Saturday, July 17, 2021

Medicare Advantage and UFT

This is not the Joe Namath plan, they say. Okay, I'm listening. Still, I'm not totally confident about privatizing Medicare for city workers. Hopefully what we'll get will be better than the nonsense Joe Namath is peddling. 

I believe the claims that we'll have access to the same doctors that use Medicare. I'm just not sure how long it will last. I see how privatization has worked in American health care, in charter schools, and in prisons.  Given this,  it behooves us all to ask questions rather than just dive in and hope for the best.

There is a very unsettling story about Medicare Advantage in the New York Times. It describes a man who got very sick and whose plan did not have access to the doctor he needed. Evidently the man had been relative healthy and expected to stay that way. (That's always a bad assumption, and if it were true no one would need insurance.) He found he was unable to return to standard Medicare, but was able to get in a different Advantage plan that included his doctor. Personally, I'd much rather not depend on luck in a health emergency. 

The UFT Retired Teachers Chapter once wrote a blistering resolution against Medicare Advantage, but now seems to embrace it as the bestest thing ever. Evidently when they themselves are advocating for it, it's a horse of a different color.

I'd like for them to be right, but yesterday I got in a Facebook discussion with a retiree who very much resented my questions, accusing me of spreading misinformation. It was as though I'd stepped back in time to 2005, and was being reprimanded for questioning that year's contract proposal. The thing is, when you try to have a discussion with someone who's fanatical, you're kind of wasting your time. The other thing, though, is that when someone reprimands you for asking questions, it absolutely reinforces their validity. 

I posted the Times story, and was essentially told that it was Fake News, and that I should just stop. I then got to hear about how terrible I was for asking. That's a familiar response in 2021 America, and it certainly does not inspire confidence in me. What choices will we have?

If you look at the UFT Q and A, you read this: 

If I enroll in the new NYC Medicare Advantage Plus Plan initially and wish to opt out later, will I be able to do so?
Yes, your choice of NYC health plan can always be changed during an open enrollment or by invoking your once in a lifetime change (under the rules that govern the NYC Health Benefits Program).

That leaves me with more questions than answers, actually. As far as I can tell, standard Medicare is not an NYC health plan. Also, how can there be a "once in a lifetime change" if open enrollment takes place every year? Did the subject of the Times story use a once in a lifetime change and was that why he was unable to opt back into government Medicare? Will New York State's more liberal rules allow people to opt back in? How will that help retirees in places like Florida?

There's also the fact that we know how health coverage evolves, particularly here. For example, I was not particularly upset when all new hirees were restricted to HIP for the first year. While I'd personally rather pay more and have the flexibility of GHI, HIP covers these people. If they're able to hack the first year, they'll have more choice. Of course it didn't end there, as the push toward Medicare Advantage indicates. Where does it end? No one can answer that. 

If it's savings we're after, why do we even need to involve Emblem Health? I've read of groups who do self-coverage. Why can't we eliminate for-profit entities altogether? Why do we need to make profit for any company whatsoever? Why not eliminate profit and return it to city workers in enhanced benefits?

We don't know the answers to any of these questions. We also don't know what this program will look like in the future. I've read that members would have the option to remain in traditional Medicare for $180 a year, but I've seen that confirmed absolutely nowhere. Even if it's true, how do we know that price won't multiply rapidly? If the plan is as good as advertised for current retirees, how do we know it will remain that quality in the future?

I've known people who've died because of our abysmal private insurance system. I will never be convinced that universal health care is not the way to go. I do not understand how we could have been part of the movement to block universal health care in NY State. If the cost is high, it still has to be less than the outrageous costs of private insurance, including the deaths of your and my acquaintances. It's a moral imperative to prevent Americans from going bankrupt due to catastrophic medical emergency. It can happen to us too, insurance or not. A lot of end of life care, for example, is not covered by Medicare, and you might find yourself divesting everything to qualify for Medicaid.

If it's important for us to preserve the health care we negotiated, why can't we find a way to do that while providing for New Yorkers who have no coverage? If our coverage is so much better, we can keep it. If it isn't, we should let go of it and get in the business of negotiating better working conditions.

Health coverage aside, it's insane for supporters of this plan to ridicule those of us who question it. That is far from persuasive, to say the least. In fact, when people approach me with hostility and fanaticism, it makes me wonder whether there's a Trojan Horse in this plan that they don't want me to see. After four years of Donald Trump, his lies still infect millions and hang over our country like a cloud.

If this plan is as great as its supporters claim, they should have no problem discussing it openly and honestly, without resorting to invective. If that's not possible, this plan isn't viable and belongs on the very crowded bad ideas scrapheap.

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