Saturday, October 8, 2022

UFT Leaders complicit in Medicare fraud? Med Part C is MedAdv - massive fraud as per NYT - How Insurers Exploited Medicare for Billions

“Medicare Advantage overpayments are a political third rail,” said Dr. Richard Gilfillan, a former hospital and insurance executive and a former top regulator at Medicare, in an email. “The big health care plans know it’s wrong, and they know how to fix it, but they’re making too much money to stop. NYT

Medicare for all would put all these scam artists out of business - why does the UFT support these crooks?

Mulgrew continuously whines about health care costs but the policies he espouses contributes to these costs.

One of these cited for defrauding the Medicare system will be a partner to the MLC in any new plan offered by the city for retirees. Let us point out that these same groups control the 20% senior plan for retirees but they ability to defraud is somewhat limited by Medicare rules. 

And the entire working membership is under the

On Monday night at the Ex Bd Vinnie Gaglione declared MedAdv was just Medicare - Part C - in essence what's the big deal with it?

Mulgrew in essence is fine with the fraud issue -- he even said we can get more money out of Medicare.
 
My own docs have told me about upcoding - say you are overweight and they have access to the records -- they now ask Medicare for more money for care that has nothing to do with how much you weigh.
 
Is it time to accuse the UFT leadership of joining the fraud game?
Norm


The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions

By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.

Reed Abelson and

The health system Kaiser Permanente called doctors in during lunch and after work and urged them to add additional illnesses to the medical records of patients they hadn’t seen in weeks. Doctors who found enough new diagnoses could earn bottles of Champagne, or a bonus in their paycheck.

Anthem, a large insurer now called Elevance Health, paid more to doctors who said their patients were sicker. And executives at UnitedHealth Group, the country’s largest insurer, told their workers to mine old medical records for more illnesses — and when they couldn’t find enough, sent them back to try again.

Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.

Medicare Advantage, a private-sector alternative to traditional Medicare, was designed by Congress two decades ago to encourage health insurers to find innovative ways to provide better care at lower cost. If trends hold, by next year, more than half of Medicare recipients will be in a private plan.

Soon, Half of Medicare Will be Privatized

Medicare Advantage is on track to enroll most Medicare beneficiaries by next year.

But a New York Times review of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs shows how major health insurers exploited the program to inflate their profits by billions of dollars.

The government pays Medicare Advantage insurers a set amount for each person who enrolls, with higher rates for sicker patients. And the insurers, among the largest and most prosperous American companies, have developed elaborate systems to make their patients appear as sick as possible, often without providing additional treatment, according to the lawsuits.

As a result, a program devised to help lower health care spending has instead become substantially more costly than the traditional government program it was meant to improve.

Eight of the 10 biggest Medicare Advantage insurers — representing more than two-thirds of the market — have submitted inflated bills, according to the federal audits. And four of the five largest players — UnitedHealth, Humana, Elevance and Kaiser — have faced federal lawsuits alleging that efforts to overdiagnose their customers crossed the line into fraud.

The fifth company, CVS Health, which owns Aetna, told investors its practices were being investigated by the Department of Justice.

In statements, most of the insurers disputed the allegations in the lawsuits and said the federal audits were flawed. They said their aim in documenting more conditions was to improve care by accurately describing their patients’ health.

Many of the accusations reflect missing documentation rather than any willful attempt to inflate diagnoses, said Mark Hamelburg, an executive at AHIP, an industry trade group. “Professionals can look at the same medical record in different ways,” he said.

The government now spends nearly as much on Medicare Advantage’s 29 million beneficiaries as on the Army and Navy combined. It’s enough money that even a small increase in the average patient’s bill adds up: The additional diagnoses led to $12 billion in overpayments in 2020, according to an estimate from the group that advises Medicare on payment policies — enough to cover hearing and vision care for every American over 65.

Another estimate, from a former top government health official, suggested the overpayments in 2020 were double that, more than $25 billion.

The increased privatization has come as Medicare’s finances have been strained by the aging of baby boomers. But for insurers that already dominate health care for workers, the program is strikingly lucrative: A study from the Kaiser Family Foundation, a research group unaffiliated with the insurer Kaiser, found the companies typically earn twice as much gross profit from their Medicare Advantage plans as from other types of insurance.

Matthew Wiggin, a spokesman for the company, called the inspector general’s report “misleading.” He said the company uses diagnostic coding to improve patient care, and noted that the whistle-blower in the lawsuit had not worked for the company in nearly a decade. “Our chart review process complies with regulatory standards,” he said, adding, “Our robust compliance program also proactively seeks to identify fraud, waste and abuse in the system.”

The company countered by suing Medicare, arguing that it wasn’t required to fix inaccurate records before regulations changed in 2014. It won at first, then lost on appeal. In June, the Supreme Court declined to hear the case.

Even before the first lawsuits were filed, regulators and government watchdogs could see the number of profitable diagnoses escalating. But Medicare has done little to tamp down overcharging.

Several experts, including Medicare’s advisory commission, have recommended reducing all the plans’ payments. Congress has ordered several rounds of cuts and gave C.M.S. the power to make additional reductions if the plans continued to overbill. The agency has not exercised that power.

