Letter to the Editor: Medicare Advantage, Kaiser and California health care

Editor,

In regard to the very good Medicare Advantage (MA) article (“Medicare Advantage: The floating crap game that threatens Medicare”, Peter Shapiro, August Mini California Red): Any piece on this topic in a California organization’s publication needs to deal directly with the issue of the largest MA provider in the state—Kaiser. I, and a very large number of other working class Californians (and I suspect union members and DSAers too) have chosen Kaiser MA over traditional Medicare plans for two very good reasons despite, in many cases, agreeing with the opposition to MA in general as expressed in the article.

1. Kaiser, unlike many other private health plans, is not just a PPO or a paper HMO, but rather an HMO that actually has its own large and comprehensive brick and mortar facilities and a nearly-fully integrated medical records and billing system which makes it much more convenient to deal with than the multiple fee-for-service private practitioners, often for-profit, that are the alternative under traditional Medicare.

2. As a result of the above, using traditional Medicare becomes a nightmare of multiple charges, billing errors, supplementary Medicare-plus insurance hassles, and unintegrated care where one has to carry records and test results and x-rays from one provider to another, etc. Also, the great reach of Kaiser in CA, especially into unionized workplaces, means that when Kaiser pursues more corporate profit-seeking types of behavior (as it often does) there is more possibility to effectively push back than to the many private providers or, even worse, the huge for-profit insurers like United Healthcare. Kaiser itself is also nearly 100% unionized and has some of the best union contracts, for patients as well as workers, in the nation in the health care sector, very much unlike the increasingly for-profit rest of the sector.

We need a good California-focused discussion of this issue that acknowledges the personal reality many of us are faced with in the here and now. The recent victory by the United Federation of Teachers (UFT), AFT Local 2 retirees chapter in New York City on a related health care privatization issue makes this an even more compelling issue right now, especially for us retired educators and public workers. We need to be looking at more than just making an "Improved Medicare For All" our demand, but getting rid of fee-for-service medicine through a government paid for direct national health service, like we have already at the VA for military veterans. East Bay DSA members Suzanne Gordon and Steve Early have written books and articles on this topic.

Thanks for your work.

In solidarity,

Joe Berry, EBDSA