Update: Labor Campaign for Single Payer Health Care and Disadvantages of Medicare Advantage

October 1, 2024

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by John O’Connor, Executive Board Member, Local 380-443 (Binghamton, NY)

At the 2023 AFM Convention, a resolution was passed designating that the AFM advocate, educate, and organize for health care justice and a single payer system that will make health care a birthright for everyone in the United States. The centerpiece of the resolution, which still awaits action from the AFM International Executive Board, called on the Federation to embark on a systematic program to educate its members about the nature of the health care crisis in the US and the importance of the single payer solution in reducing the cost of coverage for all workers and their families. (You can learn more about this 2023 AFM resolution in the February 2024 International Musician article I wrote.)

While the Labor Campaign for Single Payer, which the AFM supports, continues its advocacy for “Medicare for All,” it has recently focused its energy and attention toward the worrying development of private insurance companies successfully lobbying Medicare to move toward more privatization. Many AFM members are on Medicare and they, like millions of US citizens who have reached retirement age, have been inundated with mailings encouraging them to sign up for an option known as Medicare Advantage.

Those who sign up for Medicare Advantage transfer their traditional Medicare coverage over to the private insurance industry, which administers health coverage in place of Medicare. A major disadvantage of Medicare Advantage is that the insured are no longer able to go to the medical provider of choice but are instead put into an HMO or a PPO, limiting who they can see for medical coverage.

A June article in The Guardian reported on a woman who was facing costly treatment for cancer and switched from traditional Medicare to Medicare Advantage because the monthly premiums were less expensive. It’s a decision she regrets. The reason? The Medicare Advantage plan she switched to refused to cover treatment she was able to get under Medicare. The article further reported on a man with brain cancer who had the same experience, leading to more medical debt.

A 2023 report from The Commonwealth Fund (www.commonwealthfund.org) found “… older adults with Medicare Advantage are significantly more likely to struggle with medical bills or debt than those under traditional Medicare plans.”

Medicare Advantage and other private insurance companies have found their advertising campaigns fruitful. “Private insurers have spent millions of dollars on advertising, marketing, and hiring insurance brokers to sell Medicare Advantage plans to beneficiaries,” The Guardian reports. “In 2023, brokers received $601 per new enrollee for most Medicare Advantage plans, significantly higher than commissions for traditional Medicare plans.”

While these private schemes are negatively affecting more and more seniors, over the next 10 years insurance companies are expected to receive more than $7 trillion in payments from the government!

The fight for single payer and against privatization of Medicare go hand and hand. As long as private insurance is part of the health care system in the United States, the system will be vulnerable to the insurance industry’s powerful influence. The solution is to get private health insurance out of the health care system and to do what the rest of the developed world has done: move to public financing of health care. We do that by working and campaigning for single payer or what we know as Medicare for All.

With the AFM endorsing Kamala Harris for president, it is notable that Harris, as a US Senator, co-sponsored the 2017 and 2019 Medicare for All bills authored by Senator Bernie Sanders (D-VT). In the 2020 presidential campaign, she leaned toward supporting Medicare for All. As vice president, however, Harris refocused her health care reform position to align more closely with President Biden, who opposed Medicare for All. However, Biden has been willing to work with the health justice movement on transitional, infrastructure-building changes to Medicare, such as lowering the eligibility age to 60 and expanding benefits to cover dental, hearing, and vision.

The Labor Campaign for Single Payer has signaled its hope that Harris will continue to support these goals and move further toward the goal of a single payer system.

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