PRIOR AUTHORIZATION: Denials are way up; doctors are burning out, pleading with officials for help

 

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Wendell Potter Jan 30

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PRIOR AUTHORIZATION: Denials are way up; doctors are burning out, pleading with officials for help

Cost of Denials Saw 67% Increase in 2022

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City Workers Losing Patience With Slow Crawl to Union Contracts - the city

 

 “Garrido and other union leaders are getting vocal pushback from their ranks — and not just from retirees who would be immediately affected by health coverage changes.”

https://www.thecity.nyc/2023/1/27/23573639/public-employees-overdue-union-contracts

Unions

City Workers Losing Patience With Slow Crawl to Union Contracts

In the second year of the Adams administration, public employees are asking when raises might be coming — but a bitter and costly fight over retiree health care isn’t over.

By Claudia Irizarry Aponte  cirizarry@thecity.nyc

  Jan 27, 2023, 5:05am EST

 

DC 37 Executive Director Henry Garrido, who seeks a new contract for his union’s members, attended the mayor’s State of The City speech, Jan. 26, 2023.

Ben Fractenberg/THE CITY

Most city employees are now working under expired labor contracts that lapsed as far back as 2020 — frustrating rank-and-file union members whose anticipated pay raises are tied up in an escalating battle over proposed changes to retired colleagues’ health coverage. 

Nearly all of the city’s roughly 300,000 unionized staff are working under expired collective bargaining agreements. They include members of the city’s largest public sector unions, District Council 37 (DC37) and the United Federation of Teachers (UFT). Administrative workers, school crossing guards, teachers, police detectives, sanitation workers and health technicians are among those eager to bargain for raises as well as potential new benefits, such as flexibility to work remotely.

That their adversary, Mayor Eric Adams, is himself a former city worker who emphasized his background on the campaign trail and collected many union endorsements only adds to their frustration, especially for those who helped keep the city going during the worst of COVID.

“I think that he misrepresented himself to the unions,” said a delegate to DC37 who declined to give their name as they are not authorized to speak publicly about the issue. Delegates are elected to represent their locals at the 300-member Delegates Assembly and are themselves in charge of electing the union’s leadership.

Said Barbara Randolph, a nurse at Lincoln Hospital in The Bronx: “He won’t be mayor for too much longer if he won’t back the union.” The New York State Nurses Association contract with the city’s public Health+Hospitals system expires March 2.

A roadblock: Retired city workers successfully sued to derail Adams’ plan to move retiree health care to a cheaper alternative called Medicare Advantage and charge a monthly fee to those who wish to retain existing coverage. A City Council bill pushed by Adams that would allow him to roll out Medicare Advantage, which he says would save the city $600 million a year, is “dead,” the Daily News reported last week.

That leaves Adams hundreds of millions of dollars short. The planned Medicare Advantage shift originated in deals struck by former Mayor Bill de Blasio and the unions to pay for raises by finding health care savings. As long as that money remains in limbo, new contract negotiations are going nowhere.

“Our contract is not being negotiated until this is resolved,” said the District Council 37 delegate. “That’s what we’ve all been told.” Some public sector union leaders have also said that the health care talks have stood in the way of bargaining a new contract for their members.

Medicare Mess

The executive director of DC 37, Henry Garrido, also co-chairs the Municipal Labor Committee, the consortium of public employee unions that agreed to the health savings deals. He declined to speak about the standoff or his members’ frustrations.

“We don’t bargain in the press,” said Garrido, who declined to comment further. 

Garrido and other union leaders are getting vocal pushback from their ranks — and not just from retirees who would be immediately affected by health coverage changes.

Five chapters of DC37 Local 375 — which represents city planners, engineers and architects — wrote in a Jan. 9 letter to City Council labor committee chair Carmen de la Rosa that they did not support the Medicare Advantage switch and urged her to kill the proposal. DC37 Local 768, which represents therapists, exterminators, and other health technicians, also urged its membership to pressure their City Council members to strike down the bill.

A City Hall spokesperson said the Adams administration is “committed to offering quality and sustainable care for our retirees.

“The city and the Municipal Labor Committee worked together to take advantage of the federal funding for Medicare Advantage plans that would permit us to continue providing high-quality, premium free coverage for retirees while saving approximately $600 million a year — savings that are especially critical as we continue to face a skyrocketing health care crisis and other fiscal challenges,” mayoral spokesperson Jonah Allon said in a statement. 

Pointing to a recent Council hearing on the bill that would break the Medicare Advantage logjam, Allon added: “We presented a clear case that the city’s Medicare Advantage plan would offer myriad improvements over the current SeniorCare plan, while still encouraging the Council to preserve retiree choice by amending the administrative code.”

