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In New York, the left and right are united in a fight against the corporate takeover of Medicare
Folks, I woke up yesterday morning completely worn out but exhilarated and optimistic at what I witnessed and participated in on Monday in New York City.
I saw the city’s teachers, firefighters, cops, and others who spent their careers serving and protecting the public—many of whom voted for Donald Trump—standing shoulder to shoulder with Democratic Socialists outside the gates of City Hall on a cold January morning. What united them was their determined opposition to Mayor Eric Adams’ plan to move all municipal retirees into a private Medicare replacement plan.
I was honored to have been invited to join them. I took my place in a line that began at the City Hall gates on Lower Broadway and that stretched around the block. More than 200 of us had registered to testify at a committee hearing on whether the City Council should support the mayor’s plan.
The stakes couldn’t have been higher for many of them, especially those whose only incomes are their hard-earned Social Security benefits and pensions. If the mayor is successful, they would effectively lose their ability to remain in the traditional Medicare program and be herded into a private plan operated by Aetna, which is part of the giant CVS Health Corporation, and that comes with many strings attached.
The hearing started at 9:30. But the line was so long that hundreds of us were still in line an hour later because the City Council chamber quickly reached capacity. Shivering and believing we’d never get in, I decided to head back to Philly. But by the time my colleague Joey Rettino and I had reached Newark, New Jersey, I got a text from the leader of the opposition asking me to come back, that she could get me in and wanted me to sit next to her during our testimony. So Joey and I hopped off in Newark and took the next train back to the city.
When I finally got into the City Council chamber, representatives of the mayor and unions that supported the move were testifying and, to my dismay, using the talking points I had helped develop in my insurance industry career years ago to confuse and mislead the public. One industry talking point, in particular, that they used repeatedly was that the mayor’s plan would preserve retirees’ “choice” of health insurance options. For most retirees, it would be a choice in name only. If they chose to stay in their current traditional Medicare and Medicare supplement plans, they would have to pay the city $192 a month for that privilege.
As I wrote in the New York Times almost exactly three years ago, if a politician tells you they want to preserve your “choice,” be skeptical because in many cases they either don’t know what they’re talking about or they’re willfully ignoring the truth and trying to mislead you. “Either way,” I wrote, “the insurance industry is delighted.”
The mayor says the move to Medicare Advantage is necessary and would save the city $600 million a year. But it would be at the expense of retirees, most of whom likely would enroll in the Medicare Advantage plan because the price tag to stay in the plan they currently have and like would suddenly become completely unaffordable. And they would be in a plan that would have a restricted network of doctors and hospitals and that would subject them to prior authorization requirements for many treatments and medications.
In traditional Medicare, there are no provider networks. The vast majority of all doctors, hospitals and other medical facilities in the United States treat people who are enrolled in Medicare. That is the “choice” people value most. A patient’s choice of doctors and other health care providers is restricted under Medicare Advantage plans. And unlike Medicare Advantage, referrals are not required under traditional Medicare, and prior authorization for often life-saving care is rarely required.
The mayor’s team tried to diminish the significance of Aetna’s prior authorization requirement, but the crowd wasn’t buying what he was saying, nor should they. As the AMA and other medical societies have been raising alarm bells for years now, insurers are increasingly interfering in the doctor-patient relationship through their prior authorization demands. Millions of patients enrolled in private insurance plans, including Medicare Advantage plans, face delays and denials every year. An untold number die prematurely as a consequence.
For Adams’ plan to work, the city would also need to get millions of dollars annually in subsidies from the federal government. But taxes are taxes. Under the mayor’s plan, all of us who pay federal taxes, not just the residents of New York City, would be forced to pitch in to help him get to his $600 million. But New York retirees would definitely be paying the highest price. Not only would most of them effectively be priced out of traditional Medicare, but the pocket they pay federal taxes out of would also be picked.
You’ll find a video and link below to my testimony, which was limited to two minutes. I’ll be submitting more extensive written testimony later this week.
Is the video not working? Click here. And click here to read the full transcript of the testimony.
And watch this space for an interview with the intrepid Marianne Pizzitola, who leads the Organization of Public Service Retirees.
Regardless of what actions the City Council and mayor take, a grassroots movement is taking shape in New York that is going to spread across the country. People of all political persuasions are beginning to wake up to how private insurers are unlawfully raiding the Medicare Trust Fund to the tune of billions of dollars a year to reward their shareholders (which is why they compete fiercely with each other to capture retirees and spend millions of our dollars on misleading TV ads) while making it more and more difficult for those retirees to get the care they need from the doctors and hospitals they prefer.
Notably, the New York Daily News reported that all six Republicans on the City Council are opposed to the measure the mayor wants the Council to pass. And in Washington, Democrats are also waking up to the corporate takeover of Medicare many of them have unwittingly abetted over the years.
Medicare Advantage insurers are now on the hot seat, and the heat is just beginning to be cranked up.
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Pulling back the curtains on how Big Health is hurting Americans and how we got to this point.
Even if you can see your current doctor under Aetna's Medicare Advantage Plan, he will be restricted in how much time he can spend with you and what tests he can order.
The MA "scheme" is finally getting some light from policy makers. As you stated in your remarks to the NY City Council, the MA health plans use multiple tools to "save" money for Medicare, but then risk stratify reports to indicate that the health plan has "sicker" members - thus increasing their reimbursement from Medicare. Thank you.