Friday, February 25, 2022

Digging Behind Mulgrewcare - - Biden [and Mulgrew] Sticks with Trump Scheme to Privatize Medicare

The article below dovetails with MulgrewCare and the UFT lining up with the Biden corporate Dems: Oppose single payer/medicare for all and the NY Health Act and support the private insurance industry. 

Friday, February 25, 2022

The more you examine UFT/Unity Caucus policy the more you see the links to fundamental Republican and corporate Democratic support for privatized schemes that drain funds from public options. (Think of how the UFT didn't rigorously oppose charter schools initially and even started two of its own, both failures). 

And make no mistake about it, the core UFT policy is center-right Democratic Party. Thus the move away from traditional medicare by Mulgrew fits perfectly into the overall plan to scuttle medicare and enrich private ensurers. 


Mulgrew claims the money comes from medicare to the private insurer so it doesn't cost the city money. This is true but ignores that in essence instead of medicare paying directly to your doctors they give the money to the private insurer who then pays the doctor or hospital - after taking its profit. How do they make a profit? Medicare pays an extra 5% to cover the higher administrative costs -- which even Mulgrew admits to. Who cares he might say, it's not out of our pocket. But actually long-term it is out of our pocket.

Every month I get my socials security check from the federal govt. Imagine if they installed a private agency to get my check, take a bit off the top for "admin" costs and then send it on to me.

Private insurers have another way to squeeze medicare. Upcoding, as explained to me by my podiatrist. They use any excuse to upcode the patients -- meaning taking any condition you have that medicare might pay say $100 for and making it look worse so medicare would have to pay say $150 for the same procedure.

Now, the point is you the patient is not getting any better service or care -- in the long run worse care because abother money maker is denials and forcing you to go through a pre-approval process. Now Medicare also has pre-approvals and 85% of MedAdv preapprovals match medicare -- but 15% doesn't -- and therein lies more than a few bucks for the privatizers. 

The end-game is the total dismantling of a publicly managed program and opening up the entire post-65 population to the privatizers. The article below shows how the Biden admin has put a Trump plan into the hands of Nancy Fowler, a chief ally of private insurers in a plan that will join Mulgrew in trying to gut medicare.

I will add one one point and that is the people who are employed by Medicare --

Wednesday, February 23, 2022

What’s So Funny About Peace, Love, and Democracy at the UFT Delegate Assembly?

Whoever controls the agenda, controls the debate... old adage

I was there it was awful so much bullying and yelling from unity they look so weak.. Comment on ICE blog

The suppression of UFC Candidate Camille Eterno by Unity Caucus led Michael Mulgrew at the February 2022 UFT Delegate Assembly and the subsequent


distortions by Unity Caucus hacks on social media has resulted in some deep dives.

Unity seemed to think they had a slam dunk, but the event has sparked a lot of analysis of how the DA is run and how it should be run. 

Camille speaks up for herself on the UFC site:

Cl Nick Bacon, elected with Unity in 2019 but now running for UFC HS Ex Bd gets 2 whacks with his article at  New Action – UFT

 James posts on ICE blog: 

I posted:

  • UNITY Caucus Modus Operandi: Oppose debates and Attack Female Pres Opponents, Moms Camille Eterno and Julie Cavanagh on DA Attendance   

A Major analysis of the DA

But today the star of the show is a deep dive on the DA by a very knowledgeable UFT member with a deep understanding with a magus opus on the DA -- which I was going to write, so thank goodness I was spared -- though I still may torture readers with a follow-up.

It appears on the UFC blog: https://unitedforchange.vote/whatsofunny/  and I'm reprinting it in full.

What’s So Funny About Peace, Love, and Democracy at the UFT Delegate Assembly?

Monday, February 21, 2022

UNITY Caucus Modus Operandi: Oppose debates and Attack Female Pres Opponents, Moms Camille Eterno and Julie Cavanagh on DA Attendance

What Really Happened at the February '22 DA with Nick Bacon, UFC Candidate for HS Ex Bd  - superb and not to be missed.

https://www.spreaker.com/user/14957478/ep-29-what-really-happened-at-the-februa

...to expect a young mother to teach a full day, tend to her infant child, and travel to meetings without fail is ridiculous at best, and misogynist at worst.... Arthur Goldstein, NYC Educator, March 24, 2013- Should Working Mothers With Sick Babies Attend the DA?