The agency does periodically audit insurers by looking at a few hundred of their customers’ cases. But insurers are fined for billing mistakes found only in those specific patients. A rule proposed during the Trump administration to extrapolate the fines to the rest of the plan’s customers has not been finalized.

Some of the agency’s top leaders have had close ties to industry. Marilyn Tavenner, a former C.M.S. administrator, left in 2015, then ran the main trade group for health insurers; she was replaced by Andy Slavitt, a former executive at UnitedHealth. Jonathan Blum, the agency’s current chief operating officer, worked for an insurer after leaving the agency in 2014, then became an industry consultant, before returning to Medicare last year.

Ted Doolittle, who served as a senior official for the agency’s Center for Program Integrity from 2011 to 2014, said officials at Medicare seemed uninterested in confronting the industry over these practices. “It was clear that there was some resistance coming from inside” the agency, he said. “There was foot dragging.”

There are signs the problem is continuing.

“We are hearing about it more and more,” said Jacqualine Reid, a government research analyst at the Office of Inspector General who has analyzed Medicare Advantage overbilling.

The Justice Department has brought or joined 12 of the 21 cases that have been made public. But whistle-blower cases remain secret until the department has evaluated them. “We’re aware of other cases that are under seal,” said Mary Inman, a partner at the firm Constantine Cannon, which represents many of the whistle-blowers.

But few analysts expect major legislative or regulatory changes to the program.

“Medicare Advantage overpayments are a political third rail,” said Dr. Richard Gilfillan, a former hospital and insurance executive and a former top regulator at Medicare, in an email. “The big health care plans know it’s wrong, and they know how to fix it, but they’re making too much money to stop. Their C.E.O.s should come to the table with Medicare as they did for the Affordable Care Act, end the coding frenzy, and let providers focus on better care, not more dollars for plans.”












 

Friday, October 7, 2022

What are you willing to do- For The Contract We Deserve? - Guest Column from Contract Committee Member

What are you willing to do?
 
Friday, October 7, 2022
 

The UFT contract committee will meet with the city for the first contract negotiations on October 13th. 

Mayor Adam’s would like 1 to 2 percent raises max per year according to our sources at other unions. 

He has shown very little willingness to even sit down with the entire unionized city workforce that has expired contracts.

According to our brothers and sisters in DC 37 - one of the largest city worker unions, he is asking for high premiums for healthcare- in other words pay into health care which would offset any raise and actually mean a large pay cut for our members. 

The UFT position is clear : premium free, quality  healthcare and substantial raises because of inflation. 

We must have improvements in our working conditions and our students’ learning  conditions - safe schools so our youngest can learn , schools with AC as temperatures rise is way past due, class size compliance with the new legislation and more attention to special education to ensure that the city is actually serving our kids who need the most help.

We have to understand going into contract negotiation 2 major points: 
1. Contract negotiations are built on back and forth- compromise- we get some of what you want, the city has to get some of what they want. 

2. In order  to get even some of what we want, we need leverage- what do we hold over the city’s head that will actually bring them to the table and help us get some or even a majority of what we want?

That is a question the union leadership has to answer, the contract committee has to answer,  and each and everyone of you has to answer. 

What can you do, what can we do, what should we do to get what we want, what our students need? What are you going to do in your chapter that you want all chapters to do?

With inflation gone crazy, can we afford to live in NYC and the surrounding areas without a substantial raise? Can the city keep a work force without one? 

If you look at workers across the country right now; from Amazon, to Starbucks, now Apple, and Trader Joe’s - they have had to make sacrifices, they organized, they spent their free time after work, before work, on lunch breaks- risking their jobs to form unions, to have what we have now- a certified union that can collectively bargain for salary and conditions.

Some workers have been fired, other have had hours cut, many have had to hire lawyers and spend countless hours in court, while you walked into a job with a union already formed, but 50 years ago our brethren made those same same sacrifices- you have what thousands, if not millions of workers want right now- a union- nearly 200,000 strong. 
We can’ttake that for granted.

In Seattle and Ohio this past year teachers had to go on strike, they had to make the ultimate sacrifice of giving up pay, salary, food on their table, healthcare for their children, in order to get what they wanted -and they won. 

I’m not saying a strike is inevitable- what I am saying is that we have to be willing to fight for what we want, we will have to sacrifice, we will have to show the city and public our demands are real and fair. 

So we need to ask you, the person in the mirror, if we ask you to wear blue will you do it? If we ask you to call local elected officials and the mayor will you do it? If we ask to join a rally before or after school will you do it? If we ask to join a march in the city to the steps of city hall will you do it?

To show this mayor we mean business, what are you willing to do?  And yes, if we ask you to withhold your labor, stop working, go on strike as a last resort, so we can retain our healthcare , get the raises we need and have the schools our children deserve, will you do it?
 
Commentary from Norm:
 
I found the above under my car windshield wiper. The author clearly doesn't want to be accused of lifting the tarp put over the negotiating committee. I and others believe in reasonable open negotiating so the members and interested areas of the public can be moved in our direction. If there are some areas we want to keep secret - like what we would take on salary - I can live with that. But here's something that costs nothing -- redress the balance of power between the union at the school level and the administration. Strengthen the grievance procedure and protect the non-tenured. The author asks what are the members willing to do? I don't know what would work short of a strike if Adams just echos Bloomberg and flat out refuses to give us a contract for years if we don't offer givebacks to pay for it. Is the UFT leadership even capable of preparing the membership for a strike?  I will touch on that in a follow-up piece.

