Downstate Illinois labor council passes resolution opposing third-party Medicare pilot

The Labor Council of West Central Illinois on Nov. 28 unanimously passed a resolution criticizing Medicare pilot program ACO-REACH, and asking President Biden to stop it before it takes effect in January.

 

ACOs (Accountable Care Organizations) differ from managed-care plans and the “Medicare Advantage” plans promoted in TV commercials featuring by ex-athlete Joe Namath, comic Jimmie Walker, actor William Devane, et. al. The experimental ACO programs open up Medicare management to private, for-profit ventures.

 

The area labor council’s resolution was based on a document written by Chris Cruz of the Texas Alliance for Retired Americans. (See below for its text.)

 

“We are extremely concerned about the planned ACO-REACH changes to Medicare,” said Labor Council president Lisa Uphoff.

 

A national campaign against ACO-REACH (Realizing Equity, Access and Community Health) in recent weeks has seen other labor groups getting involved. Some who’ve taken action include the Alameda (Calif.) Labor Council, the Austin, Texas, AFL-CIO Labor Council, International Association of Machinists District 751 retirees, the Troy (N.Y.) Area Labor Council, and the Washington State Labor Council.

 

ACO-REACH’s roots date to the Affordable Care Act empowering the Centers for Medicare and Medicaid Services (CMMS) through its Center for Medicare and Medicaid Innovation division to try pilot programs to improve Medicare, and the Trump administration in 2019 initiated Direct Contracting Entities (DCE), which opened up Medicare to private companies that aren’t health providers. 

 

Medical reporter Trudy Lieberman from the Center for Health Journalism said, “This latest under-the-radar program could push Medicare deeper into private hands.”

 

Biden did cancel DCE in 2021, replacing it with ACO-REACH, and CMMS claims that ACO-REACH “increases provider governance and transparency, provides a focus on health equity, and makes improvements to risk adjustments.”

 

But Medicare advocates say ACO-REACH would retain many of DCE’s troubling features. For example, both DCEs and ACO-REACH permit private equity investors, private insurers, hedge funds and other businesses to be middlemen in traditional Medicare.

 

The national Alliance of Retired Americans has expressed concerns “about the potential for the ACO REACH model to pull Medicare beneficiaries out of traditional Medicare and into private plans without their knowledge or consent.”

 

For years, criticisms of such ACOs ranged from the lack of transparency and risks of hiking Medicare costs, to increasing the difficulty for patients to access health care, and a step toward privatizing Medicare.

In an essay in The Hill, U.S. Rep. Pramila Jayapal (D-Wash.) and Dr. Susan Rogers of Physicians for a National Health Program said there’s an urgent need to end the program.

 

“As a physician and a member of Congress, we’ve never heard a senior ask for their health care to be more complicated, or to have their choice of traditional Medicare taken away,” they wrote. “But that’s exactly what Direct Contracting would do. Traditional Medicare has proven its value for more than half a century. Instead of selling it off to the highest bidder, let’s strengthen and improve its benefits while working to expand it to cover every American.”

 

ACO-REACH companies have an incentive to limit care since funds not used for patient services can also be kept by the private ventures.

 

Dr. Abdul El-Sayed, former health director for Detroit, said, “Everyone from traditional health insurers to private equity firms are lining up to cash in. But Direct Contracting isn’t a matter of law; Congress never voted on this. It’s just a pilot program designed by the Trump administration … that the Biden administration is now carrying forward. They could kill Direct Contracting in its tracks if they wanted to.”

 

For more information, check out https://protectmedicare.net/ or write Kay Tillow, coordinator

Unions Committee for Single Payer Health Care, P. O. Box 17595, Louisville, KY 40217.