Julie Cavanagh --- I certainly do not need to defend my attendance at Delegate Assemblies. While I do attend, often, DAs are not a democratic forum. As I am sure the commenters on the ICE and MORE blogs know, and as all Unity folks know, for most chapter leaders, the first DA in October is their last. Why? Because, the room is not even large enough for all of the CLs and delegates to be seated and when you do go and sit, you listen to Mulgrew practice his stand up routine for an hour or so, after which you *might* have the chance to ask a question or bring a resolution to the floor if Mulgrew recognizes you. Regardless, it is an effort in futility because it really doesn’t matter what you say, ask or bring to the floor; the ruling Unity caucus will disagree with it or vote it down, since they control the DA. If the UFT leadership actually held Delegate Assemblies each month that were informative and provided fair and ample time for discourse and discussion, I would be there in a New York minute....
instead of relaxing while my baby takes a nap, I am writing this in response to comments on the ICE and MORE blogs attacking my commitment as a unionist and chapter leader and questioning my worthiness as a candidate for UFT President. All of this because I, and the caucus I represent, had the nerve to insist that Michael Mulgrew engage in a forum or debate with me
 
UFT Presidential candidate Julie Cavanagh, March 2013

February 21, 2022

The recent attacks at the Feb. DA by Unity hacks, led by the wailing of Leroy Barr and the bullying of Mike Sill, assaulting UFC Presidential Candidate Camille Eterno over her DA attendance record reminded us that they did the same to brand new mom Julie Cavanagh when she ran against Mulgrew in 2013. Of course Camille, due to Unity acceptence of fundamental ed deform that led to closing schools based in UFT supported high stakes testing, the end of seniority and the creation of the ATR pool, has had to shift over the past years from school to school, so attending the DA until recently was not an option, especially during the pandemic. Plus the fact that Camille's credentials were not sent in time for any of the DAs this year so she could attend in person.

Perhaps seeing the UFT under Mulgrew and Unity is a locked box, Julie went another route and became a supervisor. She is now one of the most respected (by teachers and other UFT members) principals in the city. Last week I met a teacher at her school who told me she felt blessed to find herself working for Julie.

They are not even creative enough to come up with something new. While you'll get a dry partial story on some reports from the DA you will get the full story by Nick Bacon, who was actually elected running on the Unity slate in 2019, but now in New Action and running for HS Ex Bd with UFC:

New Action – UFT Unpacking the February DA - The February DA was a farce, but not for the reasons our leadership would have you think. United for change has a problem: we haven’t been called on durin... 

And James:

ICEUFT Blog UNITY ATTACKING CAMILLE'S UNION RESUME AS THIN SHOWS THEY CAN'T EVEN DO OPPOSITION RESEARCH HONESTLY - This post is for the Unity Caucus people who have made their line of attack on Camille Eterno that she doesn't have the experience needed to lead the lar...

You can hear Camille on the Matt and Abie podcast - https://open.spotify.com/episode/5AsrTYY5hoboFYHU96Y4fI

Back to 2013 -  Sunday, March 24, 2013 NYC Educator post:

Should Working Mothers With Sick Babies Attend the DA?

There's a small ruckus on the MORE blog about whether or not UFT President Mike Mulgrew should debate his sole opponent, Julie Cavanagh. While the respondents are often more civil than the juvenile ravings that haunt the ICE blog comment section, their arguments are bizarre, to say the least. As it happens, candidate Julie Cavanagh has an infant son, and the best argument they can seem to muster against her is that she doesn't attend the DA frequently enough.

The implication that she would neglect her duties, as a result, is beyond offensive. With all due respect, Mulgrew is not a full-time teacher. It is one of his primary responsibilities to conduct the DA. Cavanagh's primary responsibility is to teach her classes. If she couldn't be bothered doing that, we might have something to discuss. Or, depending on the circumstances, we might not. But to expect a young mother to teach a full day, tend to her infant child, and travel to meetings without fail is ridiculous at best, and misogynist at worst. 

UFT members deserve to hear the ideas of those who'd presume to lead us in a free and open forum. If, in fact, Unity's ideas are so much better than those of the opposing caucus, it behooves them to demonstrate it.

The notion that the DA is remotely a substitute for free and open debate is preposterous. It is an insult to the intelligence of teachers everywhere. Anyone who contends the DA is a suitable forum for a debate between candidates is disingenuous and misleading, qualities I wouldn't seek in a chapter leader, let alone a union employee. 

and a follow-up on Mulgrew refusal to debate Julie: Saturday, March 30, 2013

Who's Afraid of Julie Cavanagh?

I think we saw at the Feb. 22 DA, nothing much has changed from this report 9 years ago - in fact the lack of democracy is worse.

James reported back in 2013

Thursday, March 21, 2013

 and here he prints Julie's response and challemge to Mulgrew to debate her.

