tag tens of billions of dollars higher than traditional Medicare. Mayor Adams and Mayor DeBlasio before him have claimed the switch to Medicare Advantage is a cost saving measure for NYC, but the switch to a Medicare for All program like the New York Health Act would save the state billions of dollars, according to a 2018 study by the Rand Corp.

A recent federal study found that Medicare Advantage plans routinely delay or deny medically necessary care.


William Shenton, who retired from the New York City Housing Authority over 20 years ago, spoke of the ordeals he and his wife, Susan, have had with their drug coverage. 


“Susan has an incurable autoimmune disease. She purchased a private Medicare Part D drug plan for medication to treat her condition. This medication costs more than $12,000 for a 30-day supply.  Her monthly premium is about $30 and her copay is about $630 after more than $3,000 in January to get out of the “donut hole”. The NYC Medicare Advantage plan does not allow Susan to purchase a private part D drug plan. We are facing untenable expenses we hadn’t anticipated when I retired.”


The City’s plan, Medicare Advantage Plus, is administered by a consortium called the Alliance. This is made up of GHI, Emblem Blue Cross, and a national company called Anthem. Historically, Medicare Advantage corporations deny about 1 in 5 medical procedures. Anthem’s denial rate is twice the national average. 


Doctors and public health experts have raised serious concerns about the switch.

“This plan will reduce by nearly 25% the amount of money available to provide healthcare for City retirees. The City claims that the federal government will make up for what the City is not spending. That claim is false. Retirees will suffer under the City's Medicare Advantage plan,” said Leonard Rodberg, Research Director of the NY Metro Chapter of Physicians for a National Health Plan.


“Medicare (dis)Advantage places a middleman (a private health insurance company) between Medicare and the patient/doctor, resulting in denying or delaying needed health care through pre-authorization requirements” said Oliver Fein, Board Chair of Physicians for a National Health Program, New York Metro-chapter. “NYC retirees should not be forced into such an inferior plan.” 


The City Hall rally was the latest in the retirees’ campaign to stop the City from forcing them into costly lower-quality Medicare DisAdvantage.


The plan, originally approved by Mayor de Blasio, was scheduled to go into effect in phases starting in October 2021. Retirees from across the City came together to fight back and took the City to court. 


In March, a New York Supreme Court judge ruled that the City could not take away the retirees’ current traditional Medicare benefits.

Mayor Adams has taken over the push from his predecessor and is proceeding with an appeal, scheduled to be heard in the Appellate Court in September. 


###


Organizers: Cross-union Retiree Organizing Committee (CROC)













 


Hi all.
 
Sharing an op-ed from today’s NY Daily News that I authored in support of the tens of thousands of retired NYC municipal workers who are opposing a NYC-mandated effort to downgrade their medical coverage from traditional Medicare to for-profit Medicare Advantage.
 
Written in collaboration with Physicians for a National Health Program, NY Metro Chapter. PNHP is a single-issue organization that advocates for a universal, comprehensive single-payer national health program.
 
Written in memory of my life partner Ellen Bilofsky, to carry on her work.
 
 
 

image001.jpg
 
 

Reject the cruelty of Medicare Advantage, NYC

By David M. Newman
 
New York Daily News, Jun 16, 2022 at 5:00 am
 
When my wife, Ellen Bilofsky, was diagnosed in 2021 with grade 4 glioblastoma, an inoperable form of brain cancer, we understood that our remaining time together was limited. We hoped to spend it with family and friends, sharing joyful memories and making Ellen as comfortable as possible. We did not anticipate that the last six months of her life would be consumed by constant battling with our medical insurer to obtain the care that Ellen needed and deserved. This happened largely because our excellent union-negotiated, employer-provided retiree health care coverage had been downgraded from traditional public Medicare to a for-profit Medicare Advantage plan.
In one instance, Ellen’s hospital-based medical team prescribed in-patient acute rehab, and, although the rehab facility approved her admission, our Medicare Advantage Plan determined these decisions to be “medically unjustified” and denied coverage. The denial was eventually overturned — but only after significant delay and interruption in treatment, and significant effort on our part to overturn the denial.
In a second instance, as Ellen’s life neared its end, her medical and rehab teams jointly determined that therapeutic and rehab treatment were no longer effective and prescribed palliative in-patient acute hospice care. The hospice facility approved her admission, but our Medicare Advantage plan again denied coverage, claiming Ellen was not ill enough to warrant in-patient hospice care and directing that she be discharged to home. We again appealed but this time we lost and Ellen returned home, presumably to die there. Only after direct intervention by a member of Congress did the plan agree to cover in-patient acute care hospice, to which she was clearly entitled per both Medicare and Medicare Advantage guidelines. Ellen passed away a few short weeks later in August 2021, after receiving excellent care at the hospice facility.
I am sharing these examples of the pain and suffering our Medicare Advantage plan caused our family because today 250,000 New York City municipal retirees are in court fighting to protect their quality health care from a similar switch from Medicare to Medicare Advantage. I urge Mayor Adams to withdraw his court appeal and cease efforts to force this switch.
Ellen was a strong and tenacious woman and, ironically, she had been advocating for years for universal single-payer health care as a social and racial justice issue. She was a tireless advocate for Medicare for All and the New York Health Act, which guarantees health care as a human right, and which would have provided the care she needed according to her medical team’s recommendations, without interference from insurance administrators. I remind the mayor that in his previous position as Brooklyn borough president, he hosted an informational forum on the New York Health Act — a forum that, incidentally, Ellen was instrumental in helping to organize and which highlighted many of the harms caused by privatized health care.
In April, an investigation by the Office of the Inspector General of the U.S. Department of Health and Human Services confirmed that Medicare Advantage plans “sometimes delayed or denied…beneficiaries’ access to services, even though the requests met Medicare coverage rules.” It also noted that “denying requests that meet Medicare coverage rules may prevent or delay beneficiaries from receiving medically necessary care.”
Given Ellen’s experience and these findings, the city’s municipal retirees are right to be concerned that, under a Medicare Advantage regimen, they may suffer denied and delayed medical care. We were fortunate that a high-ranking elected official was able to secure in-patient acute hospice care for Ellen. However, it should not require congressional intervention for insurers to cover medically necessary treatment to which patients are clearly entitled.
The purported rationale for moving from traditional Medicare to Medicare Advantage is cost savings for the employer. In my case, that was a large telecommunications corporation. With regard to municipal retirees, that is the City of New York. However, recent research indicates that switching seniors to Medicare Advantage plans between 2010 and 2019 has cost Medicare in excess of $100 billion more than keeping them in original Medicare would have been. A better way to cut costs — while actually providing comprehensive coverage — would be to pass and implement the New York Health Act, which, according to one recent analysis, would save New York State $16.8 billion annually.
On Thursday, June 16, retired NYC municipal workers will join with councilmembers at City Hall to urge the mayor and city to protect retirees, retain traditional public Medicare coverage, and cancel the switch to Medicare Advantage.
Mayor Adams should stand up for quality public health care for all, and for the employees who served our city for decades. He should drop the city’s appeal to their lawsuit, restore their access to traditional Medicare, and work with New Yorkers to lower healthcare costs, remove barriers to treatment and raise the standard of care.
Newman is a resident of Flatbush, Brooklyn.