32BJ SEIU, one of New York’s largest private-sector unions, rallied today to remind 32BJ Health Fund participants that New York-Presbyterian will go out of network on January 1, 2022.
An unprecedented decision spurred by the hospital system’s steadfast refusal to curb its exorbitant and anti-competitive prices that hurt patients.
The Health Fund, the state’s fourth-largest provider of health care, has launched a series of bus shelter ads that appear near New York-Presbyterian locations across Manhattan and Brooklyn and warn about the dangers of out-of-network costs for Fund participants. The ads starkly illustrate how the hospital system charges far more for standard procedures than its local competitors, which endangers New Yorkers’ ability to access affordable care at a critical time.
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The discovery of the Omicron COVID-19 variant demonstrates that the coronavirus pandemic is far from over, making it more important than ever for patients to be able to afford and obtain the lifesaving care they need. Reports that similar COVID-19 treatment costs can vary widely from one patient to another – even in the same hospital – further underscore the need to act now.
“The doctors, nurses, and other frontlines medical staff at New York-Presbyterian deliver excellent care, but due to hospital administrators’ refusal to lower their prices, keeping the system in our network would be fiscally irresponsible,” said Kyle Bragg, Local 32BJ SEIU president.
“New York-Presbyterian’s routine overcharging for the same services provided at other area hospitals cannot stand,” Bragg continued. “If we fail to act, these practices will make it impossible for us to fulfill an essential part of our core mission as a Union: bargaining for the highest quality healthcare at an affordable price.”
The Union bargains for health benefits for almost 100,000 essential building workers and their families – a total of 190,000 individuals. Through extensive analysis, the 32BJ Health Fund found that New York-Presbyterian charges prices for routine procedures like bariatric and joint replacement surgeries, as well as colonoscopies, that are well above-market rates when compared to other area hospitals.
In addition, NewYork-Presbyterian administrators have negotiated contract terms that would limit the Health Fund’s ability to offer innovative programs that provide Union members and their families affordable high-quality care
“My son Manuel’s life was changed because of the 32BJ Health Fund,” said 32BJ Member and Health Fund Participant Yenny Hernandez. “He was able to get necessary bariatric surgery and excellent post-care that was fully covered by the Fund. If I wasn’t a 32BJ member, I wouldn’t have been able to cover the cost of this surgery and my son would still be suffering. I cannot believe New York-Presbyterian tried to cut the program that saved my son’s life, just to make more money.”
The Union wins health insurance for its members and families through employer contributions to the 32BJ Health Fund. The Fund is a self-insured health plan, which means the cost of high-priced care is directly paid from the accumulated funds contributed on behalf of workers. The Fund has no profits or shareholders and has no interest other than providing workers with the highest possible quality health care they can afford. When employers must spend more dollars to cover the cost of high-priced hospitals, it means less money is available for the Union to bargain for wage increases and other benefits.
The key factors that led to the Fund’s decision to terminate its relationship with NewYork-Presbyterian include:
- High Prices The prices paid by the 32BJ Health Fund in 2019 to New York-Presbyterian are more than three and a half times – 358% – the price that Medicare pays for the same care at the same hospitals. The Fund analyzed the costs paid by the Fund for routine procedures performed at New-York-Presbyterian and other hospitals and outpatient facilities, and found a significant difference in costs for the following procedures:
- End of Critical Services The contract between Empire Blue Cross Blue Shield, the Health Fund’s third-party administrator, and NewYork-Presbyterian would have prevented the Fund from continuing the innovative programs it now offers participants, including a cutting-edge maternity care program with several New York City hospitals and its lauded joint replacement and bariatric surgery programs with $0 copays.
- Threat to Accessing Affordable CareThe Fund is self-insured and uses Empire to provide its network, authorize medical care, and pay claims. Those claims are entirely paid with Fund dollars, while Empire receives a flat administrative fee. Every dollar the Fund spends on higher-priced healthcare is a dollar it is unable to use to make other kinds of care more available and affordable.
Bragg noted that while the 32BJ Health Fund is taking this unprecedented step to protect participants’ ability to access affordable care in the long term, the impact of steadily rising hospital costs is a widespread problem.
“By taking a stand against New York-Presbyterian’s pricing practices, we aim to shine a light on the fact that hospital prices are rising at an alarming pace and driving the overall cost of care to an unsustainable level,” Bragg said. “It is well past time for governments to use their regulatory and purchasing powers to rein in these out-of-control hospital costs. We look forward to working with our partners at the Coalition for Affordable Hospitals, at City Hall, and the state Capitol on this important initiative.”
