By Joe Maniscalco

Despite some very strange efforts to obscure the fact, Medicare remains one of organized labor’s all-time greatest achievements 58 years after President Lyndon Baines Johnson first signed it into existence with Harry and Bess Truman proudly standing by.

“Give ‘em Hell Harry” had tried and failed some 20 years before to make Medicare a reality.  LBJ finally got it done in large part because United Automobile Workers President Walter Reuther and the American Labor Movement helped make it happen.

Fast-forward to now, and the movement is not only a shadow of what it was in 1960’s when 30 percent of the workforce was unionized, but some of the most powerful labor figures in the country today, are intent on pushing profit-driven Medicare Advantage programs onto their members, and erasing that Medicare victory from the history books.

What’s next, fellas? The eight hour workday?

In New York City, the retired city workers who keep beating back Mayor Eric Adams and the heads of the most powerful public sector unions in town from privatizing the healthcare they earned — have continually underscored that Medicare Advantage is not only bad for working class people — it’s bad for the American Labor Movement.

New York City municipal retirees having to deal with various forms of cancer and other threats to their health in the later stages of their lives are concerned about getting the care they need when they need it — without having to deal with the obstacles and obstructions that presently do not exist with traditional Medicare.

But as trade unionists, they also care about the welfare and quality of life of all those coming up right behind them and whether or not they’ll be able to get the care they need when the time comes.

That’s also something the retired civil servants Work-Bites has interviewed this past year have continually emphasized.

With fewer than 20 New York City Council Members out of a total of 51 signed onto Intro. 1099 — legislation that shields retiree healthcare from profit-driven privatization — it’s hard to know how much the rest of the membership knows about labor history in this country. Or even cares about it.  

We’ve tried to ask them…others have, too. But they are very busy public servants.

Beatrix Hoffman is a professor in Northern Illinois University’s Department of History. She is also the author of The Wages of Sickness: The Politics of Health Insurance in Progressive America and Health Care for Some: Rights and Rationing in the United States since 1930.

Hoffman reminds us that organized labor opposed the inclusion of private insurance companies in the creation of Medicare.

“The AFL CIO and its retirees chapter, the National Council of Senior Citizens, believed that insurance companies would put up barriers, such as preauthorization and limited choice of doctors, that would prevent people from accessing the health care they needed,” Hoffman recently told Work-Bites. “Insurance companies would also extract profits from policyholders by continually raising rates.”

Hoffman further said, “By giving such a large role to private insurance companies, Medicare Advantage programs undermine the labor movement's longtime goals of comprehensive coverage and economic security for workers and retirees.”

Many in New York City would agree — including members of the Municipal Labor Committee [MLC] who are fed up with the undemocratic and dictatorial nature of the organization.

Just how much of that reality do the undecided members of the New York City Council understand? Again, we’ve tried to ask. Maybe they only feel comfortable talking to media outlets whose editorial boards favor privatization? 

Moving on…

Joshua B. Freeman, distinguished professor of History [Emeritus] at Queens College and the CUNY Graduate Center in New York City, calls Medicare “one of the most successful government programs in the history of the United States.”

In an interview with Work-Bites Freeman said, “Medicare Advantage was introduced to give the private sector a slice of the health insurance market for the elderly and erode the principle of a universal state system. While Medical Advantage might provide some benefits for some people at some times, its growth is undermining Medicare and will ultimately lead to a more expensive, less effective system.”

He also said, “The support some unions have given to Medicare Advantage may in the short term help some retirees — though, that is often not the case — but in the long run, it will do grievous harm to American workers.”

A source within the labor movement who also spoke to Work-Bites, but on condition of anonymity, said the combined power of the private health insurance industry and pharmaceutical companies has become so “overwhelming"  it means a “fundamental refashioning of how [union leaders] see themselves.”

“It's almost like they're hemmed-in and outflanked,” the source said. “Labor’s been hemmed-in and outflanked by the private power that dominates the official governing sector of our society. Now, I'm not saying this as an excuse for what I still think is a lack of certain vision and imagination to get out of this conundrum — but I think it's an important context to understand.”

Mark Dudzic, chair of the Labor Campaign for Single Payer Health Care, told Work-Bites that “on the surface” privatization can seem like an “almost painless choice” to some union leaders out there. 

“You really, really need to be educated — both the rank & file and the union leadership as to why it's a bad choice often for the members,” Dudzic said. “And also undermines this very cherished program that labor fought to establish — a publicly-financed, publicly-administered Medicare program for everyone.” 

On the other side of the equation, Dudzic also said, “You have unions, including the AFL-CIO, who get incentives to promote Medicare Advantage insurance to their members; the union privilege program has a Medicare Advantage program that, you know, provides some kind of a rebate to the labor movement.”

Jeff Johnson, past-president of the Washington State Labor Council, AFL-CIO, made similar observations when Work-Bites interviewed him last spring.

Dudzic calls the fight New York City municipal retirees are waging to retain their traditional Medicare coverage a “wake up call for the national labor movement.”

“Union leaders are beginning to question why Medicare Advantage is taking over the Medicare system,” he told Work-Bites. “Last summer, the Washington State Labor Council passed a resolution condemning Medicare Advantage and asking the labor movement to begin to educate and agitate against Medicare Advantage programs. I think there’s going to be more and more state councils and other labor federations who are going to begin to address these issues.”

If, however, working people don’t stand up to privatization and Medicare Advantage, Dudzic also warns Medicare will, indeed, cease to exist.

“Medicare won't be there for us when we're ready to expand it to everyone if we allow it to be fully-privatized by the Medicare Advantage programs,” he said. “We have to fight to maintain traditional Medicare and to expand it — and improve it. If we eliminated the co-pays and deductibles in traditional Medicare — and expanded it to include dental, optical and vision — there wouldn't be any incentive for people to even consider a Medicare Advantage alternative to the program. So, we've got a push to defend and improve existing Medicare.”

Work-Bites reached out to members of the New York City Council and the AFL-CIO for comment on this story, but has not gotten a response.