I had the privilege of being one of the speakers on Zoom last night as hundreds of retirees attended the UFT Retiree Advocate webinar in advance of Michael Mulgrew's Town Hall with retirees on Tuesday. An invited medical doctor pretty much laid out the pros and cons of Medicare Advantage and then people associated with New Action, Solidarity, MORE and yours truly were able to speak.
I told the Zoom that UFT Town Halls in the age of COVID-19 are basically like call-in radio shows. President Mulgrew gives a lengthy monologue saying whatever the UFT is doing at the present time is the greatest thing ever and then some screened questions are allowed. The questions usually start with something like: "Hi Michael, thank you for the wonderful, amazing job you are doing..." My wife and some friends have tried to get through and have never had a challenging question answered live by Mulgrew. When the UFT dispatches an unprepared part-timer to call to answer the question that was posed, it is rah, rah, UFT essentially.
Tomorrow, I hope the retirees will have an open question and answer session during the Town Hall at 1:00 P.M. One retiree said we don't want a 90-minute UFT "infomercial" but rather a real dialogue on changes possibly coming for Medicare-eligible retirees.
We have reported on what we know about the probable changes coming mostly based on information from my other union, the Professional Staff Congress (CUNY teachers) which along with the UFT is part of the 152 union Municipal Labor Committee negotiating with the city.
Mike Schirtzer, who is pretty much the only independent left on the UFT Executive Board, asked two questions on Medicare and this was his followup from Arthur Goldstein's report (bold added by me):
Retiree town hall--Please take questions on Medicare.
Mulgrew- Not making any decisions yet. If we have to blow it up, we will. Lots of bad information out there. There are always factions. UFT officers get same health care as everyone else in the UFT. Of course it's very inportant. People are bored when I talk about hospitals, but when we're negotiating, those costs are on the table. The most expensive doctor is usually not the best one. It's an insane industry. They wouldn't allow us to question costs, just pay bills. That's what we're dealing with. We need to avoid high premiums. Retiree chapter has already given me lots of questions.
While I am against privatizing services like education and healthcare, early studies show Medicare Advantage does have many satisfied customers. However, research also reveals that MA does limit access to care. Then there is the question about people who are very sick.
This is from what I believe is a very objective paper published by HeathAffairs.org that acknowledges the pros and cons of Medicare Advantage (MA):
Another marker of quality is whether Medicare beneficiaries remain in MA plans when their health deteriorates. On this basis, there is reason to question whether MA plans offer higher quality. One paper found that MA members who had been hospitalized at least once had a higher rate of switching back to traditional Medicare than did other MA enrollees. The same was true for users of home care and long-term nursing home care.
We can't forget the profits:
We know that MA is dominated by a few large companies, and that it is a profitable line of business. At the end of 2020, the four largest MA companies accounted for more than 60 percent of total enrollment, and the 15 largest accounted for more than 80 percent. MA has also been very lucrative for many private health insurers. In 2017, according to MedPAC, the average pretax margin of for-profit MA plans was 5.2 percent; in 2018, it was 4 percent.
The HealthAffairs.org summary:
In conclusion, it is not clear that Medicare Advantage for All would help bend society’s cost curve more than Medicare for All or other policy proposals. In fact, the current evidence suggests that MA plans have not saved Medicare any money relative to traditional Medicare. To the extent that they lower costs, the lion’s share of those savings seems to be flowing to insurance companies, partly in the form of profits. Policy makers should consider whether this is the direction in which they want health care financing to go.