[ While a big victory, Medicare did not provide full coverage for
all services, and from its inception, there has been a drive to
privatize and hand it over to profiteers. With privatization, profits
ensue as additional restrictions are imposed.....]
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LABOR LEADERS PROVIDE COVER FOR PRIVATIZATION OF MEDICARE  
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Ed Grystar
December 13, 2022
CounterPunch
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_ While a big victory, Medicare did not provide full coverage for all
services, and from its inception, there has been a drive to privatize
and hand it over to profiteers. With privatization, profits ensue as
additional restrictions are imposed..... _

Medicare for All protest at the Baltimore Convention Center, February
2017,, Elvert Barnes Protest Photography, Creative Commons
Attribution-Share Alike 2.0

 

“Medicare is a pillar of the healthcare system”

– AFL-CIO June 13, 2022

Such a statement from the AFL-CIO would suggest that labor is
determined to protect Medicare and even support improving and
expanding it to all Americans. Additionally, President Biden and
Democrats regularly criticize Republican threats to reauthorize and
voucherize Medicare. Meanwhile, what’s left out of both the Democrat
talking points and the AFL-CIO’s 2022 national resolution on
healthcare is any acknowledgment that the _real _threat to Medicare
and healthcare today is the decades-long tax-subsidized privatization
supported by both major parties.

With major support from organized labor, including AFL-CIO President
George Meany at the signing, Medicare was signed into law in 1965.
Before Medicare, only 60% of those over 65 had insurance since it was
unavailable or unaffordable via private insurance (seniors were
charged 3x the rate of younger people). Not only economically
beneficial to the working class, the passage of Medicare was a huge
civil rights victory as payments to physicians, hospitals, and health
care providers were conditional on desegregation.

While a big victory, Medicare did not provide full coverage for all
services, and from its inception, there has been a drive to privatize
and hand it over to profiteers. In fact, 2022 marks the 50th
anniversary (1972) of Medicare permitting private insurance companies
(HMOs) to participate in Medicare.

President Clinton finalized HMO participation with Congress in 1997,
and in 2003, the _Medicare Modernization Act_, under President Bush,
further boosted privatization. The year 2003 marks the beginning
of _Medicare Advantage _plans: insurance companies essentially
masquerading as Medicare.

HMOs and all the other private insurance companies introduced into
Medicare after 1997 have not saved the government money, but instead,
raised the cost to taxpayers much more than traditional Medicare
beneficiaries. In 2005 the Government Accounting Office reported that
“It is largely . . . excess payments, not managed care efficiencies,
that enable plans to attract beneficiaries by offering a benefits
package that is more comprehensive than the one available to FFS
beneficiaries, while charging modest or no premiums. Nearly all of the
210 plans in our study received payments in 1998 that exceeded
expected FFS costs….”

Under traditional Medicare, patients can go to any doctor or provider
that accepts Medicare without prior authorization or restrictive
networks. With privatization, profits ensue as additional restrictions
are imposed, such as narrow networks, micro-managing physicians, and
prior authorizations. Routine denials of care are also a common
practice forcing patients into lengthy appeals with the insurers
betting many will walk away. In NYC, retirees have had to file
lawsuits to stop their own leaders from changing their coverage from
traditional Medicare with a supplement to a Medicare Advantage plan.

These wasted tax dollars and huge profits for Medicare Advantage have
skyrocketed over the years and contribute to draining the Medicare
Trust Fund that supports all beneficiaries. While traditional Medicare
has administrative costs of about 2%, the 10 private insurance
companies that account for 80% of enrollees in Medicare Advantage have
expenses of 15% including profits and advertising. The most recent
Federal audits show that eight of the 10 largest Medicare Advantage
companies have submitted inflated bills, and four out of five of the
very largest have faced federal lawsuits with accusations of fraud. In
2020 alone, they exaggerated risk scores of patients and generated $12
billion in overpayments.

LABOR SUPPORTS ACA – VEHICLE FOR PRIVATIZATION

With the passage of the ACA in 2010, the private insurance
industry’s role as a taxpayer-subsidized vehicle for the healthcare
delivery system was cemented and momentum for an alternative approach
was stymied. Despite 600 union endorsements for Medicare for All Bill
HR 676, union leaders joined Democrats to cheer the ACA as a
resounding success.

