The $22,000 Baby

Sarah Wildman did everything right. She went and got health insurance before she got pregnant, as our preposterous system labels pregnancy as a "preexisting condition" and doesn't cover it. But then, after paying all the numerous copays, she found her insurance policy didn't cover labor, delivery or a hospital stay, despite her rider for maternity coverage. How stupid of her to expect maternity coverage to pay for those added extras.

Now you're probably asking yourself, "Why couldn't she just have her baby at work or something?" At a high school I used to work in, a paraprofessional had a baby in the cafeteria one day. Now there was a woman who didn't believe in any of those wasteful frivolities. But actually, as she had government health care, like me, and like prominent public health care foe Rudy Giuliani (who was treated for cancer while he carried GHI), she was whisked to a hospital by ambulance and ended up getting the same care as Ms. Wildman, paying only whatever the GHI deducatable was at that time.

There's a happy ending for Ms. Wildman. When she told her insurance company she was writing an article about them, they suddenly decided to cover 90% of her expenses. But for many Americans, that's not the case. One way private insurance companies make their money is by denying coverage to people who fail to protest. That's just one reason why we should all oppose the privatization, or "for-profit" status of Emblem Health, which administers GHI and HIP, even if its IPO enriches the coffers of our unions.

It's the business of "for-profit" organizations to maximize profits, not to help you. And the results for working Americans are catastrophic:

...a new report from the American Journal of Medicine found that in 2007, 62 percent of declared bankruptcies were by people with staggering medical bills—even though 80 percent of them actually had health insurance.

Every industrialized country in the world but us avoids this one way or another. If President Obama manages to solve this problem, despite his preposterous and unfounded positions on education, it will have been worth voting for him. If not, well, we may as well have left GW to continue flushing our future down the toilet.

Thank Goodness for Private Insurance Companies

Of course, there are many reasons we should be grateful. The thoughtful and reflective individual at left offers but one point of view (though I personally was not aware Mr. Frank was a medical doctor, let alone the questionable quality of the services he appears to offer). The United States now stands alone among industrialized countries as the last bastion against that awful universal health coverage that's infected our neighbors. Thank heavens for that:

An Oklahoma man who lost an eye and a leg in Iraq says the giant insurance company AIG refused to provide him a new plastic leg and fought to keep from paying for a wheelchair or glasses for the eye in which he has 30 percent vision.

It's an honor to bail out AIG, as I suppose they're finally showing precisely what they're going to save money on. And regularly enlisted soldiers ought to know that President Obama, like his predecessors, doesn't plan to waste federal money on making sure they get VA coverage either. Not only can't we cover everyone, like most countries, but we can't even cover those who've risked their lives fighting our wars.

Nonetheless, we've got billions to bail out insurance companies that nickel and dime us over whether or not they should provide us the coverage they actually get paid for.

And if you like the way AIG protects its profits, just wait until GHI-HIP is allowed to convert to "for-profit" status. Part-time UFT President Randi Weingarten thinks that's a great idea, but wants to make sure her patronage mill gets a sufficient portion of the IPO before throwing her support behind it.

So finally, we city workers can have the sort of private insurance our neighbors have. Lucky us. If you run into Ms. Weingarten, don't hesitate to thank her in advance.

I Don't Know Much About Medicine, but I Know What I Like

That's about the size of it for hundreds of thousands of twenty-somethings here in New York. If you have no health insurance, fall off a motorcycle and rip your arm off, you go home and sew it back on. It's not the best of all possible worlds, but if you don't have health insurance, you know a visit to the hospital will be five thousand bucks on a good day.

So you stumble around and hope one of your buddies has a jar of whatever drug you need, because Lord knows you can't afford it.

As things stand now, I believe you can claim your kids on your insurance until they turn 18, or 21 if they're enrolled in college. How many 21-year-old kids score jobs with full health insurance? To my way of thinking, anything less than 100% is unacceptable. Of course, you can't get there immediately.

Governor David Paterson, though, has finally come up with a good idea, and it's about time. He wants to allow us to keep our kids covered until they're 29. That would help about 10% of the uninsured twenty-somethings, and you have to admit it's better than nothing. Not much better, but at least it's something. The Times says two dozen other states already do this, and it's nice to see we're getting with the program.

Now if we can only convince part-time UFT President Randi Weingarten that privatization of Emblem Health is an abysmal idea, we'll really have gotten somewhere. It's unfortunate that Ms. Weingarten, despite the market's recent performance, still worries about how much the IPO will benefit her patronage mill, while few doubt privatization will result in city workers paying more and receiving less from their most popular plans, GHI and HIP.