Health Care Costs

Marianne Pizzitola, an FDNY retiree and president of the NYC Organization of Public Service retirees, the nonprofit behind the lawsuit, urged the mayor and the Municipal Labor Committee to find another way to reach health care savings.

“This is not being supported by the City Council, it’s not appreciated by our seniors. Let’s do something else. Let’s go back to the bargaining table and figure something out,” she told THE CITY.

The last mayor to let contracts lapse was Michael Bloomberg, who refused to settle with any of the city’s 152 labor unions, effectively leaving those negotiations to his successor.

That was Bill de Blasio, who worked quickly to settle expired contracts upon taking office in 2014, reaching a deal with the UFT that May and DC37 soon after. (Just one union remains at sea: the Marine Engineers Beneficial Association, which represents Staten Island Ferry captains and mates, has not had a contract for more than a decade.) The health savings pact, and that $600 million in savings, was a critical piece of the puzzle — one Adams is now trying to solve. 

Mayors traditionally settle labor agreements first with the largest unions, UFT and DC37, which represent about 60% of city employees, setting a pattern that smaller unions then follow in their own negotiations. 

Members and sponsors make THE CITY possible.

The Adams administration recently began preliminary talks with DC37, whose contract covering 100,000 workers expired in 2021. The loss of expected health savings means money is not flowing into a special health insurance fund that the city and unions jointly administer to help pay for member benefits.

“The unsettled nature of the Medicare Advantage program as well as the overall fiscal health of the Health Insurance Stabilization Fund is an impediment to moving forward with regular labor negotiations,” said Ana Champeny, the vice president for research at the nonprofit Citizens Budget Commission.

She added that rising health care costs need to be dealt with, somehow. 

“The entirety of how the city finances, pays for and provides health insurance benefits and welfare fund benefits to the public sector — both current employees and retirees — needs a close reevaluation,” she said. Collective bargaining, she added, is where these issues will play out.

Reserves and Rainy Days

Experts at the Independent Budget Office, an official fiscal watchdog, say that the steep costs associated with past commitments to help unions pay for GHI Emblem Health, the plan most city workers have enrolled in since the 1940s, are bound to continue piling up. Since the 1980s, city union contracts have only guaranteed funding for an insurance plan that is typically cheaper, called HIP — and making up the difference has become a ongoing scramble.

“There are always trade-offs in any particular budgetary decision,” said IBO assistant director for budget review Logan Clark. “As long as GHI remains more expensive than HIP/HMO, then we’re going to be dealing with this problem sort of in perpetuity.” He called the gap between HIP and GHI premiums “a continuing hole that we will always have to be filling in.”

But there are options to fill the budget gap, at least for the short term, he said. The city could tap into its general reserves, funds set aside every fiscal year, or the Temporary Benefits Trust, a $3.4 billion reserve. 

“That’s something that they could be tapped into as part of the reserves, either by paying down or essentially making smaller payments into next year’s payments for retiree health benefits,” said Clark.

Another option would be dipping into the city’s rainy-day funds – in what would be an unprecedented move because “the promulgation of standards of what constitutes an emergency to tap into the rainy day funds haven’t really been promulgated yet, so that’s something that is certainly up for question,” Clark said.

So far, Adams budgeted enough in his preliminary budget to cover 1.25% annual raises — far below the current 6.3% inflation rate in the New York area.

Adams has used his rank-and-file bona fides to set himself apart from his predecessors, to the annoyance of retirees who sued his administration over the healthcare plan.

Previous mayors, he told an audience of labor leaders at the SOMOS convention in Puerto Rico last November, “never knew what it was like to hold their stomachs when it was time for union contract negotiations. Didn’t know what it was like to fight for their healthcare, to protect their pensions, to be on the union lines to really fight to get the raises you deserve.”

“Like the retirees,” Pizzitola, the president of the NYC Organization of Public Service Retirees, shot back in a moment captured on video.

Arthur Goldstein, a high school ESL teacher who has documented the health care plan saga on his blog, said that he is preparing for a long battle ahead.

“I think we could be without a contract for a very long time.”

How NY Dem Midterm Debacle Unfolded - Loss of House to Republicans Connected to Reason Progressives Rejected Judge

I just gave $100 to The Indypendent - articles like this are the reason.

 

https://indypendent.org/2022/11/how-the-new-york-democrats-midterm-debacle-unfolded/

 

A cascading series of blunders by leading NY Democrats handed half of Congress to the Republicans. Can the state party's dysfunction be reversed?

