NYS Department of Insurance Responds to Emblem Health Freedom of Information Request

For Immediate Release January 22, 2009
Contact: William Wharton (718) 869-2279

NYS Department of Insurance Responds to Emblem Health Freedom of Information Request

On January 22nd 2009 Michelle Birnbaum, the Legal Assistant at the Office of the General Counsel of the NY State Superintendent of Insurance issued a memo to Michael D. Fullwood, the Executive Vice President of Emblem Health Inc. (GHI & HIP), requesting that he issue a statement, within ten days, as to why the company’s draft application for conversion to for-profit status should receive an exemption from NY State Freedom of Information Laws. The request comes in response to a Freedom of Information Law (FOIL) request (no.:2008-001868-NYC) made by William Wharton of the Coalition Against Privatization (CAP).

Emblem Health had, in December 2007, made an application to convert itself from a non-profit corporation to for-profit status. However, in early 2008 the company rescinded its application in the face of widespread criticism from community members, healthcare advocates and a series of demonstrations organized by CAP. At a late May 2008 meeting with NY State Deputy Superintendent of Health Troy Oeschner, Mr. Wharton was informed that Emblem Health has submitted a “draft” copy of a new application. This document was subject to review by the final decision-maker in the for-profit conversion, NY State Superintendent of Insurance Eric Dinallo.

This document was not offered for public review by either the Department of Insurance or Emblem Health. The above mentioned Birnbaum-Fullwood memo indicates that Emblem applied for an exemption from FOIL regulations based on the need for “trade secret protection.” Wharton’s FOIL request was made in October 2008 and after months of negotiations is now being acted on by the Superintendent of Insurance. CAP has called for the public review of all documents related to Emblem’s application, the creation of an impact analysis study and more public hearings on the issue.

CAP and other healthcare activists have raised concerns about the public health issues connected to the Emblem Health for-profit conversion. Reports issued by the consumer advocacy group the Consumers Union indicate that premium increases, increases in denials of care and a shrinking of the subscriber pool often accompany for-profit conversions. New York City Corporation Counsel Michael Cardozo suggested that a for-profit Emblem Health might swiftly move to drop less profitable subscribers such as Medicare and Medicaid recipients from the plan. CAP has run a grassroots campaign against the proposed conversion which has featured public demonstrations in front the offices of the Superintendent of Insurance, GHI and HIP.

For more information about CAP or to receive a copy of the Birnbaum-Fullwood memo please email noprivatization@yahoo.com or call William Wharton at (718) 869-2279.

Birnbaum-Fullwood Memo

NY Says NO to Privatization

The private health insurance industry is an insatiable beast intent on devouring every attempt to modify its for-profit rules. The recent proposal to privatize the non-profit health insurers GHI&HIP (now Emblem Health) offers clear evidence that Americans need a national health insurance system. Small reforms will not protect us.

GHI & HIP are NY State’s non-profit alternative to for-profit healthcare. Non-profit status caps administrative spending at 15% of the total budget (i.e. CEO salaries), provides oversight on rate increases and restricts the companies from accepting private financing. These protections were put in place to insure that the provision of low-cost quality healthcare became a goal instead of the enhancement of profit margins.

Four million New Yorkers are now covered by GHI&HIP including 500,000 NY City employees. The plans also provide care to many of the State’s Medicaid and Medicare recipients. Removal of non-profit safeguards places subscribers in jeopardy of higher premium rates, denials of claims for care and being dropped from the plans.
The proposal to privatize is currently under consideration by the NY State Department of Insurance. A determined campaign to stop the conversion has been led by the Coalition Against Privatization. New Yorkers should oppose the privatization of GHI&HIP and support HR 676 as an alternative to for-profit healthcare.

For more information norpivatization@yahoo.com or http://saveourhealthcare.blogspot.com/

NOV. 13th - RALLY FOR NATIONAL SINGLE-PAYER HEALTHCARE at GHI

One Nation,

One Healthcare Plan!

