But one thing puts me exactly in sync with a big part of what my fellow activists are saying – that for-profit corporations insidiously worm their way into how public services are delivered, and some unions, like ours, are just playing along.
We've seen this before. In the Bloomberg/ Klein era the UFT just had to have its own charter school, didn't they. And now instead of fighting back against the behemoth health care industry and throwing their weight behind a single-payer system, our oh-so-centrist unions are going full tilt into Medicare Advantage.
Up to now, retirees had a choice. You could sign up for one of many in the dozen or so plans on offer, or you could opt for GHI Senior Care, which is a kind of hybrid plan at this point. It operates in some ways like the Medigaps people can buy in the open market, supplementing what Medicare doesn't pay for.
But that's the point: we had a choice. Now the city is saying we have to choose one of two Advantage plans or go out and find health care on our own.
Privatized Medicare in the form of Medicare Advantage plans, MAPs for short (like HMOs and PPOs), have been around since the 1970s. It's Medicare Part C, which allows the feds to give private insurance companies per capita amounts to help fund health care packages of their own design. The companies are bound by Medicare rules and governmental regs, but these plans don't look like the pure form of Original Medicare, and they don't work the same way.
Parenthetically, it's not stopping there. A new delivery structure called Direct Contracting got off the ground a couple of years ago and has been recently tweaked by the Biden administration into ACO Reach. Both give any entity on Wall St. the ability to offer health care insurance, even without the approval of Congress. (See what Katie Porter has to say about these....)
But I digress.
The point is, I'm making an effort to find common ground with the protesters and overlook their foolishness in playing loose with industry terminology and demonstrating a disconcerting unwillingness to understand how Medicare works.
If you want to see excellence, watch this film again. The messaging is impeccable, articulated as clearly as possible from every angle.
Some of what's in this film is the same battle we're in today. It's certainly against the same greedy types in the for-profit industry run by multi-millionaire CEOs who want so desperately to grab a part of the service sectors. We protested when they set their eyes on public education, and we're protesting now, when our unions collaborate with them to run our heath care plans.
What Medicare Advantage plans DON'T give us is the security that we're going to get the services we need when we need them. As long as CEO salaries and admin costs run as high as they do, Advantage plans are going to rely on co-pays, upcoding, and coverage denials – if not at this moment when they're courting the unions, but two years down the line when the negotiated terms run out.
Many of the things said in the Inconvenient Truth apply right now to the health care wars of today. Here's a sampling:
Brian Jones (04:35): "Our collective experience does not show us that public services in the hands of private entities will solve the problems that we face."
UA: Not all of us are going to get the services we need or see the doctors we want
Julie Cavanagh (08:32): billionaire hedge funders donating millions to the city highlight the "insincerity and cynicism" behind the so-called reform
UA: The trust is still not there: millions for top salaries, and lobbying out of control (see the graphs at OpenSecrets to see how the numbers keep going up). "Some firms may be wielding an outsized influence on policy making" (JAMA research letter).
Sally Lee (17:07): "You can say it's a business approach to schools . . . a direct attack on the mostly low income and working-class people who schools serve, in that they don't have decision-making power."
UA: The "inconvenient truth" is that some retirees can afford to opt out of the new plan, but the lowest paid retirees in the city unions do not have that choice. And they certainly didn't have decision-making power to come up with the new agreement.
Mona Davids (20:11): "Charters are now run by corporate interests."
UA: Yup, and so is Aetna (owned by CVS) and UnitedHealthcare (reported $5.6 billion profits in the first quarter of 2023).
Lisa Donlan (20:27): "Money vs. democracy. We have an incredibly powerful monied forces that are trying to privatize education."
UA: And health care.
Brian Jones (26:14): "You're giving up the right to education, and we're giving it over to these private companies."
UA: Other countries believe health care is a right. Our legislators go where the money is to stay in office.Leonie Haimson (34:17): "A handful of billionaires have been allowed to subvert our democracy by feeding [us] distortions and lies."
UA: And that's what I think the UFT was doing in its first sales pitch two years ago. I can't be sure what's going on now, but I expect more of the same.
Sally Lee (49:17): "We have a large and powerful union, and yet so many teachers don't feel connected to their union."
UA: That's for darn sure. They increasingly hide their negotiations and obscure what they don't want us to know. See this EdNotes post on how they're handling the new contract. But, sticking with health care, take the $15-copays that caught Senior Care retirees by surprise in 2023. Take the footnote in Aetna's brochure: "The customized City of New York prior authorization list can only be modified when there is mutual agreement among the City, MLC and Aetna every two years." That sure looks like whatever they say about prior authorization can be bargained away down the line.
Brian Jones (1:00:08): "We can't accept the status quo, but we also can't accept Wall Street's vision of education."
UA: Or health care either. Profit motives have no business in the nation's health systems.
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