Why Are Our Copays Going Up!!???

Just this month, I wrote three long (and dense) pieces describing the healthcare crisis that NYC Employees are facing. Feel free to read it. I ended the last piece by telling readers to:

"...expect the union and the city government to come up with a common sense solution. This solution would include

• Minor payroll deductions from everyone's paychecks (say 2% of the total cost?)

• An increase in co-pays (because what's the point if we can't all punish the sick and the elderly)

• A further reduction in the actual amounts that the health insurance providers pay to health care providers. .."

Well, It looks like the first attempt to offset rising healthcare costs has happened. Last night, the UFT Welfare Fund sent members and email describing a significant rise in copays for any city employee seeking healthcare. I'm pasting those increases below this post.

But before you see them, please read these three important observations:

1. This is not necessarily the last increase in our healthcare costs. The city can still call for premiums to be deducted and Emblem can still follow the practice of paying providers so little that our doctors make the decision to turn around and bill us for the difference.  Those are still two very real possibilities that will also offset the rising costs. So make sure you're aware of that. (Deductibles are still possible but I just don't want to think about that)

2. These increases are a direct result of the city's decision to pay less into the Health Insurance Premium Stabilization Fund (HISP). Direct. The unions have allowed the city to pay $153 million less into this fund this fiscal year. That difference must be made up. It is being made up through the copay increases that are posted below. This is important: We, city employees who see doctors, are paying for the mayor's healthcare savings.

3. It doesn't have to be this way, but this effects the least amount of people. In order to make up the $153 million difference, premiums of roughly $25 per paycheck would have to be deducted from each of the city's 250,000 employees. As I wrote in the past, that -avoiding payroll deductions for GHI and HIP members- is the ultimate goal of both the city and the unions (and they all share that goal together).

(JTBC: I support small payroll deduction for all employees. We are union employees, after all. We should share the boom. We should share the burden as well. That's unionism. But from a political standpoint, this 'solution' effects the least amount of people. That's Realpolitik at work in the 21st century. The ones who need the care the most -the folks who visit the doctor- will shoulder the burden).

The chart below lists the GHI changes that will take effect in the coming months:

GHI – CBP Benefits	Current Copay	New Copay
PRIMARY CARE PHYSICIAN – PCP (PARTICIPATING GHI DOCTOR)	$15	$15
ADVANTAGE CARE PHYSICIAN – ACP GENERALIST (PCP)	$15	No copay
ADVANTAGE CARE PHYSICIAN – ACP SPECIALIST	$20	No copay
NON-ADVANTAGE CARE PHYSICIAN SURGICAL SPECIALIST	$20	$30
ALL OTHER SPECIALISTS	$20	$30
EMERGENCY ROOM	$50	$150
URGENT CARE FACILITY	$15	$50
MRI/CT (HI-TECH RADIOLOGY)	$15	$50
DIAGNOSTIC LAB (BLOOD, XRAY ETC.)	$15	$20
PHYSICAL THERAPY	$15	$20
ALL PREVENTIVE SERVICES INCLUDING IMMUNIZATIONS, MAMMOGRAPHY, COLONOSCOPY AND PRESCRIPTIONS FOR CONTRACEPTION		No copay

The following chart shows the changes affecting HIP subscribers:

HIP Benefits	Current Copay	New Copay
HIP Preferred Network (new)	No copay	No copay
HIP Non-Preferred Physician	No copay	$10