Healthcare givebacks are coming based on incoming info from the New Action blog and my recent exec bd meetings reports.
 
UFT Members Take Note – It’s Not Looking Good for Healthcare - At the October 3rd, 2022 session of the UFT Executive Board, buried mostly at the end of an unusually long session with 5+ pages of unofficial minutes, we ...
 
 

Tuesday, October 4, 2022

UFT Ex Bd - Oct. 3 - Healthcare Mumble Jumble, Leroy Barr exonerates Unity for all election transgressions

Healthcare and the UFC election complaints dominated the Ex bd meeting, both causing those of us texting during the meeting some double LOL moments.

The uft leadership new solution to healthcare is to form an in-service health-care committee similar to the bogus retiree health committee loaded with Unity Caucus shills. Watch the new committee endorse whatever mess they are going to make of healthcare for working members in the upcoming contract. Maybe throw a silver sneaker or two at them. As one astute observer of UFT said:  GHI is dead - it will be all managed care and choice will cost you.

My head is spinning over the misinformation at the ex bd last night. Eterno has the raw facts: OCTOBER 3 EXECUTIVE BOARD REPORT  as does Nick Bacon: Healthcare, Healthcare, Healthcare – UFT Executive Board Minutes, 10/3/2022

Ilona Nanay, Ex bd HS: I stand in favor of the resolution (in opposition to the privatization of Medicare). A year ago my mother died of breast cancer and she was on a medicare advantage plan. It was virtually impossible for her to obtain care. I think it is one of the reasons that she passed. It is still extremely frustrating – every time I hear [Mulgrew] talk about the program. I would love a breakdown of why the NY Health Act hurts us as members of the union. UFT supported the NY healthcare in 2015. Why is NY Health Act antithetical to us? It would expand healthcare across the community. I can't understand why we are opposed to it.... 
....interrupted in midstream by point of order by Aqeel Williams because he noticed someone on the zoom with a sign - horrors - asked for her to be thrown out of meeting - double horrors.... oh my, someone held up a sign on zoom that few noticed but the Unity police were on the case to interrupt someone talking about their mom dying from cancer a year ago during which you didn't hear a pin drop? Oh, Akeel - you are so sensitive. 

The response from Gaglione was along the lines of - she just picked the wrong MedAdv program. -- Double lack of sensitivity for Vinny. And then later, an upset Ilona was approached by some Unity people who wanted to share how their family members also had cancer -- the very people who voted against the reso -- did they have the right MedAdv insurance?

And this-----

Gee -  someone might leave a comment in the chat that might contradict the lies and lines Unity puts out. These people must control every means of communication.

Chat room began meeting as enabled but as soon as some people began to post it was disabled.

Just a flavor of the Oct. 3 UFT Ex Bd meeting.  --Some more flavors from anonymous comments from observers:

The most fucked-up moments were... When Aqeel interrupted Ilona talking about her dead mother to complain about something that had been happening all along...When Vincent said “unfortunately you need to look at what you’re buying” after Ilona talked about how her mother’s poor healthcare contributed to her death from cancer...When people who had voted against the resolution came over to a crying Ilona to tell her about their dead and metastatic relatives...Then Melissa Williams told them off

More OMFG moments brought to us by DISUnity... Fake news moment when MM said the UFT doesn’t want to organize actions “bc they don’t want to tell members what to do/boss them around,” when really by my recollection of having been at times the only member of 193K+ to show up to the actions the UFT “organized” this summer, in truth, they are simply not able to do so... 

When asked by Lydia at Exec Board meeting yesterday about what is union doing to inform members they can attend Ex Bd meetings: Sill cracked jokes and asked Lydia what she’s doing to get folx involved?... He pulled that line twice. Once with Lydia and again with another speaker. They got "Silled" 😠... It’s pre-planned gaslighting Playbook... The Secretary and Assistant Secretary make close to a half a million dollars combined. They can at least show fidelity to our constitution which says ex bd meetings are open. Asking a full time teacher and Exec Board volunteer to do their work is patronizing.

Tuesday, Oct. 4, 2022

A real healthcare debate broke out at the Ex Bd meeting last night as UFT/Unity spun double talk about healthcare costs and solutions, plus the report on the election complaints. 

Mulgrew bad omen: We have to push back against rising costs and how do we do it? We find ways to work with the city to save money --- 

Where those savings actually come from is left fuzzy. UFC Ex Bd people challenged the Unity line with a resolution that pushed back. 

Here's a piece from Nick Bacon's notes during the question period:

Ibeth Mejia: According to Article 3G1, “ The Board agrees to arrange for, and make available to each day school teacher, a choice of health and hospital insurance coverage from among designated plans and the Board agrees to pay the full cost of such coverage.” Why are we discussing limiting FREE plans when a choice of free plans is in our contract?

Response: We are championing choice.

Ibeth: Don’t we already have two not premium free plans, GHI and HIP?

Sorkin: We are looking to preserve good ‘premium free options.’

Ibeth: Presses.

Sorkin: Notes rises costs. Would love to pass costs on to members. So we need to see what else is out there. We have dictates from decades of negotiations over healthcare.

