Commentary on this email is at the link below:
https://arthurgoldstein.substack.com/p/the-unity-patronage-cult-sends-us
Dear Committee Members,
Here’s to a happy new year for all! I want to again thank you for your interest & input regarding our retirees’ health care, and for participating in our committee. Your feedback has been important to preserve and protect the quality premium-free health care that we all seek.
Several of you have written to me over the past holiday season and weeks and I have been otherwise engaged. Between family events and the hospice experience of a very dear friend, the emails didn’t get the attention that I should have provided. But I spent some time putting this together. And I hope that you find it engaging as we continue to wait for outcomes in courts beyond our control.
When the healthcare committee was established, our task was a review of the EMBLEM/ALLIANCE plan that was being considered by the City and MLC, a consumer response to what the insurers offered. President Mulgrew deemed it vitally important that members’ voices be heard in the process – our ideas, concerns and so on. And when the insurers of the original plan dropped out and the AETNA plan was presented, a similar review by the committee ensued.
The UFT RTC Health Care Committee has been an effective vehicle of representation of the retiree membership during this process. While we have not been a party to whatever negotiations existed for our current health plans, we have provided our own leadership with many helpful suggestions, objections, and ideas to improve the benefits of the plans that have come forward. And those suggestions, objections, and edits have been taken seriously, addressed and in many instances implemented. I can’t stress enough how effectively and honorably the committee has served our members in the union’s fight to improve the benefits now being offered. Your work has had a meaningful impact.
But – and there’s always a BUT - I continue to find the discussions and commentary swirling about health care plans to miss a very important point. None of us can afford to ignore the one piece that President Mulgrew constantly addresses and no one seems to take up…. business and economics. Healthcare is a business. Your doctors, no matter how wonderful their bedside manners and their concern for you, are a business! The hospital that you regard so highly is a business! We live in a capitalist society and it’s all BUSINESS. They are not looking out for our personal and organizational economic interests, sometimes to the detriment of our health. The health care industry keeps raising their costs on everything in an effort to increase their profits. The seemingly only entity that I see standing in their way and holding them back in defense of our healthcare is our union. It’s a daily battle that we don’t see, and from what we are told, not a pretty one.
A number of members of the committee have expressed adamant opposition to any Advantage plan. They send to me various articles, commentary, and personal objections to Advantage plans and want me to disseminate to the committee what they provide. The reason that people send me the articles is their contention of the inadequacy of Advantage plans. Yes, some Medicare Advantage plans are a ripoff, and we’re all aware there are some bad actors out there. I surmise their intent as well is to build support to kill any Advantage plan that the City wishes to implement. Previously I have regularly ignored such requests because the choice of plans is not in our committee’s purview. That belongs to the City and, by past practice and agreement, in consultation with the MLC.
We have to keep in mind that the premium free Advantage plan that has been proposed includes significant improvements and standards that this committee recommended and that makes it far different than the plans described as ripoffs!
We can also never lose sight of the economic issues about which President Mulgrew constantly addresses vis-a-vis the healthcare plan. The City and MLC want a premium free plan to offer to retirees. And that’s a money issue, no matter how you slice and dice it, because health care costs money – more and more each year. (There is a reason why most City Council members have backed off their original bravado about funding retiree health care plans.)
I always warn my friends to be cautious when they start reading into the disinformation, the misinformation, and the stories made out of whole cloth because they almost always ignore the economic realities of the situation! And I extend that warning to all of us who are invested (no pun intended) in this issue. Our current dilemma regarding healthcare is an economic issue, and that fact must always be reflected in our discussions. Otherwise, I fear that any discussions that ignore the economics will be meaningless.
So, in my own interest, that is, to offset the contention that I am deliberately trying to block discussion of the inadequacies of certain and some Advantage plans, I send out to you some of the exhibits that have been sent to me. Personally, I find most of them incomplete discussions of the specific Advantage plans they address and, to be frank, poor journalism because they ignore some of the realities that NYC faces, not to mention the very real possibility that our quality premium-free health care may be on the line. At this point most of us know more on the topic than do the journalists writing the stories that are cited. There are so many holes in the journalism that a Mack truck can go through them. And the stories do not change the fact that the City in consultation with the MLC makes the final determination of what health plan(s) it offers based upon economics. I actually fear what the outcome of the court challenges may be. I go by the old saw, don’t start a case until you know and address all the potential outcomes.
Some links to negative Advantage articles that committee members have submitted:
'Deny, deny, deny': By rejecting claims, Medicare Advantage plans threaten rural hospitals and patients, say CEOs ---
Hospitals are dropping Medicare Advantage plans left and right –
Also attached for download is a story that fits the category.
(PERSONAL NOTE: Thanks to the Committee’s input, our representatives attacked the denial issue directly during negotiations, and not only got AETNA to agree to drop the vast majority of pre-authorizations, but also secured transparency measures and performance guarantees that would lead to heavy fines if AETNA didn’t act in good faith – just another of the many reasons why the proposed plan is steps above any current existing MA plan.)
In addition, to satisfy my own perspective that I mentioned earlier, the economic factors that go ignored as the basic issue determinative of the City trying to provide a premium free plan, I add a few articles from recent NY Times editions that might give us some perspectives.
Reading the following article I was struck by the similarity to some things that have been written regarding the healthcare issues that we have been confronting. One such routine comment and accusation is the attack on eliminating CityMD Urgent care as an emergency care provider covered by our health plans. CityMD Urgent care charges exorbitant fees for its services, far more than other emergency care providers. As consumers, we exercise our right to engage with providers to limit excessive charges. If they refuse to negotiate, we refuse to use and subsidize them.
This article about the Carrefour supermarket chain in France works on the same premise. It is instructive on several levels but most importantly the fact that the consumer must assert some leverage to contain costs, just as we do!
Major French Retailer Drops PepsiCo Products Over High Prices
Carrefour, a supermarket chain, said the maker of Pepsi, Lay’s and 7-Up was keeping its food “unacceptably” expensive despite falling inflation.
This next article talks about efforts to reduce healthcare costs, something that the Biden administration has worked to accomplish. Ironic in the current political environment that it describes a Florida application based on the Biden initiative!
F.D.A. Issues First Approval for Mass Drug Imports to States From Canada
The agency authorized Florida to purchase medicines directly from wholesalers in Canada, where prices are far cheaper. Pharmaceutical companies oppose the plan.
Enough of me, I think. Thanks for your attention. Again, happy new year.
Vinny
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