• John Tarleton Nov 23, 2022

This year’s midterm elections saw the much-anticipated Republican “red wave” turn into a red trickle in most of the country with one glaring exception: bright blue New York.

President Joe Biden won the state by 23 points in 2020. Democrats control all of New York’s statewide offices and wield super-majorities in both houses of the state legislature. National Democrats expected that the party’s control over the once-in-a decade redistricting process would help shore up its razor-thin congressional majority. 

A mighty stream of hubris, incompetence and cronyism laid waste to the New York Dems’ own electoral aspirations and that of Democrats across the country. 

Instead of expanding their majority, New York Democrats lost four congressional seats in an election in which their party didn’t lose more than two seats in any other state. Meanwhile, as The Indypendent goes to press, the Republicans appear headed for a tiny (one to three seat) House majority once all the mail-in votes are counted in California. The New York Dems’ debacle will be the difference between ceding control of the House of Representatives to a MAGA heavy Republican caucus intent on creating partisan gridlock as opposed to continuing Democratic control of the White House and Congress that would make more progressive legislation possible during the second two years of the Biden administration. 

There was no one cause, nor one culprit, for the New York Dems’ face plant. Instead, the causes of their failure flowed into each other as tributaries forming a mighty stream of hubris, incompetence and cronyism that would lay waste to their own electoral aspirations and that of Democrats across the country. 

A Journey in 11 Steps

1. State Senate Leaders Rush a Top Court Pick

Madeline Singas and former New York Gov. Andrew Cuomo at an event supporting an extension of the NY Property Tax Cap. Seaford, NY, June 2015. Photo by Ann Parry

‘Cancel This Failed Experiment’: Physicians Tell Biden HHS To End Medicare Privatization Pilot

 

‘Cancel This Failed Experiment’: Physicians Tell Biden HHS To End Medicare Privatization Pilot

Jake Johnson
January 19, 2023
Common Dreams

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The Medicare privatization program "presents a threat to the integrity of traditional Medicare, and an opportunity for corporations to take money from taxpayers while denying care to beneficiaries," said Physicians for a National Health Program. 

 

A national physician group this week called for the complete termination of a Medicare privatization scheme that the Biden White House inherited from the Trump administration and later rebranded—while keeping intact its most dangerous components.

Now known as the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the experiment inserts a for-profit entity between traditional Medicare beneficiaries and healthcare providers. The federal government pays the ACO REACH middlemen to cover patients' care while allowing them to pocket a significant chunk of the fee as profit.

The rebranded pilot program, which was launched without congressional approval and is set to run through at least 2026, officially began this month, and progressive healthcare advocates fear the experiment could be allowed to engulf traditional Medicare.

In a Tuesday letter to Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure, Physicians for a National Health Program (PNHP) argued that ACO REACH "presents a threat to the integrity of traditional Medicare, and an opportunity for corporations to take money from taxpayers while denying care to beneficiaries."

The group, which advocates for a single-payer healthcare system, voiced alarm over the Biden administration's decision to let companies with records of fraud and other abuses take part in the ACO REACH pilot, which automatically assigns traditional Medicare patients to private entities without their consent.

CMS said in a press release Tuesday that "the ACO REACH Model has 132 ACOs with 131,772 healthcare providers and organizations providing care to an estimated 2.1 million beneficiaries" for 2023.

"As we have stated, PNHP believes that the REACH program threatens the integrity of traditional Medicare and should be permanently ended," Dr. Philip Verhoef, the physician group's president, wrote in the new letter. "Whether or not one agrees with this statement, we should all be able to agree that companies found to have violated the rules have no place managing the care of our Medicare beneficiaries."

Among the concerning examples PNHP cited was Clover Health, which has operated so-called Direct Contracting Entities (DCEs)—the name of private middlemen under the Trump-era version of the Medicare pilot—in more than a dozen states, including Arizona, Florida, Georgia, and New York.

PNHP noted that in 2016, CMS fined Clover—a large Medicare Advantage provider—for "using 'marketing and advertising materials that contained inaccurate statements' about coverage for out-of-network providers, after a high volume of complaints from patients who were denied coverage by its MA plan. Clover had failed to correct the materials after repeated requests by CMS."

Humana, another large insurer with its teeth in the Medicare privatization pilot, "improperly collected almost $200 million from Medicare by overstating the sickness of patients," PNHP observed, citing a recent federal audit.

"It appears that in its selection process [for ACO REACH], CMS did not prevent the inclusion of companies with histories of such behavior," Verhoef wrote. "Given these findings, we are concerned that CMS is inappropriately allowing these DCEs to continue unimpeded into ACO REACH in 2023."

