Time to Stand Up and Go Tell It on the Mountain!

If you’re white, you’re right;

If you’re brown, stick around;

If you’re black, stay back!

It’s time for us — Black, Indigenous, People of Color (BIPOC) — to stop staying back and to stand up joining our white allies in opposing Mayor Adams and his administration’s efforts to transfer 260,000 municipal retirees (and our dependents) to a privately administered Medicare Advantage Plus program that have been in the works for more than two years now. 

Municipal retirees have pushed back, insisting that we continue to receive the traditional Medicare’s premium free senior care that we were promised when we went to work for the city decades ago. For us, the proposed Medicare Advantage Plus program is really Medicare Disadvantage. Its limitations of available doctors, coupled with its requirements of prior approvals, are major impediments to patients. Its implementation will deny or delay Black and brown retirees access to the quality, comprehensive, affordable health care we desperately need as we age in place. 

It is well known that healthcare costs are out of control and rising astronomically. The mayor’s move has the full support of the Municipal Labor Committee, a coalition of 105 labor unions in the city, empowered to negotiate healthcare benefits on behalf of their members. In 2018, the MLC made a deal with then-Mayor Bill de Blasio to produce healthcare savings of approximately $600 million annually, or about six-tenths of 1 percent (.06) of its $100+ billion budget. That was placed on hold during the pandemic, and the city is now demanding those savings in the form of funds to be gained by transferring retirees into a privatized Medicare Advantage program.

In response to a lawsuit resisting the transfer, brought by the newly created New York Organization of Public Service Retirees, the District Court not only put the transfer on hold but declared that the city could not require that any retiree who opted to remain in traditional Medicare pay a $194 individual monthly premium. NY City’s appeal is now pending while the city is insisting that a proposed change to Section 12-126 of the Administrative Code (which would render an expected unfavorable decision moot) be passed to enable the transfer, restructure health care eventually for all NY City employees, and make the Medicare Advantage Plus Program the only healthcare program for NY City workers and retirees.

The stakes are high here. This is not simply a retiree issue. It affects large numbers of the city’s current work force and the larger population as well. A change in Section 12-126 of the Administrative Code opens the door to future changes in the quality and cost of active employees’ health insurance. 

The City Council must reject the proposed changes for many reasons. 

The major reason is that rejection of the proposed change challenges a racist healthcare system that has always denied Black and brown people access to quality care. Passage of Medicare and Medicaid in 1965 required the 20% co-pay as dictated by Republicans and Southern Democrats. Healthcare inadequacies are rooted in this system, which recognizes the financial limitations of some patients as well as limited access to preventive care. Too many people of color are underinsured or uninsured. 

The four men in the room (officers of the MLC) — Gregory Floyd of Local #237 of the Teamsters, Henry Garrido of DC37, Michael Mulgrew of the United Federation of Teachers (UFT) and Mark Canniccaro of the Council of Supervisors and Administrators (CSA) — should know this! Two — Garrido and Floyd — are men of color themselves and like most of us, have experienced a life time of disrespect, discrimination and prejudice. All of the MLC leaders lead unions dominated by minorities on the low end of the totem pole, now living in retirement on small pensions and in many cases in poor health. However, they are sanctioning and cooperating with this change because they want to hold onto their power as municipal labor leaders. 

Lacking the vision of predecessors like A. Philip Randolph, founder of the Sleeping Car Porters; Bill Lucy, chair of the Coalition of Black Trade Unionists; and Norman Hill, executive director and then President of the A. Philip Randolph Institute, these current union leaders see the delivery of health care as their key asset in an environment where union membership and member expectations are shifting. They lack the vision, mission and creativity of the Black labor union pioneers of the past to craft new solutions to old problems.

Thirty-one of the 51 City Council members are people of color. They represent a NY City workforce of 305,000 that is predominantly female and minority. Eighteen percent of the workforce is eligible to retire now and 29% is eligible to retire in five years. Assessing that workforce, 58% of the men and only 36% of the women are in the top income bracket of $70,000 or more. Among retirees, the disparity in income is probably greater. The point here is that they are mostly white. 

 One in four African-American families has a net worth of zero! Imposition of the Medicare Advantage Plan would create a two-tiered healthcare apparatus dominated by women and low-income families. In a forced transfer to a Medicare Advantage Plus program, Latinx and African Americans will be denied the care we need. 

Too many of us accept rejection — in any form. We do not fight back when we’re told “No.” Higher income and higher pensioned retirees and current employees (mostly white) will opt out. We cannot afford to create or sustain such a system, and the times will not tolerate it.

None of our elected officials — current and past — have done their jobs when it comes to finding creative solutions to the city’s healthcare problems. Now, we must hold them accountable. We share this blame, but must be aware that the time has come to make them face the realities of our broken healthcare system.

 What actions have already been proposed?

