An Open Letter to President Joe Biden…
President Joe Biden is being urged to help save Medicare from privatization.
Dear President Biden,
My name is Marianne Pizzitola. I am a retired member of the FDNY EMS and participant in the 9/11 World Trade Center Health Program. For the last few years, I have been president of the New York City Organization of Public Service Retirees that we organized when New York City’s Municipal Labor Committee and then Mayor Bill de Blasio decided to force 250,000 retired civil servants off of our traditional Medicare and onto a predatory for-profit Medicare Advantage Plan.
I really appreciated your State of the Union address the other night. As retired civil servants, who share your lifelong commitment to public service, we know how disempowering it can be when your age is used against you to marginalize you from consequential conversations. Perhaps saddest of all, is that while we have had success so far in holding onto our precious Medicare through the New York Court system, it’s been our own unions that we helped build that have become our fiercest opponents.
During your speech you referenced that thanks to the Affordable Care Act “over 100 million” Americans “can no longer be denied health insurance because of pre-existing conditions.” We wanted to alert you that even as your administration has been working to expand access to healthcare for Americans, the privatization of Medicare, through the increasing reliance on private sector Medicare Advantage plans, is causing seniors to have their access to healthcare greatly restricted by way of prior authorizations and outright denials. Seniors can also be denied Medicare Supplemental coverage due to pre-existing conditions or age. Many of us are getting forced off Traditional Medicare and into these plans even though our doctors and hospitals do not accept them.
In 2022, the New York Times and Kaiser Health News published in-depth investigative pieces which raised serious questions about the nation’s largest Medicare Advantage insurers including Aetna, the latest MAP provider the City of New York is attempting to force us into. The news outlets confirmed that the insurers were on the radar of regulators who had documented a sector-wide practice of so-called “upcoding” when insurers would say patients were sicker than they were to secure a higher reimbursement from the government, while using prior authorizations as well as outright denials of care to reduce their costs and increase their profits.
Last July, our group filled two Amtrak rail cars and headed down to Washington, D.C. to participate in a Capitol Hill rally to “Save Medicare” that was organized by Be a Hero, the universal healthcare advocacy group started by the late Ady Barkan where we met several hundred activists and members of Congress who shared our concerns about the privatization of Medicare.
At the rally we met Meagan Bent, whose father Gary Bent, was a retired University of Connecticut physics professor of 23 years. He also had been an Ordnance Corps Officer in the US Army for 12 years serving several research centers, as well as the U.S. Military Academy at West Point. He died last March after his Medicare Advantage insurer, using an algorithm and artificial intelligence, denied him access to skilled nursing and acute therapy that had been prescribed by his neurosurgeon.
Bent was 82.
“Our family continues to struggle with the question: Why are people who are only looking at patients on paper or through the lens of an algorithm making decisions that deny services judged necessary by people’s healthcare providers?” Meagan Bent told us. “People that have interacted with them [the patients] personally and, sometimes, have known them for years.”
“This year, for the first time more than half of all beneficiaries are enrolled in Medicare Advantage instead of traditional Medicare,” Sen. Warren told us. “Medicare Advantage substitutes private insurance companies for traditional Medicare and that private coverage is failing with Medicare beneficiaries and taxpayers. It’s all about the money. Private insurers are in Medicare Advantage to play games to extract more money from the government. Experts estimate the Medicare Advantage insurers will receive more than $75 billion in over payments this year alone.”
Last month, U.S. Representatives Pramila Jayapal (WA-07), Rosa DeLauro (CT-03), and Jan Schakowsky (IL-09), along with 60 other lawmakers, called on the Centers for Medicare and Medicaid Services (CMS) to enact urgent reforms to Medicare Advantage (MA) plans writing that MA plans were “fraught with waste, fraud, and abuse, often sacrificing patient outcomes for higher corporate profit.”
“Corporate health insurers offering MA plans are harming vulnerable patients across the country and endangering the solvency of the Medicare Trust Funds,” the concerned House members wrote. “Supporters of MA claim the program reduces costs. Unfortunately, the MA program has never saved the government money. Other recent data has shown that the bottom 5 percent of MA plans are responsible for 10,000 preventable deaths every year.”