It’s time that hospital administrators get called out for refusing to either negotiate their prices with the Health Fund or disclose any methodology behind their pricing practices…
“It’s time that hospital administrators get called out for refusing to either negotiate their prices with the Health Fund or disclose any methodology behind their pricing practices,” said uptowns Manhattan Borough President-elect and Councilmember Mark Levine, who chairs the Health Committee. “I applaud 32BJ for taking action to protect and secure its members’ access to affordable and quality care, which is more important now than ever before. Others should follow the union’s lead and speak out now.”
“32BJ has been sounding the alarm about escalating hospital prices and unfair contracting practices for years,” said state Senator Andrew Gounardes. “We have waited too long to heed the union’s call, and New Yorkers are suffering as a result. Raising awareness about the problem is a critical step, but what we need most now is action to establish an equitable and accessible health care system.”
“My constituents struggle to keep up with the rising cost of health care, and it has been proven that hospitals are the driving factor behind that increase,” said Assemblymember Carmen De La Rosa. “New York-Presbyterian is a significant member of this community, but the prices it charges are out of line with what working people can afford in this city, and we need to ensure that everyone has access to the incredible care it offers, at a fair price. I look forward to working with 32BJ and the Coalition for Affordable Hospitals to take meaningful action to finally bring these costs under control.”
We all matter in the fight to save New York City, and our health is a major part of that effort. We can do better, and you can count me in to help make it so.
“Our city finds itself at a tipping point as it pertains to how we care for our residents, particularly for those who were on the front line ensuring our city continued to provide for others. So it is bewildering to understand how New York-Presbyterian Hospital is willing to force our union workers to pay even more money to cover their healthcare needs,” said Harlem Assemblymember Inez Dickens. “We should all be working together in order to protect all the men and women who help to keep this city functioning. We all matter in the fight to save New York City, and our health is a major part of that effort. We can do better, and you can count me in to help make it so.”
“The COVID-19 pandemic has shown us just how important affordable and accessible healthcare is to every New Yorker. Yet, for many people, even those with insurance, a hospital visit can be financially devastating. I am proud to stand with the more than 100,000 participants in the 32BJ Health Fund, which was recently forced to make the difficult decision to remove New York-Presbyterian from its network. Out-of-control healthcare costs block too many people from receiving the healthcare they need, at a time when they need it most. New York-Presbyterian and other hospitals must come to the table in good faith and commit to fair prices that will keep quality healthcare within reach of all New Yorkers,” said Assemblymember Linda B. Rosenthal (D/WF-Manhattan), Chair of the Committee on Social Services.
“Everyone knows that hospital costs are too high,” said Assemblyman Kenny Burgos. “This City is home to some of the best hospitals in the nation, if not the world, but that does no good to New Yorkers if they can’t afford the care offered right in their own backyard. It’s time for a change. I look forward to working with 32BJ and the Coalition for Affordable Hospitals to bring high-quality care within reach for everyone.”
“I cannot stand by and watch as escalating hospital prices force potentially life-saving care out of reach for everyday New Yorkers,” said Assemblymember Amanda Septimo. “It is incumbent on all of us, as we seek to build a fairer and more equitable city, to preserve and protect access to the incredible health care available across the five boroughs so everyone can benefit from it.”
“All New Yorkers deserve access to quality healthcare. When top hospitals overcharge, everyone suffers. I stand with 32BJ SEIU, a staggering 100,000 New Yorkers who will suffer a cut in choice and access to care if New York hospitals don’t come to the table and agree to fair prices,” said Assembly Member Rebecca Seawright.
The world is an unpredictable and often frightening place, and it is incumbent on our elected officials to use every tool at their disposal to bring high-quality health care with each of every single New Yorker…
“The world is an unpredictable and often frightening place, and it is incumbent on our elected officials to use every tool at their disposal to bring high-quality health care with each of every single New Yorker,” said Reverend John Flack, Pastor of Our Savior’s Atonement Lutheran Church in Washington Heights, Member, Social Justice Commission, New York State Council of Churches.“Everyone deserves that right, regardless of where they live or how much money they earn. I’m proud to stand up with 32BJ in this fight on behalf of its members and for all New Yorkers.”
For more information on the 32BJ, visit https://www.seiu32bj.org/.
32BJis a union of cleaners, property maintenance workers, doormen, security officers, window cleaners, building engineers, and school and food service workers. It is an affiliate of SEIU, the Service Employees International Union, which has 2.1 million members dedicated to raising industry standards, making life better for working families and our communities, and building a fair economy.