 

Resolution to stop a new Medicare program backed by the Trump Administration and now called Medicare ACO-REACH

WHEREAS when seniors and retirees become eligible to apply for Medicare, the majority of them choose Traditional Medicare (the original program where Medicare pays the participating doctor directly) versus the Medicare Advantage Program, a “third party for-profit middleman insurance company” that is paid monthly by Medicare to manage patient’s care and authorizes payment to the patient’s doctor; and

WHEREAS the former Trump administration supported a new pilot Medicare program created by a section of CMMS called CMMSI (Center for Medicare & Medicaid Services Innovation), and the new Medicare program named ACO-REACH (Accountable Care Organization-Realizing Equity, Access, and Community Health) claims to be a new Medicare value-based payment demonstration model, but it is actually a “third party for-profit insurance company” program that will rapidly drain away the Medicare Trust; and

WHEREAS this new program is set to be launched on January 1, 2023, with no current Congressional oversight; and

WHEREAS According to Physicians for a National Health Program, ACO-REACH allows doctors and their offices to convert a patients’ Traditional Medicare choice into ACO-REACH coverage without first informing their patients about the change nor getting their patients’ written permission; and

WHEREAS doctors and their offices will have a financial incentive to convert to ACO-REACH coverage as they will also be allowed to keep up to 40% of their revenue that they don’t spend on health-care services as overhead resulting in a “windfall profit” versus Traditional Medicare Programs that are only allowed to keep the balance of 2% of their revenue after paying for overhead;  and

WHEREAS doctors and their offices will have an additional financial incentive as ACO-REACH will pay money to treat their patients with more complicated diagnoses by allowing doctors to “up code” additional diagnoses. (Up-coding is a practice that has led to fraud by exaggerating or including related, but unnecessary, diagnoses, leading to higher costs); and

WHEREAS President Biden at an April 2019 rally in Pittsburgh – where he kicked off his campaign for the White House – called himself a “union man,” and

WHEREAS if the Biden/Harris Administration does not stop the deployment of Medicare ACO-REACH by HHS/CMMS now, it potentially could make things worse since the Congressional Budget Office has already projected the insolvency of the Medicare Hospital Trust in 2026 that could affect 52.6 million seniors whose care is provided by the Trust,

NOW THEREFORE

BE IT RESOLVED that the Labor Council of West Central Illinois opposes CMMSI’s Medicare ACO-REACH program and respectfully asks the Biden/Harris administration to immediately stop and dismantle the ACO-REACH Program, and instead, immediately protect and preserve Traditional Medicare plus adding coverage for Hearing, Vision and Dental Care.

Postal Workers’ 10 Roads Express unit on strike

 After a fast organizing campaign and an overwhelming union-election victory, 10 Roads Express drivers this month went on an Unfair Labor Practice strike.

“The strike was a powerful worker-led protest against the unjust retaliatory termination, by 10 Roads Express, of one of the main union leaders, Donna Gramm,” said the American Postal Workers Union (APWU). 

Since September, drivers concerned about worker harassment, unjust discipline, and the possible loss of full-time jobs have been working with APWU organizers Lori Cash and Rich Shelley, and within weeks a super-majority of union-authorization cards and filed for a union election with the National Labor Relations Board.

 

The Nov. 29 vote to unionize with APWU resulted in a 53-10 tally.

 

However, that was followed the next morning by the company discharging Gramm, “unjustly terminated for her union activity,” APWU said.

 

“I congratulate the Peoria 10 Road Express drivers on their outstanding union victory and welcome them into the APWU,” commented APWU international President Mark Dimondstein. “Their powerful actions of union solidarity now sets the foundation for building a strong local union and a strong contract campaign as negotiations for a first contract begin in the near future.”

 

The 10 Roads Express drivers haul mail throughout central Illinois, where holiday deliveries could be affected.

‘Do you see what I see?’ (A worker!)

If you’re getting overwhelmed by Christmas’s commercialization and needing to feel less like a consumer than someone who identifies with the season, think of Joseph.

During Advent this month, when Christians prepare for the arrival of Jesus, there are many images of Jesus, Mary and Joseph in humble surroundings in Bethlehem.