Wow. While having breakfast with my husband and almost nine month old son (who is finally on the mend after more than a week of a fever ranging 102-104 every day, during the same time my best friend’s 18 month old daughter was in the hospital, who by the way is also a teacher and a single mother of two young children) I picked up my phone to see a mention on Twitter from Arthur Goldstein (teacher and chapter leader in Queens). I frankly couldn’t believe what I was reading. Usually a mention from Arthur has me in stitches, not this time.

Now instead of relaxing while my baby takes a nap, I am writing this in response to comments on the ICE and MORE blogs attacking my commitment as a unionist and chapter leader and questioning my worthiness as a candidate for UFT President. All of this because I, and the caucus I represent, had the nerve to insist that Michael Mulgrew engage in a forum or debate with me so that our members can be fully informed and engaged when it comes to their voting choices in the upcoming election.

First let me say that I do not feel I need to defend my role as a chapter leader. Nearly every UFT member in our school, signed my petition for UFT President, and many of my colleagues are actually running in this election with MORE. 

Second, I certainly do not need to defend my attendance at Delegate Assemblies. While I do attend, often, DAs are not a democratic forum. As I am sure the commenters on the ICE and MORE blogs know, and as all Unity folks know, for most chapter leaders, the first DA in October is their last. Why? Because, the room is not even large enough for all of the CLs and delegates to be seated and when you do go and sit, you listen to Mulgrew practice his stand up routine for an hour or so, after which you *might* have the chance to ask a question or bring a resolution to the floor if Mulgrew recognizes you. Regardless, it is an effort in futility because it really doesn’t matter what you say, ask or bring to the floor; the ruling Unity caucus will disagree with it or vote it down, since they control the DA. If the UFT leadership actually held Delegate Assemblies each month that were informative and provided fair and ample time for discourse and discussion, I would be there in a New York minute. As this is not the case, I attend as many delegate assemblies as I can, but sometimes other events such as a childcare issue, my son being ill or an important meeting in my community to bring a new partner into Red Hook to service children and families with disabilities will take precedence. I do not need to go to the delegate assembly to prove who I am or that I am committed to my union; I act every day in a way that highlights why I should be president of the UFT.

I am a mother and a teacher. I have been a teacher for thirteen years, and have been working with children with special needs and their families for even longer. I have stayed in the same community and school since moving to NYC in 2001, because I am committed to the process of leading school change and improvement from the school level. I became chapter leader at the request of my colleagues a few years ago and have worked hard with them, our parents, and our principal to make sure our children and our teachers have the best learning and working conditions possible. I fought for my school during the dictatorship that my union handed to the mayor, during a co-location of a charter school in my building that my union didn’t adequately help fight (which is difficult since the UFT leadership chose to co-locate its own charter), while our class sizes rise steadily and our budgets are slashed, while teacher’s choice was eliminated and insultingly reinstated to cover no more than a few boxes of pencils, while ATR’s rotate in and out of my building- some of whom have approached me on the brink of tears desperate for someone to listen to their struggle, during a time of a tidal wave of assaults on our children, our schools, and our profession. 

Throughout this time, I not only worked in my own school community, I worked with parents and union members across the city and the country to fight back. You can find links to some of my work here, but I will list a few highlights: I co-wrote/edited/produced/and narrated a film that stood up to corporate education reform, a film that has been seen by hundreds of thousands of people in every state and on every continent (except Antarctica); I have appeared on several TV and radio programs and written several articles where I have spoken out forcefully against corporate education reform and for the schools our children deserve -- and I was invited or asked in every single case to participate, so while those in Unity caucus pretend to not know who I am or what I have done (but yet "know", falsely, that I am not at DAs) apparently the national media does; I have also worked with other union members in the city and nationally -- I helped organize a conference, and attended and facilitated, in Chicago in the summer of 2011 with other teacher union members; I helped lead the solidarity efforts with Verizon workers at the end of that same summer. I have sued, with a parent and a student, Mayor Bloomberg for the right to protest school closings and co-locations on his block and successfully organized and co-led that protest. I was the only teacher petitioner in the effort to stop and overturn the appointment of Cathy Black and also recently the only teacher on record to join with parents in sounding the alarm of student and teacher data privacy issues regarding SLC/inBloom data systems (Randi Weingarten, by the way, sits on inBloom’s advisory board). I say all of this not because I think anything that I am or that I do is so special, I share this information to highlight the outlandishness of the attacks from people whose usual line is there should be no attacks on union folks because we are under attack from outside forces and therefore need ‘unity’. I also share this because these are the things the president of a union should do.

