Smiling Mike Mulgrew's Used Car Lot and Hospital

The new destination for UFT members in need? AND what's a POS, aside from the obvious?

Michael Mulgrew may be trying to sell members a POS. Yes, that means what you think it does. But it also has another meaning, Be patient, and I’ll reveal all.

It’s ominous that UFT Unity cult leader Mulgrew told the Delegate Assembly members needed to find a primary doctor. Under Emblem-GHI, this may have been advisable, but was never required. A regular primary doctor who’d make referrals was usually a HIP thing. While I know people who swear by HIP, the appeal of GHI was always wider choice, albeit with more co-pays.

However, Mulgrew and his Unity cultists want to cut health care costs for Eric Adams by 10%, and it’s likely that we will somehow become casualties of that decision. Mulgrew has been selling Medicare Advantage, Joe Namath style, to retirees, claiming it was just as good as real Medicare. We all know it isn’t. How likely is it that they are lying to in-service members as well? The demand for a primary doctor strongly suggests future limitations, and I’ll come back to that.

I have a primary doctor, and have had for some time. I’ve had to find new ones, though. One year, my primary doctor decided he would become a boutique doctor and make himself more available to patients. This entailed paying a fee of several thousand dollars a year, which I was not inclined to do.

On the recommendation of another doctor, I found a new primary. I liked him. He was smart and funny. However, one day, he dropped GHI. I was disappointed. I asked him why he did this. “Because they pay shit,” he told me. So much for bedside manner.

I was thinking about paying the guy out of network, but my wife found another doctor. She was great, my wife said. I tried her and she was. She was thorough, smart, and really well-informed. As a result, she’s become very popular. She’s affiliated with Mt. Sinai, and when you call, they screen you before letting you speak to the office. Then the office screens you before giving you an appointment.

I like this doctor very much, and I have an appointment for a checkup some time in February. I made the appointment a month ago. However, I don’t know how long I can put up with these office policies. Once I lied about how sick I was to get in to see her, but she wasn’t there that day. I saw her partner. The partner was fine, but mad at me. I’ve gone to urgent cares three times over the last few months. I really had no choice.

It appears in-service members may be facing even fewer choices in the coming months. PSC, whose union leaders, unlike UFT bosses, oppose health cuts for its members, has aired these concerns:

• Participants will continue to have a choice of providers and hospitals, but the city and MLC plan for outpatient providers and hospitals to be “tiered.” Some hospitals/providers would charge zero or low deductibles/co-pays, while others would charge mid-level and higher-level deductibles/co-pays.

• The new CBP may reduce participants’ choices by shifting costs to participants, likely through higher co-pays for out-of-network provider visits, higher charges for imaging and/or more pre-authorization requirements.

These concerns did not simply materialize from the ether, and Mulgrew’s suggestion you find a primary care doctor seems to bolster these concerns. Much as I like my doctor, I can’t depend on her as much as I’d like to, especially under a new, more restrictive system. I’d have to find a doctor who isn’t in as much demand. I’m not at all sure that would be a doctor “as good or better” than the one I have, despite the claims of UFT Unity bosses.

So, what’s a POS, aside from the obvious? MTA has one, with Aetna.

In a POS system, you absolutely need a primary doctor to refer you to specialists. This differs from a PPO like GHI, in which you may choose any in-network specialist you wish. In a POS, if you want to pay a reasonable price, you’ll need a referral from your primary. Again, the appeal of GHI is choice, and if this is the new plan, your choices will be further restricted. That is not as good or better. I’ve lost several doctors who dumped GHI, and it’s hard to conceive that better doctors will flock to a plan that saves even more money for Eric Adams.

Mulgrew claims to be at war with hospitals. That doesn’t bode well for an agreement for us. We know the kind of agreements he makes when he is not at war. He made outlandish agreements to give billions of dollars back to the city in exchange for contracts that either hovered close to, or lagged way behind cost of living. We know he was unable to come to agreements with urgent cares that made visits affordable for members.

Will Mulgrew come to agreements with Northwell, NYU Langone, or Montefiore as preferred providers? They don’t seem to be preferred in the MTA Aetna Pro Choice POS. Are we going to have to visit Smiling Mike Mulgrew’s Hospital/ Used Car Lot in Staten Island if we want hospital care without prohibitive co-pays?

Time will tell. But details are scarce from the UFT Unity Patronage Cult. Until they crawl out of their Top Secret huddle with their Municipal Labor Committee BFFs, we’re left to wonder what they will say.

And once they do say it, we’ll be left to wonder how much we’ve been told, and whether or not any of it is true.

Thanks to Daniel Alicea