Protecting the fund or the members?

I think CityMD was billing our insurance too much. UFT President Michael Mulgrew said that about some company, and that copay increases were coming, and I learned from Nick that there are CityMD copay increases. So I figure that Mulgrew was talking about CityMD. And I believe him.

CityMD is an urgent care – I think it has by far the largest network of storefronts in NYC. Members use CityMD a lot. Not me. Used them once. Negative experience. Never went back. But other members do use them. There was a trend to pop in for small stuff – no need for the emergency room. And then we were urged to use urgent cares instead of emergency rooms, and more people switched.

Here’s what Mulgrew said. I think he was talking about CityMD. It was at the Retired Teachers Chapter meeting on Monday:

Now of course if I go to in-service today – we’re going to increase one copay because it’s a bad actor, they would vote no – what they don’t understand is the bad actor is causing us millions and millions of dollars, which is going to hurt us in the long run and we’re trying to avoid premium healthcare for anyone.

https://jd2718.org/2023/03/08/q-can-retirees-vote-on-their-health-care-mulgrew-no/

And so there is a copay increase, from $50 to $100, just on CityMD. CityMD will not pay bigger copays. Mulgrew figures fewer of our members will go there, and CityMD will lose patients.

Who is paying the extra copay? Us. And what choices do we have? There are other urgent cares, but none with this big a network. There might not be another anywhere near where you live. You might pay the $100 – something really hurts, or is clearly wrong. Or you might skip the doctor, not at $100, maybe it’s not that serious. And depending on your pay, $100 might be a nuisance fee, or it might be a substantial chunk of money.

The options, essentially, are change provider, which might not be so easy, pay more, or forego healthcare.

It’s legit to want to protect the fund, but not on members’ backs. Not by putting our health at risk. How else to deal with the overcharges. Negotiate? Lower the copays on the other urgent cares? Explain to our members what is happening, and urge them to use a different urge care, if available? But that requires treating members like colleagues, with respect, and not as pawns in some market-based scheme.

See also:

• https://jd2718.org/2019/10/21/triple-digit-copay/
• https://jd2718.org/2021/05/09/health-care-savings/