Ilona: DC37 sent out a letter to members stating bluntly that if healthcare isn’t ‘fixed’, their raises won’t keep up with inflation. In other words, if they don’t agree to lower the quality of their healthcare, one can infer that they’ll see other parts of their quality of life be reduced – income, perhaps housing, etc. In the past year or so, we’ve heard similar threats from UFT. Does the UFT leadership agree with this assessment from DC37? How will pattern bargaining affect us? And what can retirees and in-service members expect will happen to the quality or access to healthcare in the future? Will we only receive raises if we cut our benefits? Or will we fight for both.

Sorkin: Familiar with letter – speaking of cost savings not reducing healthcare. Can’t speak to UFT’s role in not negotiating until healthcare. There’s no talk of reducing benefits – just the cost.

Lydia Howrilka: Clarifying question regarding Ibeth’s question. Why has the UFT allowed the change in Administrative code 12-126.

Sorkin: Because we want to preserve choice and we want to make sure the MLC has a voice.

Alex Jallot: Mulgrew did support national healthcare. So are we only going to endorse federal candidates who support universal healthcare?

How are they reducing costs and offering us a choice only if we pay $400 a month per couple? Oh wait -- reducing costs for the city, not for us.

At 7:45 Nick raised a reso calling on the UFT to support Medicare for all - Keep Medicare as Medicare --- Vinnie from Unity gaslights - MedAdv is just part of med part c
La di da -- The benevolent UFT is calling for changes in the admin code to offer us a choice - at $400 bucks a month for couples. And those with lousy pensions who can't afford it - that's no choice.

Ibeth- Responds to Mr. Gaglione.  Supports choice. We need free choice. It would cost almost $400 a month for a retired married couple to keep what they have now. We need Medicare for all.

Another A-plus for Ibeth -- short and succinct.

No wonder Unity was desperate to keep UFC off the ex bd. Instead of rubber stamp meetings ending at 6:30 - this one ran until 8PM. I was on the zoom due last remnants of covid but that helped me notice things - with the assistance of people texting from inside.

Mulgrew: Medicare Advantage is only one piece of what has been going on, which is why we need an in-service committee. We go to the doctors more than any other employees of the City....

Is Mulgrew chastising teachers for going to doctors so often?  Like I wonder why teachers go to doctors so often? Do you think working conditions? My first two years I was sick all the time being exposed to roomfulls of children.

Mulgrew: ‘Medicare Advantage’ is still part of Medicare. We have the right to do this, so why not make our own? We want good quality premium free healthcare.

Sophistry - MedAdv is an alternative to Medicare and sucks money out of Medicare and keeps prices high through high admin costs, ex salaries, and big profits. Mulgrew actually complained about allowing them to call themselves non-profits while making high profits while at the same time trying to move retirees out of public options and into one of these plans.
 
Here is Nick Bacon speaking for the resolution in opposition to the privatization of Medicare he presented:(Click hyperlink to left for full text).

Bacon: Endorses resolution in opposition to the privatization of Medicare.  It was said earlier by Mulgrew that UFT supports a national single payer public option. Indeed we as a union have passed resolutions to this effect. It stands to reason that Medicare, the only current public option, which such a system would be modeled after, must be preserved. Therefore, we must resist privatization of Medicare. Medicare Advantage will get cost savings through privatization that limits access to care for our retirees (and future retirees) who dedicated their careers in service to our City and students. It will add to administrative costs and add barriers to care like prior authorizations. Medicare Advantage is much like charter schools, which we as a union also resist. Charter Schools offer to do the same as public schools but ‘better’ and often ‘cheaper’ through privatization. They erode public education by doing this. Medicare Advantage does the same to Medicare. Given our own obvious analogy in education,  our own precarious situation relative to privatization, we must argue for salvaging our public Medicare. And we owe it to the workers who have retired and one day will retire.

Sworkin: Stand in opposition. States things thee says things that are false and is misguided. ‘Sometimes we need to make tough decisions.’

Yeah, Jeff, your tough decision will end up screwing us.

Only the 7 vote and Mike Schirtzer in favor of the resolution. Unity votes down resolution.

UFT Election Complaints report by Leroy Barr:
This is part 2 of the UFT report on the UFC complaints. There's lots here to revue but Eterno and Nick cover a bunch of it. I took note of this one:
The complaint charged that UFC delegates had been shut out of making resos at the DA. Leroy reported: It is false that non-Unity members have not been allowed. November: (Bacon), Daniel Alicea (had on agenda), January (Strivers), various motions to amend also noted.
BULLCRAP - Actually, close observers have noted very clearly that after the oppo won some points at the October 2021 DA -- notably on class size - Unity shut down oppo voices for the rest of the school year. Leroy claimed Mulgrew doesn't know where people sit when insiders have told us repeatedly that they actually hold DA practice sessions with what is known as the Unity Speakers Bureau - one Unity member told me Mulgrew has a seating plan for Unity people. The LOL moment came when Leroy pointed to Nick Bacon being given the opportunity to make a reso as an example of UFC Oppo - except Nick was actually a member of Unity at the time and UFC hadn't yet been formed.
 