 

Although Joseph has been celebrated as “St. Joseph the Worker” on May 1 since 1955, the Nativity depictions of Joseph after an arduous journey to fulfill government census obligations might remind us of how integral this working man was to Christmas and the centuries since.

 

In some ways, the 90-mile trek walking from Nazareth to Bethlehem perhaps drew on Joseph’s labors, the hard work that prepared him for the physical challenges of that journey and also the demands and responsibilities ahead as the head of that household.

 

Decades ago, Pope Pius XI said, “St. Joseph belongs to the working class, and he bore the burdens for himself and the Holy Family, whose tender and vigilant head he was.”

 

As author and Catholic priest Donald H. Calloway has written, “The devil hates an honest and diligent worker. At the beginning of human history, the wicked serpent initiated his attack on the human family in the workplace — that is, the garden God gave to Adam and Eve to tend and keep. Lucifer hates work. He particularly disdains the fact that because of love, God humbled himself and became a man, making himself capable of manual labor. Jesus spent many years in St. Joseph’s workshop diligently working.

 

“It was preparation for his re-entering man’s original workshop — another garden; the Garden of Gethsemane, specifically — and accomplishing the work of our redemption,” Father Calloway continued.

Later, Jesus learned the proper place of work in His life through the loving example of St. Joseph.

 

“At the workbench where he plied his trade together with Jesus, Joseph brought human work closer to the mystery of the redemption,” remarked St. John Paul II years ago.

 

Today, St. Joseph might teach us how to be diligent workers, on the job outside the home, and in our families.

 

“Our Lord desired to do manual labor for many years before initiating His public ministry,” Calloway added. “Why did He do it? He did it because He wanted to sanctify work and teach that work is honorable and pleasing to God.”

 

Merry Christmas!

A lion in winter

As winter increases its mean freeze, there’s something warm and inviting about Byron DeHaan.

The long-time director of public affairs at Caterpillar for decades helped instill a sense of corporate citizenship at the Fortune 500 company, and the 96-year-old resident of Lutheran Hillside Village is remembered for helping Peoria pass a Fair Housing law (years before Congress did) and serving on the Illinois Commission on Human Relations.

Besides experience as a business executive and civic leader, though, DeHaan has been active culturally, from chairing the collaboration that led to the Peoria Riverfront Museum to personally participating in music, art and writing.

“Byron is the epitome of what it means to be ‘a gentleman and a scholar’,” said Keith Butterfield, a newsroom pal who later worked for and with DeHaan for eight years at Cat.

“He also never disappointed when it came to his knowledge of things beyond Big Yellow,” Butterfield continued, “ – be it literature, the arts or just sitting down and having a engaging conversation about the current marketplace of ideas.”

In fact, nestled in the middle of his 66-page collection of 32 poems from 2004, Breviary, is a favorite DeHaan poem I’ve enjoyed in December, poetry that somehow suggests acceptance and hope amid folly and cold:

“Cold Villanelle Hell”

I drive my car on streets of ice and snow

As clouds appear and threaten storms of sleet.

The weather experts oft aren’t in the know.

 

The elms are laced with ice in winter’s glow.

As winds now howl and rage and freeze the feet,

I drive my car on streets of ice and snow.

 

Then falls a hail of ice (this wintry foe),

Surprising sheep that freeze – and whine and bleat.

The weather experts oft aren’t in the know.

 

I soon must opt to stay or stop – or go.

Since I have friends I hope to join and greet,

I drive my car on streets of ice and snow.

 

The sun emits a friendly evening glow –

consigning hellish storm to full defeat.

The weather experts oft aren’t in the know.

 

This warming trend has conquered icy woe –

I have no need to plan a weak retreat;

I drive my car on streets of ice and snow…

The weather experts oft aren’t in the know.

 

“The villanelle is a French form poem – that is, one with a fixed pattern – with roots in medieval Italy,” DeHaan explains in the book. “It requires two rhyme patterns and two repeating full lines in five three-line stanzas and a concluding four-line stanza. It often appeared in iambic pentameter, as above.”