Beyond of all of this, if Unity caucus can attack me for the number of times I went to the DA (this year I believe I have been to four DAs), the number of grievances I have filed (none), the number of UFT trainings or committees I have attended (none), then I wonder why they nominated Randi Weingarten as their presidential candidate, since she never attended a DA as a chapter leader, was never a chapter leader, and therefore never filed a grievance, attended the trainings etc.  

I personally do not think any of those things are what makes someone qualified to run our union. What matters is leadership. What matters is vision. What matters is the philosophy by which one will govern and represent the membership. I believe in a union that is member led and member driven. When I, or a candidate from MORE caucus, become president of the union, you will not have to attend a DA and sit idly and listen. The DA will be yours. When we take over leadership of our union, we will organize, support and build fighting chapters at the school level with elected district representatives who are trained organizers.  When we run the union, leadership and staffers will make salaries equivalent to the teachers we represent -- there will be no extra perks, no double pensions.  When we lead our union, you will not go more than three years without a contract, at least not without organized job actions and a fight. 

When Unity’s stranglehold of the leadership of our union ends, the members will have representation that believes in solidarity with other unions and in the power of our collective action. You will have a union that educates, mobilizes, and organizes our members and the public and who organically partners with parents and young people. You will have a leadership that truly understands that our working conditions are our students' learning conditions, that a harm to one is a harm to us all, and that we must stand side by side with deep roots in the communities we serve to fight for social, racial and economic justice in our schools, in our city and across the country.

I am more than ready to share who I am with the members of the UFT and I am happy to answer their questions. In fact, that is precisely the reason I sent the email below to Michael Mulgrew. I believe a union membership with a less than 30% voter turnout needs to be engaged and exposed to open discourse and conversation between the two people who seek to represent them.

Mr. Mulgrew, I am still waiting for a response. 
My email to Mulgrew:
Sent: Mar 14, 2013 8:01 PM

Michael,

I hope this email finds you well.

While we have differences and disagreements concerning education policy and union democracy, we both are committed to our union and the children we serve. In that spirit, we should be able to engage in an open conversation during election season so we can ensure our fellow members are informed and engaged.

To this point you have ignored outreach regarding your participation in a debate or question and answer town hall with me. I would like to directly and formally ask you to participate in such an event.

I believe that our members deserve the opportunity to ask questions of their presidential candidates and I strongly believe this kind of open and honest discourse strengthens our union: an educated and engaged membership that is listened to and participates makes us stronger.

There is precedent for an event such as this between presidential candidates during election season.  As you know, Randi has participated in presidential debates in the past: one in 1999 and again in 2001.  

I am open to a debate format with a third party moderator or a town hall question and answer event with the membership. My only specific asks are that the event be filmed and/or livestreamed so that we can maximize member participation, that the date, which I am open to any, be agreed to a few days in advance, so that I can secure child care and that the date be as close to April 3rd as possible, so that we provide a fair amount of time for members during the election timeframe.

I look forward to your response.

In solidarity,
Julie Cavanagh
 

Saturday, February 19, 2022

Video: CROC Valentine's Day Protest MulgrewCare - A RUMP Group - Retirees United for Medicare Preservation

RETIREES' VALENTINE TO MAYOR: DON'T BREAK OUR HEARTS WITH HEALTHCARE SWITCH

Hello CROC supporters, 


Thank you for endorsing and joining us at our Valentine's Day event at City Hall, at which we insisted that Mayor Adams disavow the plan to move city retirees to the so-called "Medicare Advantage Plus" medical plan.  Our message was loud and clear!

And thank you, Prudence Hill for creating this wonderful video of the event.
Please enjoy and share widely. The link is below. 
 

https://vimeo.com/679276160 


CROC DEMO FINE CUT from Martin Lucas on Vimeo.

 

Link to story text and video clip (about 2 minutes long) about the 2/14 rally against Medicare Advantage Plus:



 

 =========

Learn how the UFT took a secret vote to put us into a Medical Advantage plan. Marianne is the woman who led this whole movement and got us a top-notch lawyer.

It's a long video, but very informative on why Medical Advantage isn't Medicare!!!
 

 

Wednesday, February 16, 2022

#UFTElections - Petitions - What we can learn about the upcoming election - Part 1

With the UFT election petition campaign coming to a close. I've gotten a good read on the potentials in this election from the petition campaign. I can actually predict some vote totals from certain schools based on the success of petitioning and the effectiveness in organizing in that school. In this and followups I will share what I can without stepping on too many toes. We are keeping a spreadsheet with numbers submitted and from where they came from. If I get my proposal for school level percentages of voting to be reported I can check the spreadsheet against those numbers and I bet I will be pretty accurate.) I also have been getting a lot of reports on the state of the attitudes in schools regarding the Unity leadership -- it seems more people have heard of the existence of Unity caucus than in the past.