UFC HS Ex Bd Nick Bacon responded: 
Simply want to clarify that it’s unfair to say UFC was called on in resolutions. When I was called, I was a member of Unity. UFC did not clearly exist yet. When Daniel was called up his resolution had been put on the docket the previous school year, well before UFC existed. It had been on the docket so long that it was moot when he brought it up, hence him taking it off the agenda. All other members discussed did not bring up original resolutions. They simply called up amendments or other points of order, which they don’t need to be called on by Unity-elected officers in order to do.
[Note - Leroy informed me they are editing the report to take Nick's comment into account].
 
By the way - UFC election percentages show serious support from members who voted -- UFC should be given time and space at the DA.
 
Mike Schirtzer calls for lifting UFT Negotiating committee Cone of Silence a crack. 
Can we publicize contract meetings and some our demands that serve our students and parents. Get members in front of cameras to say we want what families want.
 
Mike did this in a good way --- pointing out that keeping negotiating issues behind closed doors is not the best way to galvanize support. Teachers major demands help children - we should be showing that.
 
Good for Mike ---

Monday, October 3, 2022

UFT Sept. 19 Exec Bd Takeaways: Coalition Jells in Pre-Meeting, Unity turns down working with Oppo on Ex Bd, Big Grievance win with serious money at Aviation HS

Monday, Oct. 3, 2022
 
Tonight is an Ex Bd meeting (see below for agenda). 
 
I attended the Sept. 19 meeting and tested pos for Covid 36 hours later -- unlikely I got it there. I feel great but last tested pos on Thursday - a deep dark line. I may be neg but with the weather I am staying home and will zoom in. I will test again tomorrow because we have a Peter Lugers date with family on Friday and have to give notice if we are still pos. Some people stay pos for up to 90 days I was told. Fingers crossed. I can taste that steak -- thank goodness I still have my sense of taste - my wife feels she has lost some sense -- I
think I can steal some of her steak if we end up going to Lugers.

Anyway, I started writing this report two weeks ago but got distracted by covid. They serve food and despite my request for Peter Luger steaks being rejected, the food has been quite good.

Sept. 20, 2022: UFT Ex Bd meeting - 18 people associated with opposition show up in person and more on zoom.

It is important for non-Unity people to attend these meetings as a declaration that the UFT is not owned by Unity.
 
I enjoy these meetings for the camaraderie of the various elements of the United for Change coalition, which has not been very active since the election ended in May. At both the Sept. 12 and 19th meetings we all met an hour before and talked about which issues that need to be addressed, questions asked, etc. 

Here's what's really interesting. Many Retiree Advocate people are there mingling with the 30 something new people and what a nice dynamic. That's what I will miss tonight.

We discussed a reso calling for a bi-partisan ex bd action committee - similar to the arrangement New Action had with Unity in their ten years of bipartisanship -- I will admit to have a gag reflex at that memory --- I don't believe in working at the top with people who really have little interest - and that was proven immediatly at the Unity reaction - or over reaction to this mild reso.

When the elected high school Exec. Bd. members presented their resolution --- Nick Bacon did it - see Nick's New Action report on the Exec Bd.:
....it was predictable Unity would line-up to attack the resolution. As one Unity Caucus speaker after another lined up at the microphones to speak against you could tell how scripted the attack was. Many speakers stated that the UFT Negotiating Committee of 500 should constitute and be the controlling factor in forming a UFT Action Committee. This was supposed to make sense! Really a committee of 500?...New Action: Substitute Rights, Healthcare, Buses, 6th Classes, and a No to Action Committee – UFT Executive Board, 9/19/2022
  
It's not a bad argument - if the negotiating committee is legitimate and not a rubber stamp. I don't feel forming little bi-partisan action committees with Unity has much worth. I'm not for participating in the Unity stacked negotiating committee either -- but the UFC people think they had to be there or get slammed - and some even think they can accomplish something. Maybe they will. I don't hold out much hope.

To me what was interesting was the initial reaction - or non-reaction - of the UFC people who didn't seem to have an offhand response to the Unity argument that the negotiating committee was more democratic. But saving the day from the zoom was Mike Schirtzer -- the lone independent on the Ex bd even though he was elected on the Unity slate. He came up with a cogent, logical reason for this committee that almost convinced me. Sorry, Covid fog has wiped out what he said. (And what a great excuse I have now for anything I screw up.) Mike seemed to unlock the door for the UFC people and one after another they went to the mic and made their case.

Ok - what else happened at the meeting? I claim Covid fog but you can read the official UFT minutes below. But Ibeth Mejia, CL of Aviation HS, talked about her school's major grievance win. Eterno has a more detailed report on how Unity/UFT has let 20 years go by without forcing the issue - CHAPTER LEADER WEEKLY UPDATE: CONTRACT NEGOTIATIONS START OCT 13; AVIATION HS SIXTH PERIOD PAY GRIEVANCE WIN;
 
I also wanted to share some thoughts about the UFC crew from someone I will keep anon due to some connections to Unity -- but it is so well written and thought out:
I just wanted to express my gratitude for all you have done in just 2 executive board meetings. 
You have brought school based, member issues to the leadership of our union, it is important that the folks leading our union hear from working members so they are aware of what is going in our classrooms. 
I know some of you may be disappointed the reso didnt pass, but the debate around it  was great and meaningful. 
Resos brought by opposition will not pass unless it is run by adcom (officers) first- but it still serves at least two purposes.
1. It redirects or changes the conversation-even when it doesnt pass- i would expect at the next contract meeting there will be talk about school based actions-this only happens because of your reso. 
2. it serves a political purpose, I hope all your groups send out to your members the reso you brought forth and the rationale for it and share the minutes of the meeting from nick and eterno-it is important that members see what theyre votes resulted in-a group of representatives bringing members' interests forward to our leadership. I also hope you share the ex bd meeting notes with your chapter 

The tone and meaning of these meetings have already changed, the talk is about member issues and member concerns-your very presence at these meetings makes it better. It is important that our leaders are accountable to the members they serve-you are there holding their feet to the fire.

