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Nevada’s Culinary Union opposes Medicare for All to the detriment of their members

February 13, 2020

Topics: Quote of the Day

By Kate Sullivan
CNN, February 12, 2020

The influential Culinary Union distributed a flier that says Vermont Sen. Bernie Sanders would “End Culinary Healthcare” if elected president of the United States.

The flier, obtained by CNN on Tuesday, outlines where the leading 2020 Democratic candidates stand on health care, immigration and “Good Jobs.” It singles out Sanders as the candidate who will end the union’s health care among the top six Democratic candidates, pointing to his “Medicare for All” plan.

Former Vice President Joe Biden, former South Bend, Indiana, Mayor Pete Buttigieg, Minnesota Sen. Amy Klobuchar and businessman Tom Steyer are expected to “Protect Culinary Healthcare,” according to the flier.


Statement by Culinary Union Secretary-Treasurer Geoconda Arguello-Kline

Culinary Workers Union Local 226, Press Release, February 12, 2020

The Culinary Union is Nevada’s union and largest immigrant organization with members who come from 178 countries and speak over 40 different languages. Our union is comprised of majority women, and we are proud to have changed the lives of over 800,000 hospitality workers in 85 years through rank-and-file organizing and mass actions.

Culinary Union members are empowered to engage in democracy – whether at the bargaining table, while canvassing in neighborhoods, or on the streets in the desert heat – we fight for workers across Nevada, union and non-union alike.

We have welcomed Senator Bernie Sanders into our union for a town hall with Culinary Union members, and we hosted tours of the Culinary Health Center and the Culinary Academy of Las Vegas with Senator Sanders, to show what we have fought for and won.

Our union believes that everyone has the right to good healthcare and that healthcare should be a right, not a privilege. We have already enacted a vision for what working people need – and it exists now. Workers should have the right to choose to keep the healthcare Culinary Union members have built, sacrificed for, and went on strike for 6 years, 4 months, and 10 days to protect.

It’s disappointing that Senator Sanders’ supporters have viciously attacked the Culinary Union and working families in Nevada simply because our union has provided facts on what certain healthcare proposals might do to take away the system of care we have built over 8 decades.

We have always stood up for what we believe in and will continue to do so. The Culinary Union has faced some of the toughest companies who wanted to break our union, and even the President of the United States Donald Trump – and won.

Together, we will figure out the best way to fix healthcare in America, and the Culinary Union is committed to fighting until we win for everyone.


Culinary Health Fund: Las Vegas Plan Unit 150

Weʼre the Culinary Health Fund. The Fund provides healthcare benefits (insurance) to culinary workers in Las Vegas. We provide medical, dental, pharmacy and eye care benefits. The Culinary Health Fund is a multi-employer Taft-Hartley Fund. We were established in 1981. We’re funded by collective bargaining agreements that are negotiated by unions and funded by employers.

The Summary of Benefits and Coverage (SBC) document shows you how you and the plan would share the cost for covered health care services.

Summary of Benefits and Coverage (SBC)

(Edited excerpts from a seven page document. Parenthetical comments are by Don McCanne and are based on PNHP’s Physicians’ Proposal for Single-Payer Health Care Reform, sometimes referred to as single payer Medicare for All which is very similar to the legislative proposals of Sen. Bernie Sanders and Rep. Pramila Jayapal.)

• The plan type is a PPO (Preferred Provider Organization). It is a form of managed care that uses a provider network.

(Single payer Medicare for All – M4A – is not a managed care entity. It includes all physicians, hospitals and other health care facilities such as laboratories and radiology services.)

• This plan uses a provider network. You will pay less if you use a provider in the plan’s PPO network. You will pay the most if you use a Non-PPO provider, and you might receive a bill from a Non-PPO provider for the difference between the Non-PPO provider’s charge and what your plan pays (balance billing). Be aware, your PPO network provider might use a Non-PPO provider for some services (such as lab work). Check with your provider before you get services.

(M4A does not use a PPO network. It pays in full the publicly administered prices for all covered services. The patient pays nothing.)

• No deductible is required for covered services. This does not apply to non-PPO providers.

(Under M4A, there are no deductibles and since there are no networks there are never any deductibles.)