This is the 6th petition campaign I have helped run  - 04, 07, 10, 13, 16 and I've learned from my mistakes in each one. This time I think we ran a flawless campaign due to the support of the amazing crew from Retiree Advocate who have given up 3 Wednesdays plus another one today and this past Sunday to assist, plus the in school people led by Lydia from Solidarity (a wonderful partner0, Mike from MORE who worked as a liaison, the Eterno clan, and of course my main partner in crime Jonathan Halabi who I worked with so well in the 2016 election.

Wednesday, Feb. 16, 2022

Rice Pudding at diner signing
This Friday is the deadline for petitions to be turned in to get on the ballot for the UFT elections when ballots go out on April 8. After weeks of work as the point person for the United for Change coalition, I'm shlepping 2 suitcases of petitions with thousands of pages (an entire forest) to 52 Broadway this morning to meet up with others from Retiree Advocate to try to finalize everything and turn them in today so I can go home with empty suitcases.

Why two days early? I live by the words: Shit happens. I can imagine going in on Friday and I get sick or in an accident. Unity runs unopposed, which I'm sure would make them happy.

Well, anyway, I survived an intense 4 weeks and a possible divorce over forgetting to get chocolates for Valentines Day --- my excuse of being preoccupied didn't work and it cost me a day of silent treatment and no dinner. But today I hope it is freedom day. We want to turn in at 2 and then hang out for late stragglers before the DA and then the petition store is closed. (I am still getting stuff in the mail but yesterday's mail is the last I'm turning in.)

Big turnout at Bryant Park


There are about 400 people running with a few late comers coming on board. We started out aiming for 700 but handling that number seemed too much and I urged people to stop recruiting. About 130 are retirees and we could have had 300 due to the Medicare situation but I don't believe we should run so many retirees compared to working members. People could have signed up dozens in their schools but the strategy of having so many people from one school isn't all that effective. Theories abound that most opposition votes come from schools where there is an active and proficient organizer to get out the vote. 

But petitions are an indicator of the effectiveness of the organizer and as the point person I have a good read on where votes will be coming from. Of course today we are handing over all that info to the UFT membership committee. Would it be beyond Unity to take a peek to see where our strengths lie? Some in the opposition argue that we should hand in the minimum as a strategic move but most of us feel that would be a betrayal of the process. So instead of handing in 900 officer petitions, we will hand over 3000. Late arrivals at the DA will be brought up to the office at 4:30.

Bobby, Bennett and me Sunday at 40th St library after a full day of work

Delegate 

We will try to listen to the Assembly while waiting.

Gotta get ready to catch the ferry dragging my suitcases. I will be back tomorrow with some petitions stories that might be early election indicators.


Monday, February 14, 2022

Retirees Valentine Day Rally for Medicare at City Hall - Plus video of rally


Video of WPIX 11 News Report of Todays Rally at City Hall

Jumaane Williams Speaking today-Tell Adams- No Privatization of our Medicare

 


 

Media advisory: City retirees to protest healthcare switch TODAY near City Hall

RETIREES' VALENTINE TO MAYOR: DON'T BREAK OUR HEARTS WITH HEALTHCARE SWITCH

Scores of retired city workers will gather near City Hall on Monday, Feb. 14, at noon to tell Mayor Eric Adams he's breaking their hearts with his plan to change their beloved Medicare coverage.

Rally organizers will unscroll a Wall of Broken Hearts signed by 1,800 municipal retirees who want Adams to reconsider moving a quarter-million Medicare beneficiaries into a controversial new Medicare Advantage plan by April 1. To keep their current coverage, retirees would need to pay stiff new premiums, unaffordable for many. Adams recently endorsed the plan, begun under the de Blasio administration and still tied up in a lawsuit brought by retirees.

Speakers, including a physician, will address the devastating effects of the plan, which would limit access to doctors and services. Retirees holding giant Valentine cards will collect more signatures. Scroll and cards will be delivered to the mayor at the end of the event.

Organized by the Cross-union Retirees Organizing Committee (CROC,) the rally is endorsed by other organizations, including the District Council 37 Retirees Association, the New York Public Library Retirees Association, and the NYC Organization of Public Service Retirees.