Suggested repeatedly is having the city self-insure, negotiate reduced reimbursement rates to our wealthy nonprofit hospitals, combine many of the member unions’ welfare funds to reduce administrative costs (perhaps saving millions), and consolidating drug purchasing and auditing insurers for claims and financial accuracy.

Next, the pharmaceutical companies — some of which have already agreed to pay billions of dollars for their role in facilitating access to opioids nationwide — must reduce their high prices. They charge retired seniors (and others) hundreds of dollars for pills costing a few dollars to produce and rake in billions for the salaries of their executives and their colleagues.

 The insurance companies also must be held accountable. Floyd of the Teamsters, who is a moard member of Emblem, which originally shared the contract for the new MA+ plan, annually earns $256,687. Garrido makes $315,381. Mulgrew gets $334,000 and Cannizzarro brings home $289,422. CEOs in these insurance companies are paid handsomely. (Emblem’s CEO, Karen Ignagni, made $$3,095,534 in 2021.) The fact is that the structure of the healthcare delivery system responds to the profit motive, which drives much of the economic activity in this country. Note that some DC 37 retirees’ pensions hover around $22,000 and some are as low as $10,000 annually.

Let’s mention the hospitals. Costs have spiraled out of control. Read your Explanation of Benefits (EOB) and marvel at the rates charged for simple procedures. No wonder hospitals can buy up smaller competitors, build new palaces and celebrate their CEOs with million-dollar annual salaries. 

Now, new strategies have been proposed. However, first and foremost, there has to be a rejection of the economic austerity that has shaped the city’s budget since the 1976 fiscal crisis. Then, unions stepped up to the plate, purchasing city bonds eschewed by Wall Street in a then-toxic bond market, and “saved the city.”

Today, the city has to identify new revenue sources. Recognizing that the top 0.1% and the bottom 90% of American households hold close to the same amount of wealth, it is obvious that most of this new revenue has to come from those at the top. Funds could come from the billionaires who are purchasing Manhattan coops and do not live in this country, as well as the many corporations that make their fortunes here yet pay no taxes at all. There are individuals in the top 10% (and below) who cheat on their taxes — paying none or too little. Tax the Wall Street titans who are currently reaping billions via schemes that bilk Medicare Advantage plans — the NY Times has documented fraud in the program as it continues to delay and deny care. Tax the real estate interests that manipulate markets and gain millions and sometimes more.

The newest proposal is to seek an interim moratorium by tapping into the Retiree Health Benefits Trust Fund, which would provide new revenue while a permanent solution is sought.

Next, recognition and inclusion of retirees in the collective bargaining process is key. There can be no acceptable resolution as long as retirees are excluded from the process of reaching one! The New York Organization of Public Service Retirees’ lawsuit marks a new beginning in retiree militancy. So does the decision of, allegedly, 66,000 retirees to opt out of the city’s proposed MA+ plan. That number probably obscures many thousands more. 

Recognizing that current legislation and practice excludes retirees is no excuse for continuing that practice. The times demand change. Failure to do so puts any final resolution at peril. 

There is also a growing feeling that if the MLC leaders cannot seek a fairer, better solution, they should stand down and permit others to do so. Note the exclusion of women from the ranks of leaders and decision-makers. 

Acceptance of the New York Health Act, which would provide access to universal, comprehensive, affordable, quality health care for all NY residents, is a given — but fierce resistance to its passage continues. Municipal unions must withdraw their resistance and share in designing creative solutions to the issues they oppose. There is much for unions to do in our age of climate change, including securing higher wages, better working conditions and increased job security. New organizing leaders are, to some extent, overlooking offers of assistance from current union leaders, as well as adapting new strategies to respond to changing times.

What, then, can we as ordinary people do? 

First, we must contact our City Council representatives by calling 311 or emailing them at https://council.nyc.gov/map-widget. We must tell them that they must vote against the proposed change to Administrative Code 12-126 and protect the free senior care we were promised and now have.

 Next, we must Go Tell It on the Mountain by notifying immediate family, friends, neighbors and acquaintances to do the same. Our daily contacts with everyone and our holiday cards must include a reference to protecting our health care. We must publicize this issue in our churches, our social clubs and our encounters in supermarkets, dry-cleaners and drugstores.

 Finally, we must see ourselves as members of a new army of ordinary people, determined to change the delivery of health care in New York City. Let’s take power away from those who “stay back” and move forward, seeking a permanent solution to the central issue of our time: access to free, comprehensive, affordable health care. 

Health care is not only a human right. Access to quality, comprehensive, affordable health care is imperative. We are an army of older residents engaged in this struggle and determined to win it — for ourselves, our children and our children’s children.

Evie Rich is a retired educator and municipal retiree; veteran of the civil rights movement; progressive; and still active in education, feminist and aging issues.