RALLY FOR NATIONAL

SINGLE-PAYER HEALTHCARE

THURSDAY, NOVEMBER 13, 2008

Demonstrate in NYC demanding the end of the private health insurance industry and calling for a national SINGLE-PAYER health care system that would guarantee healthcare for all.

4 pm: Rally at 42 St & 7^th Ave. NYC

5 pm: March to GHI, 34th St & 9th Ave (via 7th Ave)

Sponsored by PHIMG and supported by AIDS Coalition to Unleash Power (ACT-UP); American Medical Student Association (Region 2); Astorians for Peace and Justice; Brecht Forum; Children Rise Foundation, New York City Region; Coalition Against Privatization; Code Pink; Community Empowerment Network, Inc; For a Better Bronx; Green Party of New York State; Healthcare-NOW!; Housing Works, NYC Chapter; Hunger Action Network; International Action Center; International Socialist Organization; Latinos for National Health Insurance; Long Island Coalition for a National Healthcare Plan; Malcom X Grassroots Movement; Million Worker March Movement; National Conference of Black Lawyers, NYC Chapter; NY Solidarity Coalition with Katrina/Rita Survivors; NYC Katrina Solidarity Committee; Operation Power; Physicians for a National Health Program - NY Metro Chapter; Progressive Democrats of America; Progressive Democrats New York City Congressional District 14; Socialist Action; Socialist Party - USA (NYC)

For more info visit The Private Health Insurance Must Go! Coalition (PHIMG)

at http://www.phimg.org/, or contact Jean Fox at 212-865-6027 or Ajamu Sankofa at

718-703-4041. rev. 10/16

CAP General Membership Meeting

Join the Coalition Against Privatization for our general membership meeting -

Friday, October 10th, 2008 at 6:30pm
A.J. Muste Institute, 339 Lafayette Street Buzzer #11 (6 tain to Bleecker Street / BDFV to
Broadway Lafayette)
(508)-524-2118( phone)

Join us to learn more about how the for-profit conversion of GHI and HIP will affect more
than 4 million New Yorkers.

Help plan Our role in the upcoming "One Nation, One Plan" march:

-March to Demand National Health Insurance-
Bryant Park 6th Ave & 42nd St.
Thursday, Nov. 13th 4:00pm

CAP news letter: http://www.healthcare-now.org/pdfs/CAPENewsletter.pdf

See you there!
Zelig Stern

**Sat. Oct. 11th - March for National Health Insurance Outreach

**Sat. Oct. 11th - March for National Health Insurance Outreach
---Please Forward this Email---

Meetup with Healthcare Rights activists this Saturday in support of the November 13th March for National Health Insurance - "One Nation, One Plan."

Community Outreach Locations:

Saturday October 11th – 12:00 pm
St. Vincent's Hospital
Meet at 12th Street and Seventh Avenue,(take 1, 2 or 3)
Contact: Elizabeth 212-989-2751 or
hansiadam@hotmail.com

Saturday October 11th – 2:00 pm
Bellevue Hospital (Hospital Row)
Meet at 26th street and 1st avenue (take the 6 train
to 23rd St.)
Contact: Billy (718) 869-2279 or billyspnyc@yahoo.com

Saturday October 11th – 3:00 pm
Harlem Hospital
Meet at 135th street and Malcolm X Boulevard (take the
2 or 3 to 135th St.)
Contact: Ajamu (917) 620-3548 or
ajamusankofa1949@aol.com

To pick up flyers to distribute to your union,
community, or church group contact:
Jean - jeanmaryfox@yahoo.com

www.phimg.org

** Friday 4:30p - Protest Against Budget Cuts

..

New York Says No to Budget Cuts

Save GHI / HIP! No Privatization!

No Cuts to Social Services!

Full-funding of Transportation and Education!

Support HR 676, Single-Payer National Healthcare!

CAP speak-out
4:30 Friday September 26th
Governors office 633 3rd Ave. (41st St. )
noprivatization@yahoo.com
http://saveourhealthcare.blogspot.com/
..
.. ..See you there!
.. ..Katie Robbins..

