Sunday, March 06, 2022

Medicare and Unintended Consequences

What this country really needs is Medicare for All. Given the state of our government and country, I don't see that on the immediate horizon. Meanwhile, we city workers have our own issues, and the latest one centers around Medicare coverage.

First, I have to applaud Retiree Advocate for taking action to halt fees for standard Medicare. I understand the apprehensions of retired teachers looking at changes to health coverage, and it's far from something to be taken lightly. 

The rollout was awful. The new city program was presented as a fait accompli, a thing of wonder and beauty, and no one in MLC had bothered to anticipate the completely predictable outcry. In fact, they hadn't even bothered to recruit doctors for the program. I knew people who said their doctors wouldn't take it.

We've all seen the Joe Namath commercials and their ilk. At first blush, I took the program as one and the same. It was a natural reaction. After hearing about it at many, many meetings, I started to warm up to it a bit. The fact was it would compensate doctors at the same rate as standard Medicare. It was hard to understand what objection doctors would have toward it, particularly with such a large group of us potentially using it.

I didn't envy proponents. It was very hard to argue this plan would be an improvement, particularly since it did not yet even exist. It was hard to credibly argue it would be terrible for the very same reason. I ultimately didn't believe this would've been a Joe Namath stunt, which is one reason I'd have been willing to try it.  

Unlike others, I was not much troubled by having to get pre-approval for procedures. I had cancer about 15 years ago, and with GHI had to do the same. The company that runs GHI was in charge of this new plan. I can tell you a lot of terrible things about that year, but pre-approval wasn't one of them. Being able to take a restoration of health sabbatical was a great gift that most Americans would not have access to.

I have a friend who works as a school supervisor on Long Island. Right now he's contemplating retirement. He's also contemplating taking a job driving a school bus to cover the 1100 bucks a month it will cost him for health care. I don't much understand my friend, as I'd much prefer teaching five classes to driving a bus, but hey, we're all different. I'm very glad not to be looking at this kind of expense when I retire. I'm very glad we've managed to avoid the premiums many of our brothers and sisters around the state pay.

That said, I'm looking at the judge's decision, and it's not reassuring me that all is good for UFT retirees, or even in-service members. One of the selling points of this plan, according to Mulgrew, was that it would've halted potential premiums for five years. As this program is no longer in effect, neither is that guarantee. 

The judge wrote the following:

First, the respondent and nominal respondent have taken many strides to improve the information available regarding the Plan, and thus, while the steps they have taken may not make things perfect, the Court finds that at this point the implementation of the Medicare Advantage Plan is no longer what thus Court would consider irrational.

The plan is no longer unacceptable to the court, and thus may be implemented. Again, we don't know how good, or how bad the plan would be. Only time would tell that. Now I don't speak for Michael Mulgrew, but if I were him I'd have made damn sure this plan worked well, because if it didn't, the fallout would've made hellfire look like a walk in the park. We may never know. Or we may, but I'll get to that.
Here are some more excerpts from the ruling:

The respondent was well within its right to work with the Municipal Labor Council to change how retirees get their health insurance... as the petitioners freely acknowledge, the New York State Constitution does not guarantee specific health insurance for retirees. 

However, based on this Court’s reading of New York City Administrative Code Section 12-126, so long as the respondent is giving retirees the option of staying in their current program, they may not do so by charging them the $191 the respondent intends to charge. This section states unequivocally that “[t]he City will pay the entire cost of health insurance coverage for city employees, city retirees and their dependents, not to exceed one hundred percent of the full cost of H.I.P.-H.M.O. on a category basis.2” 

So the city may change how retirees get insurance, but may not charge $191 monthly under the current code. Of course, the code could be changed. Or perhaps the city could place all retirees in the Advantage program the unions devised, or indeed some Joe Namath program if it saw fit. I don't anticipate the latter, but I'm not certain about the former. Mayor Swagger went from objecting to this plan to endorsing it, likely because it saved the city money. (Since he's taken office, the only thing I've found consistent about him is how wonderful he believes himself to be.)

There is another issue, of course. That is that this plan was designed to save money somehow. If that money isn't saved here, will it be saved some other way? Will the city swallow the cost? If not, will NYC employees rise up en masse in protest? I know some of my former friends in MORE were borderline orgasmic over the prospect of strike. Most teachers I know, while willing to walk for safety last year, do not share that enthusiasm. Some wouldn't even have done that.

I recall that one I was friendly with said flat out to me, "I will be a scab." This person was shocked at my reaction, evidently expecting me to laugh it off or something. A big flaw in our union is that a lot of people do not understand very well what union even is. And while opposition will jump all over that, blaming Unity, I don't believe the fanaticism some of them hold is very appealing to most. (And no, I'm not knocking anyone for being socialist. I'm a huge fan of Bernie Sanders. There's something else there, and everyone in opposition who's worked with this faction knows it.) It certainly didn't appeal to me when they falsely wrote I was a "right-winger," for reasons that continue to elude me.

Furthermore, we have very real right-wingers in our union. The ones I know were happy to have me as chapter leader, but would not have supported me for, say, US Senator. That was fine with me. I was happy to enforce the contract for everyone regardless of political persuasion. I was not happy with the one willing to cross our picket line, though, and he represents a not inconsiderable portion of our union.

Of course we need to educate our brothers and sisters. Trump supporters benefit from union as much as anyone. Spreading the word will be a big job. This is the fault of not only ourselves, but also our school system. I don't like to brag, but I'm a high school graduate, and aside from hearing a Woody Guthrie song here and there, I didn't learn much about union until I joined one. I learned even more when I became an activist, and a whole lot more when I became a chapter leader. 

I frankly don't expect this to go away for good. Opposition can promise the sun and the stars. We will get back all the givebacks from 2005, we'll beat the pattern, and we'll get 10% raises every year, unless we want more. Okay, great. That said, I've had opposition members scheme behind my back, outraged that I'd introduce a class size resolution without their explicit approval. I read the opposition blogs sometimes, and have very recently seen myself blatantly misrepresented in more than one of them. Now I know myself fairly well, better, in fact, than any other blogger.. A few weeks ago, I spoke to one blogger about a correction, and was told no, that wasn't gonna happen. Okay, fine. Keep making promises.

But no matter how loud opposition screams, even if I get up and scream with them, this can come back to bite us. It doesn't matter whether or not we're retired. I absolutely hope I'm wrong. I absolutely hope we continue to receive premium-free health care. 

That's not gonna be a walk in the park, whatever anyone else may tell you.

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