Retired Bradley University English professor Kevin Stein, Illinois’ poet laureate from 2003-2017, commented that, “Breviary invents a modern prayer book whose mode is less supplication than inquiry. With graceful intelligence, DeHaan embraces subjects ranging from Mother Teresa to pedophile priests… No matter where his eye falls – upon Normandy, Machu Picchu, or the Illinois River valley – what DeHaan see there redeems our bloodied humanity.”

Just 600 copies of the book were printed, so if you have a copy, treasure it – and DeHaan’s subtle, playful poetry. Like the man himself, it affects me like a soft blend of Louis Armstrong singing “What A Wonderful World” and filmmaker Frank Capra presenting “It’s A Wonderful Life.”

Planting trees -- and hope -- in Peoria’s bare spots

The prime time when trees were center stage passed with fall’s spectacular colors gone or muted into stands of dark-brown red oaks. But forests in the city may yet be in the wings, awaiting their cue.

There are initiatives to improve Peoria’s timber, enhancing the city’s appearance, to be sure, but much more.

And funding will be there.

Cities and states across the country are starting to see trees as a key part of critical infrastructure.

“We’re on a trajectory of meteoric growth for urban forestry,” said Ben Thompson, manager of the urban and community forestry program at Washington state’s Department of Natural Resources. “All of a sudden everyone’s passionate about this.”

Nationwide, more than 130 million acres could be reforested, according to research by the nonprofit Nature Conservancy, which counted land formerly used for farming and acres where trees were lost to wildfires.

Locally, the Peoria Urban Forestry Advisory Board and the Peoria Park District are discussing possibilities for increasing local trees – and why that matters.

When trees are in and around residential areas, such green spaces create neighborhoods with less violence and fewer property crimes, places where neighbors tend to support and protect one another, according to scientists at the Human-Environment Research Laboratory of the University of Illinois at Urbana-Champaign.

“Time spent in natural surroundings relieves mental fatigue, which in turn relieves inattentiveness, irritability and impulsivity, recognized by psychologists as precursors to violence,” says their report, “How Cities Use Parks to Create Safer Neighborhoods,” published by the American Planning Association.

“Green spaces also support frequent, casual contact among neighbors,” it continues. “This leads to the formation of neighborhood social ties, the building blocks of strong, secure neighborhoods.”

Large swaths of Peoria, especially along the river from Averyville to Bartonville, have few spaces where construction or development would be controlled to lead to green rehabilitation generally and especially a restoration of urban forests.

“There is no protected space within the Southern district,” said Peoria Park District Trustee Aelx Sierra

“I want everyone to keep in mind that urban forestry is more than just trees. The recent project led by our Board, introduced by myself, positively contributes to our global environmental crisis, while improving quality of life and safety for our residents and patrons.”

Historically, the City has participated in related ventures, such as a proposed tree-lined route from the airport to downtown, but that was decades ago. More recently, there was Well Farm at Voris Field in 2017-18, a commnuity garden a few blocks west of Dozer Park that also had another, practical function.

That project originally “was driven by our (now-defunct) Innovation Team [which] partnered with Fresh Coast Capital (later renamed Green Print Partners) and the now-defunct Gifts in the Moment group to establish an area that would be used for stormwater management,” said City spokeswoman Stacy Peterson. “The Well Farm was comprised of native plants, bioswales, and some trees that could be considered under the definition of ‘urban forestry.’

“The Well Farm is still functioning as a stormwater management feature and has been regularly monitored,” she contined. “So while the urban agriculture piece hasn’t been maintained, the stormwater management feature has worked.”

Building blocks envisioned by Sierra and others aren’t necessarily imminent in Peoria.

“There are no plans for another large tree planting like the Well Farm in the near future,” said Andrea Klopfenstein, Assistant Public Works Director. “Operations plants trees throughout the city on a regular basis. Engineering is looking at native plantings at Public Works, the Well Farm, and Orange Prairie in the next few years.”