WHEN: Monday, Feb. 14, 2022, noon to 12:45 pm
WHERE: Broadway and Murray St., near City Hall

Contact: retireequestions@gmail.com
or Sarah Shapiro, sarahmorah@gmail.com 

The Hits Keep Coming for Mulgrewcare - Pre-Authorization - Patients Harmed

A Third of Docs Saw a Patient Harmed by Prior Authorization
— Treatment delays have led to permanent damage, disability, and even death


Pre-authorization is a hot item in the Medicare vs MedAdv debates. An old friend and former UFT activist who supports single payer and medicare for all doesn't have an issue with this switch because she always had HIP and when she turned 65 took a MedAdv plan rather than taking the 80/20 split of public vs private and has issues with the way we have gone after Mulgrewcare. One thing she points out is that Medicare also has pre-authorization and she sent an article claiming that 85% of the pre-auth in Adv plans are the same as those traditional Med requires. But what about the 15% that are not required by Med? And someone pointed out the article was sponsored by people connected to the health care industry. So be careful out there as to what you are reading, including this rag.

The Unity attack dogs are claiming we tell lies but every day we get knew info.

The language is inexact:  It´s not the pre-authorization that is the problem, but would seem to be the delay caused by the demand for pre-authorization, or the refusal of a pre-authorization.  Presumably, that is what they mean.... RP

So here is an article about pre-authorization. And the point made by RP is right on. I know of a few cases of UFTers on HIP who in the process of diagnosing they had cancer, were delayed in getting to the top of the chain because they had to go through the "steps" required, thus delaying them for weeks. Both died.
 

This note came from Amy R:
Please note that this article emphasizes the harms of prior authorization to working patients and to patient productivity at work (diminished by prior authorization's eating up of time and damage to health outcomes). Employees by definition are younger and healthier than retirees, and have a professionally staffed human resources (HR) department with people who are paid to advocate for them, against their insurer, full-time. Retirees are older, sicker, more isolated, and more disabled, and have no HR department or employer watching out for them. Medicare Advantage (MA) companies know this full well, and their political power (shown in the 80% of members of the U.S. House of Representatives signing a recent letter of support to this cruel and dangerous form of health insurance) is likely connected to weak regulatory enforcement traditions for MA plans, compared with traditional Medicare plus comprehensive Medigap. The latter is a safe and effective form of medical insurance, as long as you avoid Direct Contracting Entities.

Best regards,
Amy
 
 
Practice Management
A Third of Docs Saw a Patient Harmed by Prior Authorization
— Treatment delays have led to permanent damage, disability, and even death

by Shannon Firth, Washington Correspondent, MedPage Today February 11, 2022
 
A prior authorization form
One in three doctors said prior authorization led to one of their patients requiring hospitalization, being permanently disabled, or worse, according to a survey conducted by the American Medical Association (AMA).

In the sample of more than 1,000 practicing physicans, 24% said that a prior authorization led to a hospitalization, and 18% said a prior authorization led to a "life-threatening event" or an event that "required intervention to prevent permanent impairment or damage."

Another 8% saw one of their patients experience a disability or sustain permanent bodily damage, a congenital anomaly, a birth defect, or even death.

For physicians treating patients between the ages of 18 to 65, the majority said a prior authorization interfered with a patient's ability to do their job.

"Health insurance companies entice employers with claims that prior authorization requirements keep health care costs in check, but often these promises obscure the full consequences on an employer's bottom line or employees' well-being," explained AMA President Gerald Harmon, MD. "Benefit plans with excessive authorization controls create serious problems for employers when delayed, denied or abandoned care harms the health of employees and results in missed work days, lost productivity and other costs."

The AMA urged employers to ask insurers more questions about their plan requirements and to solicit feedback from employees about their own experiences with the insurer tool.

Rep. Suzan Delbene (D-Wash.) echoed Harmon's message in a press release: "The data is clear that the prior authorization status quo delays care, worsens health outcomes, and is an additional barrier for seniors, families, and medical providers."

Delbene urged passage of the Improving Seniors' Timely Access to Care Act , a bill she introduced and is pressing House leadership to advance. She argued it will "streamline" and "standardize" Medicare Advantage plans' prior authorization programs and require greater oversight and transparency of the requirements.

Multiple states including New York, Texas, Illinois, and Indiana either introduced or passed laws restricting insurance plans use of prior authorization.

Other grim feedback from the AMA survey found:

93% said prior authorizations were linked to delays in patient care
91% said prior authorizations had negative impacts on clinical outcomes
82% said prior authorizations can at least "sometimes" lead patients to abandon recommended treatment
30% said prior authorization criteria is "rarely" or "never" evidence-based (despite 98% of health plans claiming to use evidence-based studies to design their programs)
Only 7% of survey respondents said prior authorizations had no impact at all on patient outcomes.