Do you doubt it? When they merged, there was talk of improving benefits for subscribers. But GHI subscribers still don't have the option of HIP-style care with no co-pay, and HIP subscribers haven't got the wide variety of doctors available to those with GHI.

Tell your state legislators you support Governor Paterson's plan, and would like to see it enacted ASAP.

Watch Your Step

Emblem Health, which you may know better as GHI or HIP, has resubmitted its proposal for privatization. This is very bad news for the overwhelming majority of NYC employees. Don't count on support from the UFT because Randi Weingarten's prime concern is how much cash the IPO will bring her well-oiled patronage mill.

If you're looking for someone who supports working people, check over here for the coalition to save our health care. They're more than happy to tell you what you can do to help. Evidence suggests that privatization benefits only the shareholders, and does so by passing higher costs onto policy holders, i.e. you and me.

This is the biggest issue facing working city employees right now. In 05 Ms. Weingarten demonstrated her willingness to give away virtually every gain the union had made over thirty years for a compensation increase that failed to meet cost of living. Sacrificing our health care, however, goes beyond the pale.

When her minions come to visit your school, remind them their job is to fence off the cliff, rather than push us over it.

Tragedy!

Poor William L. Jews. His compensation package for leaving his position as CareFirst CEO has been cut by more than half. This means Mr. Jews will not get the $18 million severance he was expecting, but will receive less than 9 million bucks. Can you imagine having to get by on just shy of 9 million bucks? I mean, you can't even buy a decent Santa Barbara estate for that kind of money anymore.

Why was this outrage perpetrated? Well, it seems CareFirst is a nonprofit health provider, like New York's GHI and HIP:

In a 65-page order, state Insurance Commissioner Ralph S. Tyler wrote that CareFirst's board had violated a 2003 state law requiring executive pay for the nonprofit to meet a "fair and reasonable" standard. The decision marks the first test of the law, which was passed by legislators furious with Jews for trying to convert CareFirst to a for-profit entity and sell it to a California company.

The proposed deal to sell CareFirst included $39 million in potential bonuses for Jews and led to sharp criticism over the insurer's pay to executives, which helped to scuttle the deal. While executive pay has skyrocketed on Wall Street, lawmakers and regulators have argued that CareFirst should be held to a different standard. The company is the region's largest insurer, but its nonprofit status means that its mission should be to provide affordable and accessible health insurance, they contend.

So that, apparently, is the problem. Had Mr. Jews been successful in converting the company to "for-profit" status, he'd have been able to collect his 18 mil, and policy holders would have been left to pay the tab one way or another. In fact, NYC employees, most of whom are covered under GHI and HIP, are facing a very similar situation.

UFT/ AFT President Randi Weingarten is fighting privatization right now. That's because she'd like a larger share of the IPO to feed her Unity/New Action patronage mill, which now has to sputter by on less than a hundred million per annum. And heartbreaking though her situation may be, the fact is that "for-profit" status will most certainly mean price-hikes and care reduction for most of the city's employees.

There is an intrepid group of teachers fighting this money grab and you can find them right here. Here is their most recent newsletter. And here's something you can do tonight, if you're so inclined:

Our next meeting is Friday July 18th at 6:30pm at 339 Lafayette St. Buzzer #11 Please email us at [email protected] or call (718) 869-2279

If you're a teacher, don't be afraid to reach out and let Ms. Weingarten know you oppose privatization. Ms. Weingarten, living in a rah-rah Unity cocoon, is blissfully unaware that there are working teachers who can envision the future. Her double-pensioned sycophants are not about to educate her, so it's up to us.

We are teachers, after all. But you're also doing it for the police, the firefighters, and all the hard-working people that make the city what it is.

A Worthwhile Reform

Eduwonk has a very thoughtful post about the possibility of using adjunct teachers to help out where needed. I was leaning against this idea until he mentioned that a rational health care system might make it easier. With that, I couldn't agree more. I happen to work as an adjunct, but I certainly couldn't afford to do so in lieu of my regular gig, which provides me and my family with health insurance.

In fact, I know people who work as paraprofessionals not for the salary, but simply for the insurance. I was speaking with one and telling her she might do better as a teacher.

"Teach?" she said. "Who needs those headaches?" And if that's how she feels, she shouldn't do it. Of course, if she didn't need the insurance she might be able to afford doing something she liked better.

Here's my response to Eduwonk:

Amen to your notion of a rational health care system. I think if we were to have such a thing, we’d have a lot more common ground on educational issues. Many things would be possible in a country like that, and I hope we live in such a place one of these days.