Healthcare Justice Week

In solidarity with American Patients United's 2nd
Annual Health Care Justice Vigil in Washington DC,
single-payer healthcare activists are holding
solidarity activities from New York City to the state
of Washington. The events uphold a deeply important
time for those who have lost someone to the broken
U.S. healthcare system, or who are still fighting the
denials of the for-profit health insurance companies.

http://www.healthcare-now.org/

Mon. Sept. 22, 1-4 p.m. – “Health Action: Medication
Madness – The Dangerous and Violent Effects of
Psychiatric Drugs”; special program featuring Peter
Breggan, MD (author, Medication Madness); on
WBAI/Pacifica (99.5 FM or www.wbai.org); program
available online for live streaming or downloads for
90 days; more info at 212-925-1829.

Mon. Sept. 22, 3:15 p.m. – “March for Health Care and
Economic Justice”; a march to remember those who died
for lack of health care; gather outside Mt. Olivet
Baptist Church, 201 Lenox Ave (at 120th St.) in Harlem
and march to the Adam Clayton Powell State Office
Bldg. at 163 W. 125th St. for a rally; more info at
healthcarenow08@gmail.com or 212-475-8350.

Fri. Sept. 26, 10 a.m. – Monthly meeting of the NY
Network for Action on Medicare and Social Security;
agenda includes discussions of the new Medicare reform
bill, and the role of insurance industry money in NY
politics, among other items TBA; at JASA/Cooper
Square’s Green Residence, 200 E. 5th St. (at 3rd
Ave./Bowery) in Manhattan; more info at 212-925-1829.

Fri. Sept. 26, 4:30 p.m. – Speak-Out Against Budget
Cuts! Demand Healthcare for All! Say No to the
Privatization of GHI & HIP! sponsored by the Coalition
Against Privatization; outside Gov. Paterson’s NYC
office, 633 3rd Ave. (at 41st St.) in Manhattan; more
info at noprivatization@yahoo.com or call (508)
524-2118.
http://saveourhealthcare.blogspot.com/

Privatization Isn't HIP

Privatization Isn't HIP: Join the Fight to Save Affordable Healthcare for New Yorkers!

*********************************************

Privatization Isn't HIP:
Join the Fight to Save Affordable Healthcare
for New Yorkers!

Thursday, September 18
7:30-9:00pm
Food provided

6th Street Community Center
638 E 6th St (between Aves. B and C)
Manhattan
Subway: F/V to 2nd Ave/Lower East Side; L to
1st Ave; 4/6 to Bleecker St.

Speakers:
-Clarice Torrence, President, New York Metro
Area Local of the American Postal Workers Union
-Billy Wharton, Coalition Against Privatization
-Tom Duane, State Senator, District 29 (invited)

Sponsors:
NYC Democratic Socialists of America, NYC
Young Democratic Socialists, Coalition Against
Privatization, Progressive Democrats of America -
CD14,and  Democracy for NYC

The New York State Insurance Department is considering
a plan to convert the not-for-profit health plan,
GHI/HIP, into a for-profit company.  Mayor Bloomberg called on
State
Superintendent of Insurance Eric Dinallo to stop the
conversation (privatization), call it "bad policy".
The Mayor's
Office filed a memorandum in opposition to the
conversion
of GHI/HIP, which currently provide health-care
coverage for
93 percent of city employees, as well as many
low-income
New Yorkers.

"GHI and HIP have each provided quality health
insurance
benefits to New Yorkers for more than 60 years," Mayor
Bloomberg said in a recent statement. "The conversion
to a single for-profit entity could increase
health-care costs
by hundreds of millions of dollars, and threatens the
health
and financial well-being of city workers and retirees.
We
don't need city dollars intended to protect
hard-working city
employees and retirees used instead to pad the
compensation of health-care executives. This
conversion
should be rejected."