On average, physician practices complete 41 prior authorizations each week -- accounting for more than two full business days of additional work. Two in every five physicians said they employ staff whose job it is to exclusively work on prior authorizations as well.

"Now is the time for employers to demand transparency from health plans on the growing impact of prior authorization programs on the health of their workforce," Harmon urged.

The survey was conducted online in December 2021 and completed by 1,004 practicing physicians drawn from the M3 Global Research Panel. All participants currently practice in the U.S. and provide at least 20 hours of patient care each week.

author
Shannon Firth has been reporting on health policy as MedPage Today's Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team. Follow 

NYC selects Anthem for retirees’ coverage — after feds sue over alleged Medicare fraud - NY Post

"I'm not a crook." ---  - Many options

 NYC selects Anthem for retirees’ coverage — after feds sue over alleged Medicare fraud - NY Post

https://nypost.com/2022/02/13/nyc-selects-anthem-for-retirees-coverage-after-feds-sue-over-alleged-fraud/

The healthcare insurer that the city recently chose to provide medical coverage for 275,000 retired workers is being sued by the US Justice Department for overcharging Medicare by millions of dollars.

The Manhattan US Attorney’s Office brought the civil-fraud suit against Anthem in March 2020, and the case is still pending.

But that didn’t stop former Mayor Bill de Blasio from selecting Anthem for local-government retiree coverage this past fall — or now-Mayor Eric Adams from signing off on the deal last week.

The fraud suit against Anthem alleges that the company did not clean up faulty data rendered by hospitals and other medical providers in its reimbursement claims submitted to the federal Centers for Medicare and Medicaid Services.

“By ignoring its duty to delete thousands of inaccurate diagnoses, Anthem unlawfully obtained and retained from CMS [Center for Medicare Services] millions of dollars in payments under the risk adjustment payment system for Medicare Part C,” a press release accompanying the suit said.

Saturday, February 12, 2022

UFT Pres. Candidate Camille Eterno with Daniel Alicea: WBAI Saturday, 1 PM; Halabi calls for Unity to Replace Mulgrew, Election petition return day

The UFT’s leadership has an opportunity to make the union stronger. Will they do the right thing?... Over the course of the pandemic members of our union have seen our union leadership in different situations and different ways than before the pandemic. Policies affected us directly, in what were truly life and death situations. Members who never paid attention paid attention. And now that members were paying attention, what did they see?..... Jonathan Halabi

This is a wonderful explanation of how teachers were thrown under the bus. All other city workers union stood up for their workers for as long as they could. Mulgrew said he didn’t try because he knew he not win, so why did we vote for you. Try, try and you may succeed. I am sick of this mess, teachers are left to fend for themselves. Kudos to you. double thumbs up.... Comment on New Action blog. Dear Michael Mulgrew, We’re Overworked!

Why You Should Vote for Camille Eterno - This is not going to be a wordy post. Just want to get right to the point. I could go on an on about how Camille Eterno will be there for the members of ...

There's a lot of anti-Mulgrew talk out there. Jonathan Halabi touches on a crucial issue -- the activation of people in the UFT who had never been active before.

A high school teacher who has not been active in UFT politics but is running with us for AFT delegate, at one of the biggest high schools in the city sent this:

I've been reaching out to everyone I know in the elementary schools since that seems to be where we need most support. Spoke to 4 elementary school teachers at 4 different schools. All friends of mine. At least 2 of them indicated they were already supporting UFC. I encouraged them to spread the word at their schools. The other two seemed to lean UFC as well - UNITED FOR CHANGE - UFT: HOME - 

These are the kind of rumblings I haven't seen before. I went to a petition signing party at a home on Long Island last Sunday expecting to find 5 people. Instead there were 25, mostly from Queens elementary schools happily signing 400 petitions. This is an area rarely penetrated by the opposition and an indication of a shift of sorts. One woman in her 50s was so excited and said she ordered a UFT sweatshirt which she will wear around her school.

The day before MORE held a signing event at a bar in lower Manhattan for 70 people. I tried to imagine a merging of the Sat MORE event with the Sunday Long Island event and my head began to swim. Yet here we are -- two signing parties with such a contrast but for the same candidates. I couldn't have imagined that happening even 6 months ago.