Klopfenstein also said the Well Farm location will be turned into a native prairie in future years, as budgets allows. 

That could change with renewed interest – and new money.

“The City of Peoria and the Department of Public Works are looking at expanding native plantings throughout the City,” said City of Peoria spokesman Nick McMillion. “Any opportunity or space that becomes available to expand the City’s green footprint will be utilized, which will include the development of areas of native plantings, the continued effort to plant new trees, and to maintain the mature canopy throughout the entire City. The opportunity to advance green spaces is an ongoing effort with multiple routes being explored and considered.”

New funding is available through federal measures such as the Inflation Reducation Act and the bipartisan infrastructure package, which together provide for billions of dollars to plant trees in underserved neighborhoods as well as reforesting millions of acres if thin timber or barren land.

The Inflation Reduction Act alone has $1.5 billion for the U.S. Forest Service’s Urban and Community Forestry Program, which supports widespread efforts, including big cities and small towns.

Various federal agencies will handle the distribution of the funds, some of which will entail competitive grants and some direct funding to states.

“As an advisory board, [the] Peoria Urban Forestry Advisory Board itself would not seek additional funding,” McMillion said. “If federal dollars do become available, then the City in conjunction with the Peoria Park District would work with one another to expand the funding for the goals and mission of PUFAB.

“Available grants and funding opportunities will be reviewed as they become attainable.”

Some areas are hoping to restore urban forests decimated by disease such as Dutch Elm Disease or pests such as the emerald ash borer. Other places also imagine not only reducing violence and increasing property values, but expanding ways to help the environment.

Climate change has contributed to more heat waves, flooding and severe weather nationwide, and some leaders see trees as part of a solution. Neighborhoods with tree cover – shade – are much cooler than thinly covered or exposed areas called “heat islands,” which can affect human health and utility bills. Also, more trees absorbing carbon dioxide and releasing oxygen means more carbon can be sequestered, creating a “green infrastructure” in cities.

Naturally, as with many ambitious programs, some obstacles are foreseen, such as “where will all the trees come from?” asked Danielle Okst, director of policy with the Council of Western States Foresters.

There are limits to the tree-nursery system, which has seen some businesses close. Also, like many industries, there’s a labor shortage in forestry.

However, if forestry companies improve pay and provide on-site housing like the Civilian Conservation Corps did in the 1930s, they could attract applicants, according to Matthew Aghai, General Manager at the

Silvaseed Company in Roy, Wash.

“Having a mission and fair compensation is the bare minimum,” he told Stateline news service.

Whether strengthening nurseries, engaging citizens or tapping available dollars, there seems to be an optimism reminiscent of teacher, poet and suffragette Lucy Larcom’s line, “He who plants a tree plants a hope.”

In Peoria, Sierra said, “I value the abundance of resources available to make urban-development investments. It is a good scenario to have so many resources to support our work and turn our ideas into reality.”

5 ways investing in public spaces helps reduce violence and crime

Planting new trees is a key part of investing in “public spaces,” according to Reimagining the Civic Commons, which for years advocated for reinvigorating public spaces such as parks in Chicago and other Midwest cities and also stressing how developing such shaded neighborhoods not only improves an area’s appearance and property values, but reduces crime in five ways:

1. Time in Nature relieves mental stress, and cuts aggressiveness.

2. Clearing and greening barren lots creates welcoming settings and supports a sense of safety.

3. Parks or even shaded spaces around churches, libraries or other public grounds helps build gathering places, social ties and community connections

4. Public health benefits: More trees means more carbon dioxide is absorbed and more oxygen is released, plus more shade reduces cities’ dangerous “heat islands.”

5. Socially, improving the liveability of neighborhoods through tree-planting can help reverse years of the vicious cycle of inequality, disinvestment and poverty.

 

SOURCES: Reimagining the Civic Commons; “How Cities Use Parks to Create Safer Neighborhoods” (University of Illinois);USDA