At any rate, every member has a better union, a more responsive union, because of your presence and action at these meetings.

And notes for tonight:

Wednesday, September 28, 2022

UFT Election Committee Meets: Cone of Silence Vaporizes Those Who Reveal Anything, The Play's the Thing - UFT Up for (lower) Broadway Tony

The Takeaway:  New contract will be the same as the old one with some minor tweaks.

The UFT Cone of Silence has descended on those who attended today's contract committee meeting with a new twist. The Cone has been electrified to zap anyone who repeats even a few words of what was discussed. I experienced this first hand as people who tried to call me with the latest info on the upcoming sell-out had their phones go dead to the sounds of loudly screaming their final words: And then Mulgrew said....... SILENCE --

Before the blackouts hit I managed to hear that the event was very well managed by the Unity machine. See, they haven't lost their mojo at what they do best - managing the membership. If the Negotiating committee '22 is made into a movie, the screenplay may win an Oscar. 

It's appropriate the play version is being performed on Broadway and is up for a Lower Broadway Tony - the only show in that part of  town. The magic in making the cast of 500 actually believe what they had to say counts is a miracle of UFT/Unity PR.

As for delivering a contract with real gains --- no worries - just vote NO now.

Ed Notes has covered The Cone over the years:

Thursday, June 23, 2022

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

Saturday, August 8, 2009
UFT Contract UFT Cast of Thousands Contract Committee
I raised some questions on the then 350 member Neg Comm, n

 

Monday, September 26, 2022

I was in the first class (56-59) at George Gershwin JHS in East NY Bklyn - Happy B-Day George

UPDATE: Jimmy Smits who I knew went to Jefferson HS, just said on TV he also went to George Gershwin JHS where he was on Damn Yankees. I remember the great theater programs there -- and also a teacher or guidance counselor named Miss Smits. Hmmmm!
 
I sub to the daily posting, The Writer's Almanac with Garrison Keillor (free sub) and the b-day of George Gershwin reminded me of how remarkable it was for a major new school complex that opened in East NY in 1956 was named after a musician who had died at an early age - 39 in 1937 - just think - less than 20 years and he has a school named after him. And his brother Ira came to the school and even wrote the school song -- 

There's a bit of personal history related to the coming neighborhood white flight out of ENY. The school was place on Linden Blvd and Van Sicklen  - a few blocks east of Pennsylvania Ave, not far from the future Starrett City - about a half mile walk for many of us. For decades, kids in my area had gone to Strauss JHS 109 on Strauss St in Brownsville which had already experienced white flight and the white parents in my area had been complaining about the walk we had to take to get there. The school was in a very old building from the 1890s named after the Strauss family that died on the Titanic.



Older students told us about rookying - where the incoming 7th graders were harassed and that fear became a big deal. As the new school year in 1956 rolled around, the new school wasn't quite ready to open and we had to go to the old school they told us for a month. But after the first day of rookying, parents were outraged and after the 2nd day they pulled the entire 7th grade out and sent us to the unfinished Gershwin which was still having its roof put on I believe.
It was heaven - for a month - a new gleaming school - in a fairly newly settled area of  Brooklyn which was almost all white. A month later the rest of the JHS 109 8th and 9th grades came over with the entire staff. The school number was changed to JHS 166. For the Brownsville kids it was quite a walk and they got bus passes.

Along with the school, we also got a massive complex of playgrounds, basketball courts and a full sized football field with real grass -- that part took almost a year to finish. 

While the JHS 109 rep was not good, the JHS 166 school with mostly the same kids - well, probably much more white - was considered one of the best in Brooklyn at the time. There were 16 classes on a grade -- I was in 7-16 -- they reversed the numbers that year - so 7-1 was the tough class. Generally, there were two top level performing classes on each grade -- the school fed into Thomas Jefferson HS -- the only kids who didn't go on to there were the ones who passed the Brooklyn Tech and Stuy tests -- and we were given after school prep for those tests - which I still bombed out on.

Decades later, as even that new at the time white neighborhood began to experience white flight, the poverty in the area increased and the school by the Bloomberg era was considered a failure and charter schools, including the UFT middle school charter (which ultimately failed) were installed and the JHS 166 school was replaced. So the very promising George Gershwin JHS disappeared into history a half century after it began.
 
I previously wrote about the closing of Gershwin (all 3 of the schools I went to as a kid ended up being closed) ten years ago: Tweed Terminates and my family history 5 years ago: My Family History of White Flight From East New York in the 60s.
 
And I placed some blame on the UFT for opening a competing charter school in the same building: Saturday, February 28, 2015 UFT Closes Charter: UFT Charter Created Wrecked Co-Located Public Schools in its Wake .
 