Hear the alternative to Mulgrew, Camille Eterno: From Daniel-

Join me, Sat 2/12 at 1pm on @WBAI 99.5 FM  as I chat with @NYCSchools educator & parent, Camille Eterno about the state our our city schools and her run for president of @UFT. We will discuss smaller class size, mayoral control, health & safety, evaluations, ATRS, more!--

Jonathan Halabi wrote a scathing blog obliterating Mulgrew on his record. His call for Unity to replace hm at the top of the ticket for the benefit of the union. In fact if Unity were to replace Mulgrew, their odds of doing better in the election go up.

While the internal leaks of unhappiness with Mulgrew inside Unity stopped once the UFC coalition was announced. reports come filtering in of hidden Unity support for UFC and backroom offers to assist. I won't believe that until I see it. 

Those are signs of Mulgrew lack of popularity internally. Jonathan Halabi blogged about just how bad Mulgrew is and asks:

The UFT’s leadership has an opportunity to make the union stronger. Will they Do the right thing?

He is asking Unity to replace Mulgrew at the top of the ticket to save the union. I guess from the perspective of hoping UFC will win, the worst thing that can happen is Mulgrew not running. But not to worry - Unity has no mechanism to make Jonathan's wish come through. Unity is a pseudo feudalistic system which requires Shakespearian-driven solutions. Mulgrew will be running for president against Camille Eterno. The choice can be no clearer. But if you are in doubt, go read Halabi filet Mulgrew under the following headings of transgressions:

  • Policy, Pandemic, Conciliation
  • Running Meetings Poorly, and Being Obnoxious About It
  • Endorsements
  • In the Field
And the deepest cut of all, Medicare Advantage / Mulgrewcare.
Retiree votes make up 40-50% of those who vote in UFT elections. I would say the major threat to Mulgrew and Unity is the potential loss of enough of those votes to cause real damage to Unity.
 
Go read through them and think of whether you want Mulgrew as president for the next 3 years. https://jd2718.org/2022/02/10/do-the-right-thing/
 
Jonathan, who is running for HS VP on the slate but is urging Unity to do the right thing to save the union even if it allows Unity to stay in power.

He says:
...while I do not support the reelection of this leadership, it is still OUR union. I am fiercely proud of our union. I want it stronger, better.

So United for Change has a better (still slim) chance in the election because Michael Mulgrew is at the top of the Unity ticket.

But the UFT is weaker, has less support from members, with all the negative attention Michael Mulgrew has garnered. We all suffer with him in the lead.

We (United for Change) cannot do the right thing here. It has to be Unity. Make our union better. Shore up support from members whose confidence in the union has been shaken through the pandemic. Even though it hurts my election chances, I am asking, pleading with Unity, do the right thing. Remove Mulgrew. Replace him with someone, anyone. Promote him to some position where members don’t see him.

Because in the end, no matter who wins, we all lose if members are turned against our union, against the UFT.

I'm not sure we don't all lose if Unity wins without Mulgrew. The Unity machine has been in charge since the UFT's inception over 60 years ago and that is the problem. Mulgrew being pulled would only lead to another leader who would distract us. I saw that happen when Randi was becoming unpopular and Mulgrew took over. "A breath of fresh air" proclaimed an opposition supporter who quickly jumped on the Mulgrew bandwagon and is now a full time UFT employee. Other Randi haters came on board too. 
 
Mulgrew may be toxic and often inept but so is the Unity machine where loyalty is prized over competence. Besides, there is no mechanism inside Unity where a coup could take place.
 
And who is on that Unity bench to be taken seriously as a UFT leader? I used to think it might be Evelyn de Jesus but Randi snatched her away for AFT Executive Director and potential heir apparent.

In many ways this all a fantasy and Jonathan knows that and is making a point about just how bad Mulgrew is. 

This past Wednesday, Unity met to sanctify its slate. There are supposedly petitions with Mulgrew's name as president that are due next Friday, though no teacher has actually seen these petitions in schools. I think the UFC election committee, of which I am a member, should ask to see these petitions. 

But if the opposition wins high schools and challenges in middle schools and makes a big leap in elementary schools and oppo retiree vote climbs to around 40%, I would bet Jonathan will get his wish before the next election. Which is why even if you are Unity and don't like Mulgrew you should vote UNITED FOR CHANGE.

And here's a little secret - many Unity people are actually saying they will, some even offering to campaign for us in their schools. 

I'm still in middle of the petition campaign for UFC, along with Jonathan, and this weekend is "turn in and collating time". Today in Bryant Park from 1-4PM near the ping pong tables and tomorrow a team is meeting nearby to put all ths reams of paper together. 

It's going to be 60 degrees today so stop by at Bryant Park and even if you don't have a petition, I will have one for you to sign.

We should have had  a system of electronic signing so entire forests didn't have to die for the UFT petition campaign.