• There are copayments required for primary care visits ($15), specialist visits ($30), X-rays ($20 to $45), blood work ($0 to $15), CT/MRI ($125), PET scan ($175 to $225), drugs ($10 to $35 and 25% coinsurance for Tier 4 drugs), outpatient surgery ($150 to $250), emergency room care ($350), emergency medical transportation (25% coinsurance for ground, $500 copay for air), urgent care ($40), hospital admission ($250), mental health/substance abuse (outpatient $0 to $15; partial admission $150; inpatient $250), childbirth facility ($250), home health care ($0), Rehabilitation ($250 inpatient; $20 to $40 outpatient), skilled nursing care ($250), durable medical equipment (10% coinsurance), hospice ($0), and children’s eye exam ($20). Non-PPO providers are not covered for any of these services except for a $2000 copay and 40% coinsurance of allowed charges for hospital facility fee, inpatient mental health services, and childbirth facility fee.

(Under M4A, there are no copayments nor coinsurance fees, and there is no out-of-network care since all professionals and facilities are covered. The patient pays nothing to access these services and products.)

• The out-of-pocket limit that the patient must pay is $6,350 individual / $12,700 family. Premiums, balance billing, and out-of-network care do not apply to the out-of-pocket limit, and thus the financial exposure to the patient could be much greater.

(Under M4A, there are no premiums, deductibles, copayments, coinsurance, out-of-network care, surprise bills or balance billing and thus there is no need to establish an out-of-pocket limit. The only payment made is a tax contribution based on ability to pay – a progressive tax – which may be as little as $0. Thus health care is affordable for everyone.)

• Services that are not covered include bariatric surgery, cosmetic surgery, infertility treatment, long term care, non-emergency care when traveling outside of the U.S., private duty nursing, and weight loss programs.

(Under M4A, with the exception of vanity cosmetic surgery, most of these services are covered when they are legitimately indicated. Long term care, management of obesity, bariatric surgery, and infertility treatment are particularly important services that should be covered, and they are under M4A.)

• You do not need a referral to see a specialist, but you might receive a bill from a Non-PPO provider for the difference between the Non-PPO provider’s charge and what your plan pays (balance billing). Be aware, your PPO network provider might use a Non-PPO provider for some services (such as lab work). Check with your provider before you get services.

(Under M4A, there is no balance billing and no surprise medical bills.)

• Employees must work 240 hours every two months to maintain health benefits. For those who work fewer hours, it may be possible to continue the benefits through self-pay, but that can be a problem at a time that income is reduced.

(Under M4A, coverage is automatic, forever, even for those who have no income. Health benefits should be totally de-linked from employment, especially since this is an unstable source of coverage as over 60 million people leave their jobs each year.)


PNHP’s Physicians’ Proposal for Single-Payer Health Care Reform:


By Don McCanne, M.D.

The Culinary Union is opposed to single payer Medicare for All because they went on a strike for six years to protect the coverage they have? Well, that’s a non sequitur. Rather they should be comparing their current coverage with the single payer model of Medicare for All and decide their support on that basis.

They would find that the single payer benefits are significantly better; financial barriers to care are eliminated; they would have free choice of physicians and hospitals rather than being limited to a network; the coverage would be stable – for life, and the costs would be significantly less for the beneficiaries because the system would be funded through progressive taxes making it less expensive for those with modest incomes, plus single payer efficiencies would recover profound administrative waste currently estimated to be about $600 billion of our annual national health expenditures.

Perhaps the most important reason that they should reconsider their position on single payer Medicare for All is that, as a strong and effective union, they should be able to negotiate with the employers a deal that will cost the employers no more than what they are already paying, but a deal that will greatly benefit the employees. The employers should agree to give their employees a pay raise equivalent to the current insurance premium that they will no longer be paying, minus any health care tax that they would be required to pay under a single payer system. The employers will be paying the same whereas the employees will receive a much better health plan plus a net pay increase equivalent to the total pay raise negotiated with the employers minus the health tax paid by the employee which would be quite modest because it would be based on their modest incomes. Much better insurance plus a significant pay raise – how can you beat that?

In their release they state, “we will figure out the best way to fix healthcare in America, and the Culinary Union is committed to fighting until we win for everyone.” Even though their plan is quite good by today’s standards for private plans, it is still deficient compared to what they could have. And fighting to protect their existing plan will do nothing to provide “a win for everyone.”

We really want our sisters and brothers in the Culinary Union to have the best in health care plus a pay raise, but they are going to have to use their negotiating strength to achieve that, convincing the employers that they have nothing to lose, but they actually gain by being relieved of their obligation to provide health care benefits as part of the employees’ compensation packages. If the union members read this brief analysis of their current plan and the potential of single payer Medicare for All, maybe they’ll decide to do the right thing for themselves, which will then benefit all of us – that “win for everyone” they support.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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