 
Here is Keillor's post today:

Today is the birthday of the composer George Gershwin, born Jacob Gershvin in Brooklyn, New York (1898). He was the middle child in a tight-knit family of recent Russian Jewish immigrants. When his father bought a piano for his brother Ira, George sat right down on the bench and started to play. At 15, he left school to work on Tin Pan Alley as a song plugger, a sort of house musician for the music companies. Gershwin had an ear for arrangement, and before long, he was writing his own songs. His first one earned him just $5, but soon he was turning out hits such as “Swanee,” which sold in the millions.

Encouraged by this early success, Gershwin partnered with his brother Ira and began composing full Broadway operas. The two produced popular musicals, including Funny Face (1927) and Strike Up the Band! (1930). At the age of 25, Gershwin premiered his “Rhapsody in Blue,” and later “An American in Paris,” which featured accompaniment written for taxi horns. These compositions became orchestral standards. In 1935, he composed his folk-opera, Porgy and Bess, which features such classic songs as “Summertime” and “It Ain’t Necessarily So.” In 1936, at the end of its original run in Washington, D.C., the cast successfully protested segregation at the National Theatre, leading to the venue’s first-ever integrated performance.


Saturday, September 24, 2022

MulgrewCare Run Amuck: Union Leaders Lobby City Council on Admin Code that has protected healthcare delivery since the late 60's?

Yellow - union/city modifications to 12-126 admin code - giving city an out on coverage

The unions' first mistake was in agreeing to $600 million in savings every year - Marianne Pizzitola, President, NYC Organization of Public Service Retirees Inc

Saturday, September 24 -- I almost lost track since I tested positive for covid for first time this week -- I can still type.

When did our unions become the fiscal hound dogs like Adams? Imagine he comes to the UFT and says no money for class size reductions but if every UFT member pays 191 bucks  month we can make it happen. Let's pay for our own contract like Mulgrew is asking retirees to pay for what was free.

I got a call asking me to get more involved in the city council lobbying campaign being hit hard my our UFT misleaders who are telling the council people that the Unity Caucus stacked UFT retiree health committee supports changing the admin code which will free the unions and the city to offer me a choice of their privatized Med Adv plan or I can stick with my currently free plan for the cost of almost $400 a month for me and my wife. The city has been paying $191 a month for each of us to cover the 20% senior care uncovered by Medicare. Now I'd have to pick that up. I've been told that if the UFT gets its way, the city costs would drop to $7 a month per UFT member. That number should get us great coverage. But they can only get around the court case by convincing the council to change the admin code from 1967 which forces the city to pay much higher fees.

The reason was that the city wanted to only pay the 20% that Medicare didn't way and this addition to the code was viewed as a money saver in 1967. Even the massive fiscal crisis of the 70s didn't lead to calls to change the code.

Thanks a lot. And by the way, there are a bunch of Retiree Advocate (the caucus) members on that committee who oppose the changes but are given no voice at the town halls. The lobbyists on our side want to show the city council that the UFT top is a locked box where rank and file voices are stifled.

I got a quick primer on what exactly is going on with the changes. The admin code provision goes back to 1967 and covers retirees and working members for guaranteed city coverage of over $900 per member for health coverage. Due to Mulgrew 2014 raid of the stabilization fund to cover the raises for working teachers contract with back pay after 9 years without a contract, and a 2018 agreement to help the city cover healthcare costs, the unions owe the city a billion dollars and selling out the members on healthcare is the only way.

Actually, rather than have me interpret, watch this video from Marianne Pizzitola- a sentence by sentence explanation of the admin code - https://youtu.be/SiveIIwCaPc

Let me just interject that the two main competitors for the city contract are Emblem (which pulled out after the recent debacles over the court case) and CVS owned Aetna - by the way note this about the people we want to run our healthcare --

Yeah, these are the people I want our union to hand a $38 billion contract.

Eterno comments on ICEUFT blog:

The Municipal Labor Committee (an umbrella group of over 100 city government unions) is working with the city to try to get the City Council to change the Administrative Code (city law) on city employee healthcare benefits. 

The UFT Contract entitles UFTers to a choice of premium free healthcare plans (see Article 3G1). The change in the law would make it only a choice of health plans. This is part of a checklist on what the UFT is currently doing that is part of the Chapter Leader Update:

Lobbying the New York City Council to amend the administrative code to state explicitly that the city must negotiate with the Municipal Labor Committee on all employee health care plans and must allow that city unions may negotiate for employees to have health care plan choices.

Notice they don't say choice of free healthcare plans.  A judge threw out the city-MLC's attempt to move Medicare-eligible retirees into a Medicare Advantage Plan (privatized healthcare or what we termed Mulgrewcare) or pay premiums for what they have now. 

The city is trying to change the law so they can easily end choices for premium-free coverage and impose the inferior Mulgrewcare. They could then charge around $400 a month for couples to keep traditional Medicare-Seniorcare that today costs $0 in premiums. Unions like the Professional Staff Congress are opposing the change. The city and MLC will be able to end premium-free healthcare choices for active UFTers and non Medicare retirees if the change passes in the City Council.

Go to the Professional Staff Congress (CUNY union) page for more information and to get involved in the fight to oppose healthcare givebacks. 

