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*Sent:* Wednesday, March 8, 2023 at 10:27:09 AM EST
NY Daily News op-ed today
The city and its unions declare war on their workers with Medicare Advantage
By Leonard Rodberg Mar 08, 2023
Since the mid-1960s, when Medicare became available, the city has given its
retired workers a cost-free supplement to fill the 20% gap left in
Medicare’s coverage.Two years ago, with the support of the leaders of its
employee unions, it declared its intention to move these retirees from
public Medicare to a private Medicare Advantage plan, unless they opted out
and agreed to pay nearly $200 per month for the Medicare supplement, known
as SeniorCare.Now, following multiple lawsuits and two years of political
debate, marches, and protests, the city and union leaders are about to
agree on a plan that will be much harsher and far more expensive for their
retired workers,Retirees protesting the Medicare Advantage situation
relating to the 12-126 law outside of City Hall, Manhattan,
New York, Wednesday, October 12, 2022. Retirees protesting the
Medicare Advantage situation relating to the 12-126 law outside of City
Hall, Manhattan, New York, Wednesday, October 12, 2022. (Shawn Inglima/for
New York Daily News)When the city and the leaders of the major city unions
issued their initial plan, they claimed, falsely, that the federal
government would make up for what the city was not spending. They asserted
— and continue to assert — that the private Medicare Advantage plan will be
as good as what retirees now have. That claim was false then, and it is
even less true today. The city was paying 20% of the cost. Those funds are
missing from Medicare Advantage plans, with the federal government
providing them with a supplement that barely reaches 2% today.In 2021,
then-candidate Eric Adams decried the city’s plan, declaring it was a “bait
and switch,” luring workers with the promise of good benefits in return for
middling wages, and then withdrawing those benefits when they were most
needed.Today, as mayor, Adams is implementing that “switch” on steroids.
The plan the unions are about to vote on would not only require that city
retirees, if they want to remain on Medicare, buy their own supplemental
plan; it would require them to waive all other city health benefits. No
longer would the city reimburse them for their Medicare Part B (physician
care) premiums, nor would they be eligible for city drug benefits.The cost
to every retiree would be $5,000 or more each year. No wonder retirees
refer to this as the “nuclear option.” Most retired workers would be unable
to afford this and would be forced into Aetna’s Medicare Advantage plan.
The poorest among them, often Black and Brown, would be hurt the
most.Retirees on Medicare have coverage run by a federal agency whose
mission is to provide access to health care for seniors. Medicare
Advantage, by contrast, is private insurance. While the federal government
pays for it, the mission of any private insurer is to make money for its
shareholders. Every dollar spent on health care is a dollar not going to
the shareholders.Retirees currently receive first-class care under
Medicare. Under the city’s new plan, retired city workers will be relegated
to second-class, cut-rate care. Without the city’s supplemental payment,
and with the additional cost of executive salaries and corporate profits, a
Medicare Advantage plan has 25% less to spend on health care.Medicare
Advantage plans save money by imposing a variety of measures that limit
their spending. They require ubiquitous copays which not only shift cost to
members, but discourage them from seeking care. They limit the choice of
physicians and hospitals. And, unlike Medicare, they require prior
authorizations by the insurer for any treatment or procedure likely to be
expensive. The resulting delays and denials can be deadly to patients.New
York City, which claims to be a world leader in commerce and social policy,
is unwilling to learn from countries around the world which have found they
cannot turn over their health care system to private insurance companies
and expect to achieve high quality, affordable care. Authoritative
comparisons of systems globally show ours to be the most expensive, least
effective among all leading countries, yet this city and its unions want to
move from the effective public Medicare to the costly, inefficient private
insurance model.There are solutions that will not cost the city any money
in the short run and would save large sums long-term. The union
representing CUNY faculty and senior staff has proposed using excess
reserve funds to pay for the current retiree benefit while organizing a
special commission to find ways to contain future health care costs.
Meanwhile, the City Council should direct the mayor’s administration to
continue the current benefit with public Medicare and the city-funded
supplement. That is the fairest way to honor the commitment the city has
made to its dedicated workforce. The city’s workers deserve the very best.
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