Inserted into the passage of the ACA was language that created a new
agency, the _Center for Medicare and Medicaid Innovation _under
the _Center for Medicare Services (CMS)_. Labeled as an office of
“innovation,” it has been given the authority to establish
“pilot projects” that hand traditional Medicare to corporations.

These “pilots,” established under the Trump administration and
continued seamlessly by President Biden, accelerate the privatization
and are even more insidious. Now called ACO REACH (Accountable Care
Organizations, Reaching Equity, Access and Community Health), this
program auto enrolls beneficiaries who have selected traditional
Medicare into a privatized program without their consent. These
programs can be eligible for profits of 25 to 40 percent. The aim of
CMS is to put all beneficiaries into a privatized plan by 2030.
Incredibly, it has no congressional oversight and little pushback by
Congress.

TOP LABOR COMPLICIT AS BIDEN CONTINUES TO PRIVATIZE

Why Should the Rank-and-File Care?

Even as labor negotiations continue to be inhibited by rising
healthcare costs, labor refuses to expose the corruption and waste
within the ongoing privatization of Medicare, harming its members,
reducing union credibility, and contributing to the downward spiral of
health benefits for all. The promotion of an official AFL-CIO Medicare
Advantage plan and a do-nothing attitude towards ACO REACH must end.

The _Alliance for Retired Americans, _the AFL-CIO’s national
retiree organization, has refused to issue any statement against the
privatization of traditional Medicare. Activists

around the country are reporting that they are being cautioned to not
call for the cancellation of the ACO REACH privatization program.

What we are facing in 2022 is the destruction of Medicare by corporate
privatization, supported by many top labor unions and their
compromised “allies” in Washington. For comparison sake, take a
look at labor in Canada where the top five healthcare unions are
taking a stand to warn the public that the government in Ontario is
intentionally creating a healthcare crisis to justify privatization,
just like in the U.S.

WHAT KIND OF LABOR MOVEMENT WILL LEAD THIS FIGHT?

There is ample reason for hope. A budding bottom-up movement has
already garnered signatures from over 250 organizations in a letter
sent to Health and Human Services Secretary Becerra asking him to end
the ACO REACH privatization program. Included were the Alameda County,
CA and Austin, TX Central Labor Councils plus the state AFL-CIOs in
Vermont, Maine, Washington, and Kentucky and other labor groups. There
have also been resolutions passed against ACO REACH by the Seattle
City Council, West Virginia Democratic Party and the Texas State
Democratic Executive Committee. Labor has the resources and
organizational strength to lead this battle. It needs to multiply
these actions tenfold to grow a real movement on behalf of working
people everywhere. These efforts accompany a broader movement for
healthcare justice spanning beyond retirees which include recent
referendums in counties in rural Wisconsin and parts of Illinois
calling for a national healthcare program as well as supermajority
support in the US for Medicare for All.

We need to be clear that change cannot be achieved without a sea
change in the ideological direction of labor. Discussions and debates
inside labor unions and among workers about the best strategies and
tactics to tackle the corporate assault on public need are necessary.
It’s clear that the current approach is not working. People are
looking for answers that protect and advance the public interest. For
unions to assume their proper role they must discard the petty,
bureaucratic, and ossified approach of business unionism: a losing
strategy which at its core is the “partnership” with corporations
and a futile lobbying approach tied to the Democrats. It cannot meet
the possibilities and needs of the day.

Labor needs to stop providing cover for the privatization of Medicare
and join the fight to end ACO REACH. We must mobilize a broad
independent movement that unites all for the public interest. It’s
only the power of the people that can win this.

_[ED GRYSTAR has more than 40 years experience in the labor and
healthcare justice movements. He is co-founder and current chair of
the Western Pennsylvania Coalition for Single Payer Healthcare. Served
as the President of the Butler County (PA) United Labor Council for 15
years. Has decades of experience organizing and negotiating contracts
for health care employees with the Service Employees International
Union and the Pennsylvania Association of Staff Nurses & Allied
Professionals.]_

 

* Medicare
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* Medicare Advantage
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* Medicare Advantage Plans
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* M4A
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* Medicare for All
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* Healthcare
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* privatization
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* Labor Unions
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* Trade Unions
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* AFL-CIO
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* ACO REACH
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