Zohran Mamdani campaigned on the idea that the government should make life better and more affordable for the working class and protect them from corporate greed and corruption. His critics have attacked his platform as delusional and dangerous.
Mayor Mamdani can prove his critics wrong, and demonstrate his commitment to his principles, by making traditional Medicare a central pillar of his health policy.
Medicare is a public health insurance program for senior citizens. Under traditional Medicare, the federal government pays doctors directly for the services they render. Seniors can go to virtually any doctor (since nearly all doctors accept traditional Medicare) and receive whatever care their doctor orders (since there is no insurance company denying coverage).
When combined with a Medicare supplemental plan, which the city has always provided to Medicare-eligible retired municipal workers, costs are minimal. In short, traditional Medicare is effective, life-saving, and affordable.
Medicare Advantage (“MA”) — a private, for-profit alternative to traditional Medicare — is none of those things.
Under MA, money flows through insurance companies. The federal government pays insurers to cover seniors who enroll in their MA plans, with the payment amount varying based on the seniors’ health (as reported by the insurers). The insurers profit by pocketing whatever they don’t spend. The original idea behind MA was to let market forces drive down the cost of health care and improve efficiency. It has been a spectacular failure.
As countless empirical studies have confirmed, MA plans cost taxpayers far more than traditional Medicare despite spending far less on, and delivering worse outcomes for, patients. Why is that? Corporate greed and corruption.
MA insurers (i) fraudulently overbill the government by exaggerating patients’ medical problems and (ii) improperly deny coverage for care these elderly, infirm individuals desperately need. Such greed and corruption have resulted in historic profits for MA plans (indeed, MA plans are the most profitable insurance product). They have also resulted in criminal charges and civil fraud lawsuits against most of the leading MA insurance companies.
Making matters worse, a large percentage of medical providers refuse to accept MA plans. According to an October 2024 U.S. Senate report, “61% of health systems are either considering ceasing to accept all Medicare Advantage patients within the next two years, or will definitely do so.” Doctors despise MA plans because the insurers make it nearly impossible for them to do their jobs. The insurers drown them in prior authorization paperwork, refuse to cover their patients’ care, and deny and delay payment.
Because MA plans impede access to doctors and life-saving treatment, patients are often forced to choose between paying out-of-pocket and forgoing medical care. In short, MA plans are a nightmare for seniors when they become sick, particularly if they are low-income.
Disgraced former Mayor Eric Adams opposed MA when he ran for office in 2021. He said it would “devastate” and “traumatize our retirees.” However, after becoming mayor, he quickly reversed course and sought to force retired city workers into an MA plan. He claimed it would help balance the city’s budget. The New York City Independent Budget Office found this to be false.
The truth was that the MA plan would have funneled money from low-income seniors to a discretionary fund controlled by the mayor and union leaders. Adams also claimed that an MA plan could be just as good as traditional Medicare. Retirees exposed the truth in litigation, leading the courts to find that MA would irreparably harm seniors. Eventually, Adams gave up.
During last year’s campaign, Mamdani quietly posted a statement on his website pledging to “reject Medicare Advantage.” However, since taking office, he has not publicly addressed the topic. That is a missed opportunity. Mamdani should proudly reaffirm his commitment to traditional Medicare. This health care program is one of the most compelling examples of the government making life better and more affordable for the working class and protecting them from corporate greed and corruption.
MA enriches insurance companies at the expense of vulnerable senior citizens. No city leader, especially none with Mamdani’s political beliefs, should ever force retirees into it.
Pizzitola is president of the New York City Organization of Public Service Retirees, representing 300,000 retired members of the city’s municipal work force who are Medicare retirees.