The reality, though, is UFT President Randi Weingarten is looking at privatizing the NYC healthcare network, and her prime reservations seem to relate to how big a cut will reach union coffers and a very short-sighted temporary stop on turning over the company. It’s sad Ms. Weingarten feels she can’t operate her patronage mill on a piddling 80 million a year.

Still, it’s remarkable that her myopic vision indicates teachers need what the rest of the country has. Particularly in terms of health care, the rest of the country needs what teachers have, and the sooner the better.

Let's say a prayer that Ms. Weingarten doesn't get her way and sell us off for the usual pittance she manages to negotiate. I'd say more money to pay her propagandists and sycophants ought to receive the lowest possible priority from working teachers (who might get sick one of these days).

The Letter

Dear GHI/HIP subscriber:

As you know, GHI and HIP have merged. Therefore, we're delighted to be able to offer you the benefits of both companies. GHI subscribers will now be able to visit HIP doctors and hospitals with no copay, and HIP subscribers will now have access to the GHI network of providers if they wish to pay the copays.

Did you receive that letter? Me neither. That's because this merger was not done to benefit subscribers. It's the precursor to a "for-profit" status, or privatizing your health care. The benefits of privatization consist primarily of an IPO. This may bring cash to the UFT, which now has to squeak by on as little as 80 million a year. Heartbreaking though that may be, if your heart were to break, literally, you'd need to get it fixed on even less.

GHI/HIP privatization is the single most unconscionable and witless venture Ms. Weingarten and her merry patronage mill have ever embarked upon. It's bound to hurt union members and their families if no one stops them. Check Save Our Health Care on a regular basis. Find out the status of the privatization grab, and find out where demonstrations will be held this Saturday, July 12th.

Sleep With One Eye Open

That may be good advice for working people in New York City. GHI and HIP are embroiled in a project to merge and adopt "for-profit" status. It's hard for any objective soul to imagine privatization will benefit those of us, 90% of city employees, who utilize these services.

When Americans can't get insurance because of pre-existing conditions, when the number one cause of bankruptcy is catastrophic medical emergency, and when people are literally dying because they are uninsured, more "for-profit" entities are hardly the answer.

You'd think that union leaders would be looking out for their members. But you'd be sorely mistaken. There's a huge windfall here in the form of an IPO, and union leaders have an eye on precisely who will be reaping the considerable profits:

The municipal unions are also looking to share in what has been estimated as up to a $5 billion windfall from an IPO if the new company becomes a for-profit. There was actually some internal friction a couple of years ago after a group of uniformed union presidents led by Sergeants' Benevolent Association head Edward Mullins supported a bill in Albany that would have allowed Service Employees International Union Local 1199 to share in a significant piece of the windfall if HIP became a for-profit. While Local 1199 is one of the state's largest unions and a political powerhouse in Albany, it represents only about 2,000 city workers, and there were concerns expressed by Ms. Weingarten and others that it might wind up with a disproportionate share of the IPO money.

The amount of money the unions receive is not remotely as important as maintaining affordable and adequate coverage for working people. I see precious little evidence Ms. Weingarten and other union leaders are giving this adequate consideration. It's true Ms. Weingarten has written tepid missives hoping that the company would not be sold (at least not immediately):

...rumors persist that upon conversion there will be a “flip” of both the management and control of the converted entity. That is unacceptable. At a minimum, a multi-year “freeze” must be imposed as a condition to the grant of any approval.

Once again, though, Ms. Weingarten's chronic myopia fails to protect working people. Not to belabor the obvious, but what happens after this "freeze?" Ms. Weingarten brought us the ATR mess, and endorsed an entirely ineffectual "hold harmless" clause which failed to help the hundreds of teachers now caught in this unnecessary limbo. She also declared victory on the class size issue on the basis of a nebulous unenforceable law that proved 100% ineffectual.

And here's a little more of Ms. Weingarten's letter, looking to enrich union coffers:

As I noted in my February 8 letter, our initial concern remains that if the state, through your agency, approves conversion, both New York City and its unions must share in the proceeds since it was their assets and business that made possible the current financial viability of HIP-GHI. Any approval, therefore, must make provision therefore.

There is certainly monetary benefit for shareholders in "for-profit" status. But it doesn't take a genius to know who will pay so others may benefit. Now Ms. Weingarten, who makes many times the salary of any teacher, has little reason for concern. But you and I had better keep an eye on her.

Ms. Weingarten is much admired by Rod "The NEA is a terrorist organization" Paige because she gave Mayor Bloomberg everything but the kitchen sink in 2005 (She's saving the sink for his successor). Whether or not she worries about the welfare of those she ostensibly represents, her complete and utter lack of foresight is ignored at our peril.

And, no kidding, our very lives are at stake.