In a letter to Superintendent Dinallo, State Senator
Tom
Duane has pointed out that "all other states
considering
such conversions within the past five years – Kansas,
Washington, North Carolina, and Maryland – have
rejected
these plans. As with all other for-profit
corporations, the f
oundational legal obligation of [the new company] will
be to
maximize profits for its shareholders. The pursuit of
profit
will therefore be the company's premiere priority,
surpassing
the provision of quality health care services to its
members
as the company's primary goal. This will inevitably
lead to
higher prices for health care consumers and the
cutting of
corners with respect to the quality of health care
services.
If EmblemHealth raises its rates, its competitors are
likely
to do so as well, and all New Yorkers will suffer."

At recent events outside the Superintendent's office,
protesters
have highlighted the negative aspects of the
unregulated
private health insurance system in the United States.
Payments for medical care now eat up the highest
percentage
of household disposable income and premiums have
increased
by 80% from 2001-2006. The privatization of GHI & HIP
will fully
expose 4 million people in NY State to the worst
effects of this
system.

To learn more about the event, please contact Maria
at marisvart@gmail.com.
*******************************************************

The Bridge to GHI/HIP Privatization

Sen. Tom Duane Speaks Out Against GHI/HIP Privatization Proposal

http://www.tomduane.com/news_2008/letters_2008/Emblem%20Health%20Letter.html

July 2, 2008

Honorable Eric R. Dinallo
Superintendent
New York State Insurance Department
25 Beaver Street
New York, NY 10004

Dear Superintendent Dinallo:

With the 2008 Legislative Session behind us, I understand the New York State Insurance Department will be continuing its consideration of the proposed conversion of GHI/HIP to the for-profit entity EmblemHealth, Inc. I am deeply concerned about the impact this conversion would have on many of my constituents and GHI/HIP members throughout New York State.

As you know, NY Insurance Law §7317(b) prohibits such a change in the status of not-for-profit health insurance entities to a for-profit company if the move would "adversely affect the applicant's contractholders or members," or "negatively impact on the delivery of health care benefits and services to the people of the state of New York." I believe that this conversion will both negatively impact the provision of health care services to the people of New York, and, more specifically, will adversely affect those individuals who are currently enrolled in GHI and HIP's health plans.

All other states considering such conversions within the past five years – Kansas, Washington, North Carolina, and Maryland – have rejected these plans. As with all other for-profit corporations, the foundational legal obligation of EmblemHealth will be to maximize profits for its shareholders. The pursuit of profit will therefore be the company's premiere priority, surpassing the provision of quality health care services to its members as the company's primary goal. This will inevitably lead to higher prices for health care consumers and the cutting of corners with respect to the quality of health care services. If EmblemHealth raises its rates, its competitors are likely to do so as well, and all New Yorkers will suffer. A number of studies have shown that for-profit health insurance companies provide poorer quality health services and have lower rates of customer satisfaction than not-for-profit health care providers.

Currently, both GHI and HIP are financially viable and provide quality health care services to New Yorkers. There is absolutely no reason to permit a conversion to not-for-profit status, particularly when for-profit health care providers have been proven to be worse for New Yorkers than not-for-profits. Comprehensive, quality, healthcare for all New Yorkers must be the primary goal of health care providers – not the acquisition of profit. For all these reasons, I strongly oppose the conversion of GHI and HIP to the for-profit EmblemHealth.

Thank you very much for your consideration of my position on this important matter.

Sincerely,


Thomas K. Duane

New York State Senate
29th District

NYC June 19 Demo Report-Back

Friends,

We had a great rally and march in NYC yesterday. About 300 people turned out in front of the office of GHI (a non-profit insurer in NY State) and we then marched to the office of United Health. Speakers included Ralph Nader, actress Vinie Burrows, Dr. Oliver Fein of the Physicians for a National Health Program, Chuck Bell from the Consumers Union and longtime socialist-pacifist activist David McReynolds. Jean Fox from the Private Health Insurance Must Go! Coalition and Billy Wharton from the Coalition Against Privatization shared duties as the MC.