The House members note that CMS pays 6 percent more per enrollee than it would for traditional Medicare coverage, wasting billions of dollars every year.
We are hearing from retirees across the country that despite these higher costs, insurers administering MA plans provide consistently worse coverage. Representatives Jayapal, DeLauro, and Schakowsky cited research that “recently found that patients covered by privatized MA programs are significantly more likely to die in the month following surgery for stomach, pancreatic, or liver cancer compared to those in Traditional Medicare.”
I was encouraged by your reference during the State of the Union to the longstanding gender gap that exists when it comes to medical research and that your wife Jill was “launching the first-ever White House Initiative on Women’s Health Research” in recognition of this longstanding inequity. We'd like to meet with her.
Those of us women who are in the 9/11 WTC first responder community know all too well about the consequences of medical research that skews to the male cohort. Under the ground rules of the 9/11 World Trade Center Health Program, individuals who document they were first responders are entitled to free lifetime annual screening for dozens of WTC-linked cancers. Civilian survivors, which includes many of our members who worked in lower Manhattan at their municipal agency offices but were not first responders, have to display symptoms first before they can apply to participate in the 9/11 WTC Health Program.
Currently, close to 72,000 of the first responders in the 9/11 WTC Health Program are males and just 10,200 first responders participants are women. By contrast, the 9/11 WTC survivor cohort includes 22,000 men and 18,700 women. Because of the preference given to testing first responders, who were overwhelmingly men, the prevalence of female reproductive cancers in the female cohort was missed for many years. In fact, it was only just last year that the World Trade Center Health Program finally added uterine cancer, including endometrial cancer, to the List of WTC-Related Health Conditions.
“With the publication of this rule, a critical gap in coverage for women in the Program has been eliminated,” wrote WTC Health Program Administrator John Howard, M.D on the occasion of the announcement. “All types of cancer, if determined to be related to 9/11 exposures, are now covered by the World Trade Center Health Program, providing women equal access to the treatment they deserve.”
A considerable number of the members of the New York City Organization of Public Service Retirees are public employees who were ordered back to their desks in lower Manhattan and western Brooklyn in the immediate aftermath of the 9/11 attack based on the representations by the City of New York and the U.S. EPA that the “air was safe to breathe.”
There was no Zoom back then. Today, many of our members, both first responders and civilian survivors are dealing with chronic illnesses directly related to their post-9/11 WTC occupational exposure to the toxic air and can’t afford being left to the documented precarity of Medicare Advantage.
Seventy-two hours after the 9/11 attack, Whitman, told reporters that "the good news continues to be that air samples we have taken have all been at levels that cause us no concern." Two years later, an investigation by the EPA Inspector General found that the agency "did not have sufficient data and analyses to make such a blanket statement" when it did.
"Air-monitoring data was lacking for several pollutants of concern," the Inspector General found. The report stated that President George W. Bush's White House Council on Environmental Quality heavily edited the EPA press releases "to add reassuring statements and delete cautionary ones." The IG also found that the Council described the readings as just "slightly above" the limit, despite the fact that samples taken indicated asbestos levels in lower Manhattan were double or even triple the EPA's own limit.
One of our most active members, I am proud to say, is Evelyn Jones Rich, who retired from the City University of New York 30 years ago, and at 90 years-old is an active member of the Professional Staff Congress and the executive director of the New York City chapter of the Americans for Democratic Action. Evelyn comes out of the original Freedom Riders era, and is an inspiration to us all.
In the 1950s, after President Eisenhower signed an executive order integrating places of public accommodation in the nation’s capital, Evelyn and her fellow activists picketed D.C. restaurants, theaters, and anyplace else that was resisting. “I am in the winter of my life, but I am going out with my boots on,” she told me.
The federal government’s role in our life-altering exposure is well documented and we would appeal to you to help us in our quest to hold onto the Medicare benefits we worked for our entire career serving the public.
What’s left of our lives depends on it.
