NYC Retirees Healthcare Fight For Traditional Medicare: Update With Marianne Pizzitola
- Marianne Pizzitola
- 11 minutes ago
- 2 min read
Staten Islander News sat down with Marianne Pizzitola of NYC Organization of Public Service Retirees to discuss the importance of continuing to fight for traditional Medicare over Medicare “Advantage.” As Marianne and many others have stated, it’s not actually Medicare and it’s not an advantage.
What does that mean? Medicare Advantage is supposed to cover everything that traditional Medicare does. However, in practice, that doesn’t actually happen. This is a stark example of how public-private partnerships harm people. Medicare Advantage is a plan that people can enroll in when they turn 65, just like regular Medicare. But instead of seeing any doctor they want, they have a very limited network to choose from. And if their doctor says they need something (a test or treatment usually), they have to convince a non medical professional at the insurance company that they need it.
Often the insurance company denies their claims, after which there is a five step appeals process that they or their doctor must go through. This is because it’s actually private insurance whose goal is profit maximization. The only way they can profit is by denying care and holding more of the monthly fee paid to them by the government.
It should be noted that, as Marianne discussed, traditional Medicare has no monthly premium the government must pay for each person. It is a cost for care model. An enrollee goes to the doctor, Medicare pays the bill. They get a test, Medicare pays. There’s no monthly cost to it. With Medicare Advantage, however, the federal government pays a premium each month for each enrollee, regardless of if they are sick or healthy or even use the care provided. The model is based on perks and things that people will do to keep themselves healthy.
This is totally overlooking the fact that most Medicare retirees have had a lifetime of bad habits and no nutrition education. So they’re not going to the gym that they are now members of. They’re not eating better. They’ll do the same thing they always do, but when they do get sick, there won’t be any coverage for it because it will be denied or delayed. This was an idea in the 1980s and 90s that it would save the government, but it’s done anything but. It just makes it so the insurance companies profit at the expense of those with the inferior insurance, and employees can be auto enrolled without their consent into this inferior program.
Since the election is happening soon, you can learn more about who supports the retirees and who doesn’t at http://retiredlaborstrong.nyc
See our previous articles earlier this week, about the court case issues and about the politicians who have come on board and where the fight is now that the court case was lost.
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