We began the event by reading aloud three healthcare horror stories and holding a moment of silence dedicated to all the victims of private health insurance. The GHI section of the protest was high-energy. There is currently a proposal to "convert" GHI & HIP into a merged for-profit company. Many speakers spoke against this proposal and in favor of H.R. 676. Included here were rank-and-file trade unionists including John Powers from the United Federation of Teachers, Marvin Holland and Marty Goodman from the Transport Workers Union Local 100 and Ronald Crenshaw from District Council 37 who, despite their union leaders support of the conversion, found the courage to speak up. Ralph Nader, Dr. Fein and David McReynolds gave strong speeches demanding single-payer as both a human right and as part of the routine services that citizens demand from the government (fire, police and postal).

We then marched to United Health, a company which is housed in a massive glass monstrosity on 34th street. Vinie Burrows began this section of the march with a fine speech which highlighted the significance of Juneteenth and the overall struggle for social justice. Later, the Raging Grannies belted out some tunes including lines like "Oh Medicare, my Medicare, Why don't you pay for Long Term Care?" We closed with a fiery speech by Ajamu Sankofa of the Private Health Insurance Must Go! Coalition and call by the MC (me!) to treat the demonstration as a beginning point for further organizing.

Media coverage was unusual. I suppose that more people in Tokyo and Rome will know about our demonstration than in New York City. Film crews from Asahi news and an Italian TV station filmed and reported on the march. Longer-term reporters from A&E and Bill Moyers Journal also turned up. In addition, several independent media sources and our main trade union newspaper picked up on the story.

To follow up, we distributed leaflets for a meeting on June 26th at 6:30 pm at 339 Lafayette Street (Buzzer 11) to discuss both the GHI/HIP privatization and the struggle for HR 676. Overall, the demonstration was quite invigorating as I felt like we were at the beginning and not the end of something.

I have attached a photo of TWU Local 100 member Marvin Holland delivering a speech just before we began the march from GHI to United Health. Video and other reports are forthcoming.

Peace,
Billy Wharton

Organizer
Coalition Against Privatization

Letter to the NY State Psychological Association

To All Members of the NY State Psychological Association,

Our listserves are buzzing with the news of the defeat of HR6331, the "Medicare Improvements for Patients and Providers Act", resulting in a 10% cut in reimbursements to doctors for Medicare services. The 10% cut in our payments will preserve the subsidies that Medicare pays to private health insurance companies.

It is crucial to understand that this current situation is just one example of how the private health insurance industry swindles doctors and patients! These "managed (mangled) care" companies are responsible for up to 30% of insurance premiums being wasted on needless bureaucracy. Much of that money is spent on exorbitant salaries of insurance company executives, whose mandate is to maximize profits of their shareholders by minimizing health care benefits to patients and reimbursements to doctors. Our pocketbooks suffer and the welfare of millions of Americans are jeopardized by that profiteering.

It is time for a fundamental change in America's health care system. HR676, a bill currently in Congress, would eliminate private health insurance companies and create a national healthcare system which would cover all necessary medical care, including mental health services. A national single-payer insurance program that is publicly funded, an expanded and improved Medicare for All, would replace the current wasteful and confusing patchwork of hundreds of private plans and save billions of dollars a year currently wasted on needless administration. This savings would be more than enough to cover the uninsured and under-insured and fairly compensate us for the work that we do.

What can we do? The question of the existence grassroots organizations that are working to combat the rackateers has been raised in the context of this listserve discussion. Yes! There are many grassroots organizations that are working to support the passage of HR676.

One of those organizations is PHIMG - "Private Health Insurance Must Go". I invite you to go to the website www.phimg.org to learn about specific actions that are being taken by this group and others (for example "Physicians for a National Health Program" and "Heathcare- now"). And join us! PHIMG meets monthly to inform the public of important issues in this battle and to mobilize for action.

Hear about the current proposed privatization of GHI and HIP, which threatens the healthcare of 4 million policy holders, including 93% of NYC workers, and how the "Coalition Against Privatization" is working to keep GHI and HIP non-profit!

Join Us!