Here is a supporting response from Tiffany Caban, one of the most progressive city council members, a Dem Socialist (boo to you corp dems and republicans): 
Good morning,

Thanks for taking the time to write. Our office is supportive of retiree's having a choice in their healthcare coverage. CM Cabán was among the signers of the Open Letter to cancel the proposed Medicare Advantage Plus plan (attached) and continues to support the current Medicare/Senior Care health insurance coverage for municipal retirees. We are keeping an eye out for any legislation on this topic that may appear in Council.

Best,
 
Steph Silkowski (she/her)
Chief of Staff
Council Member Tiffany Cabán
District 22, Queens

The above is in response to a letter from a UFT retiree on the Retiree Advocate listserve:

Dear Council Member Caban,

I am on your mailing list because I have supported you in the past.  I believe we share the same political philosophy.

I am 78 years old, and my wife is 77.  We are being threatened with a severe reduction in our healthcare by the plan to eviscerate the protection provided to New York City retirees and their spouses by § 12-126 of the city administrative code since 1967.  The proposed changes would eliminate the cost-free guarantee to retirees and would pave the way to completely privatizing our Medicare/Senior Care.  

The Medicare Advantage private insurance plan that would be forced upon us is significantly inferior to our current plan, which was cost-free until co-pays were recently added (in violation of §12-126) for breathing near any healthcare provider (slight exaggeration).  That plan, or whatever replaces it, since Anthem pulled out, has a restricted network of providers, imposes financial liability on retirees if their out-of-network doctors do not obtain “prior authorization”, and, most important, incentivizes the private insurance company to deny expensive medical procedures, as they are allowed to keep anything they don’t spend on care.  

Medicare Advantage companies typically deny medical procedures at a much higher rate than Medicare itself does, even though they are supposed to use the same rules.  It’s all in the interpretation of those rules as applied, and depends completely on who is doing the interpreting.  Last April, the HHS Inspector General came out with a scathing report exposing the significantly higher rate of denials of care by Medicare Advantage companies as compared to Medicare itself.

When an expensive procedure gets denied by the Medicare Advantage company, what happens?  Either the patient goes without the necessary procedure, suffering health consequences or even death, or the patient comes up with the money somehow, and saves her own life by paying for what Medicare would have covered in the first place.  THIS  IS  NOT  A  COST-FREE  PLAN.  The cost can be enormous.  It violates §12-126, which requires cost-free healthcare (not merely premium-free).  And there is no way to remedy this by tweaking the plan.  It is the Medicare Advantage business model to spend less on healthcare by denying expensive procedures.  

That’s why the Mayor and the complicit Municipal Labor Committee is now asking the City Council to destroy our guarantee of cost-free health care since 1967 by undoing §12-126.

 Please, we beg you, do everything in your power to stop this atrocity.

Sincerely,


Sunday, September 18, 2022

Message to Unity Caucus defenders of profit making healthcare - You've been misinformed

Contributing to the high costs of privately managed healthcare are: high executive salaries(often based on the price of the stock), advertising (those Joe Namath ads), high administrative costs (significantly higher than Medicare), profits, stock buybacks, dividends higher employee turnover - compare benefits to Medicare employees ---and are they unionized compared to employees of private insurers? So how can moving out of Medicare and into plans controlled by these companies save the city money? Unless those savings come out of our hides. And by the way, do you think these jacked up prices have anything to do with inflation?

  • ANTM initiated cash dividends in early 2011 and has raised its dividend ever since. Share buyback activity was resumed last June, considering its solid solvency position. ANTM expects to buy back shares worth $1.6 billion for 2021 and around 60% of the target has been achieved so far.

Note: American Federation of Government Employees
AFGE Local 1923 was chartered as a labor organization in October 1959, representing approximately 30,000 employees nationwide that are employed in the Social Security Administration, Centers for Medicare and Medicaid Services (formally HCFA), Veterans Affairs, Department of Defense, and the National Mediation Board.  Local 1923 is the largest federal union in the country with over 8,000 members and continuing to grow.

....the median pay of health insurance executives in 2018 was $7.7 million. Fourteen CEOs made more than $46 million each....There’s nothing wrong with companies trying to make the most profits as long as the market is kept fair, transparent, and accountable. The personification of corporate entities is an utter mistake. It places them at an unfair advantage, more so the sophisticated, or as I like to call it, twisted policymakers need to realize what happens when private markets get involved in public policies and politics.....The Insurance Industry will always Strive to keep Healthcare Costs High - To maximize their profit, insurance executives take decisive strategies to exploit income... to widen their profit margin, insurers often utilize various avenues, including lobbying, manipulating the social determinants of health and sickness, legal kickback privileges, ..the term “nonprofit” is misleading, as numerous nonprofit organizations even take in millions of dollars annually and consistently run in the dark

 ... the total incentives are toward less medical care because the less attention to patients, the more money kept in the pocket.

In the year, 2020 insurance companies spent over $80,428,145 for 166 clients..

Above are a few key takeaways from this 2 year old article which carries lots of important lessons for our union leaders who know not what they've done.


Also watch this video explaining the administrative code Mulgrew and Adams want to remove:
 

 
https://medium.com/beingwell/health-insurance-for-profit-or-nonprofit-58ad393e3191
Dr. ADAM TABRIZ

Sep 21, 2020