Antonia Cedrone, Ph.D.

acedrone@mindspring.com

May 30 Demo Report-Back

COALITION AGAINST PRIVATIZATION (CAP)

Friends,

On Friday May 30^th, the Coalition Against Privatization held its second street demonstration against the proposed conversion (privatization) of GHI/HIP to for-profit status. As you may have heard, this privatization would remove an important non-profit healthcare carrier thereby exposing 4 million people in NY State to a for-profit health insurer. Non-profit status places a cap on administrative spending at 15% of the overall budget, provides oversight on premium increases and restricts access to funding from financial markets (thereby insuring that the overall goal of the company is the provision of healthcare and not the accumulation of profits).

The application for conversion sailed through Albany in April of 2007 and met little resistance until January 2008. Democrats, Republicans and, until recently, most of the leaders of municipal trade unions supported the privatization. They hope to profit from the estimated $3 – $5 billion dollars in assets, which will be liquidated if the conversion is approved. Plan subscribers, including 1.2 million municipal workers and their dependents (retirees included), would be thrown into a for-profit system which has left more than 46 million people without health insurance and 50 million under-insured.

In January 2008, 300 people, many retirees on fixed incomes, testified at a hearing held by the Superintendent of Insurance. The vast majority spoke against the proposed conversion with many demanding single-payer national health insurance. Since then, CAP has been formed and has organized street demonstrations on May 9th and May 30th. In addition, CAP supporters flooded the phone lines of the Superintendent of the Insurance on May 12th in a planned call-in action.

Friday's demonstration targeted the office of GHI in midtown. Protestors then moved to the office of Governor David Paterson. Along the way, the march received support from passers-by in the form of conversations, pumped fists and words of encouragement. The employees at GHI, who face possible termination or transfer if the conversion is approved, were also receptive to our message. Chants included: "Eric Dinallo–Just Say No!" / "David Paterson–Tell Him No!" and "People over Profits–Healthcare is a Right!"

Speakers included representatives from the UFT rank and file caucus, Independent Community of Educators, TWU Local 100 rank-and-file activists, UFT retirees, D.C. 37 retirees, Socialist Party USA, Healthcare – NOW and Socialist Action. The speakers highlighted the need to break through the silence on this issue by taking the word directly to rank-and-file workers who have largely been kept in the dark by political and trade union representatives. It was also noted that one unelected administrator, Superintendent Eric Dinallo, now controls the fate of 4 million people. Finally, many speakers combined their opposition to the privatization with renewed calls for building the movement for single-payer national health insurance.

Coverage of the march will air on a WBAI (99.5 FM) program entitled, "Building Bridges," this Monday evening, June 2nd, at 7:00pm. There will also be a second article by Ari Paul in this Tuesday's edition of The Chief.

The march began with a surprise announcement that Randi Weingarten, the head of the Municipal Labor Council and the President of the UFT, had penned a letter to Superintendent Dinallo expressing concern about possible increases in premium rates and denial of access to care should the conversion be approved. She stated that the municipal unions were in the process of reviewing their support of the proposed conversion. This is an important victory for CAP since we have consistently argued that premium rates and access would be jeopardized by a for-profit carrier. Activists in ICE have also attempted to bring this message to the floor of the UFT Delegate Assembly for the past three months and have had many positive conversations with DA representatives.

Going forward, CAP is participating in the June 19^th national demonstrations in support of single-payer national healthcare. Demonstrations will be organized in 17 cities throughout the U.S. The New York City demonstration will unite CAP with Healthcare NOW! and Private Health Insurance Must Go! We will demand the passage of H.R. 676 and speak out against the privatization of GHI/HIP. The demonstration will be held on Thursday, June 19th, at 5:00pm in front of the office of GHI at 441 9th Avenue (34th & 9th). We will then march to the office of United Healthcare at 1 Penn Plaza (33rd bet. 7th & 8^th).

Please consider participating in our growing movement to stop the privatization of GHI/HIP and secure healthcare as a basic human right!

A CAP organizer can be contacted at (718) 869-2279 or by email at noprivatization@yahoo.com

In Peace and Solidarity,

The Coalition Against Privatization