While the Medicare pilot garnered little attention from lawmakers when the Trump administration first launched it during its final months in power, progressive members of Congress have recently ramped up scrutiny of the program.

Last month, Sen. Elizabeth Warren (D-Mass.) and Rep. Pramila Jayapal (D-Wash.) led a group of lawmakers in warning that ACO REACH "provides an opportunity for healthcare insurers with a history of defrauding and abusing Medicare and ripping off taxpayers to further encroach on the Medicare system."

"We have long been concerned about ensuring this model does not give corporate profiteers yet another opportunity to take a chunk out of traditional Medicare," the lawmakers wrote, echoing PNHP's concerns. "The continued participation of corporate actors with a history of fraud and abuse threatens the integrity of the program."

[Jake Johnson is a staff writer for Common Dreams.]

Licensed under Creative Commons (CC BY-NC-ND 3.0). Feel free to republish and share widely 

Medicare Advantage Is a National Scandal - How Thick Could New York City’s Information Bubble Be? Work Bites

 

 https://www.work-bites.com/view-all/1n72juz2psj2e6v48d80bgwyati58c?fbclid=IwAR1yo5uAUf0jpWL723sE2H3PfUvGn-rsymJaC3lr0pWhrF2hwPdFX1p5x5c

Medicare Advantage Is a National Scandal - How Thick Could New York City’s Information Bubble Be?

 

By Joe Maniscalco

Collusion.

That’s what the campaign by New York City Mayor Eric Adams and the heads of the Municipal Labor Committee [MLC] to push municipal retirees into a privatized for-profit Medicare Advantage healthcare program looks like to the many thousands who’ve spent more than a year trying to stop the plan.

What else can a rational human being conclude other than collusion against municipal retirees?

Medicare Advantage is one of the filthiest scandals in America today with lawmakers in Congress calling for the program’s nationwide abolition. And yet, the heads of the biggest city in the country are running around insisting Medicare Advantage is a good deal for retirees.

Really?

How thick would that bubble have to be to keep all that information out?

Work-Bites has already reported on some of the mounting evidence against privatized, for-profit Medicare Advantage plans and the delays, denials and deaths that come with them.

Here’s a little recap: earlier this month, retired Delaware State Senator Karen Peterson told us how “your healthcare can really go off the rails” with Medicare Advantage.

Nevertheless, the powerbrokers in Peterson’s state, as here in NYC, tried to sell municipal retirees on Medicare Advantage, insisting it was “just as good” as what they already had — “only better.”

Turns out, the Medicare Advantage contract Delaware signed with a private healthcare insurance company in September, actually contained 2,030 pre-authorizations — 340 pre-authorizations for medications — and 1,690 pre-authorizations for procedures.

Few things concern dedicated municipal retirees more than suddenly not being able to see their doctor.

A recently-released report from the U.S. Senate Committee on Finance critical of Medicare Advantage chicanery found instances of “provider network confusion” across 10 states where the beneficiary was “switched into a new plan and was unaware that their current doctors were not covered under their new plan’s network until they began to use the new plan.”

Gale Brewer, former Manhattan Borough President and current City Council Member representing the Upper West Side, doesn’t seem to have any problem piercing any sort of Medicare Advantage information bubble.

“The city has offered various Medicare Advantage plans for years,” Brewer said in a statement this week, “but few retirees choose them because they are demonstrably worse than Senior Care.”

She goes on to say, “Medicare advantage plans give private insurance companies the power to overrule primary care physicians — and to say which procedures will be permitted,” she added. “Many retirees have health care issues and work very hard to stay healthy. Keeping their current insurance plan, called Senior Care, is critical in retaining access to their doctors and ensuring continuity of care.”

Gale Brewer gets it.

WHY AREN’T THEY TALKING WITH RETIREES?

That awareness has prompted Brewer to urge all parties involved to “sit down together and work this out.”

Marianne Pizzitola, president of the NYC Organization of Public Service Retirees and Fire Department EMS Retirees Association, has spent months calling for a sit-down with MLC heads Michael Mulgrew, Harry Garrido and Harry Nespoli.

Instead of taking her up on the offer, however, the trio, along wih Mayor Eric Adams — the former Medicare Advantage critic who used to call the program a “bait and switch” — have been pushing pell-mell to privatize the healthcare for tens of thousands of retired trade unionists — raging in the courts, issuing ultimatums, leaning on New York City Council members to tear up part of the City Administrative Code and implementing extra health costs.

Again, all at the precise moment Medicare Advantage plans are being exposed as predatory money grabs and raked across the coals from coast-to-coast.

Brewer correctly characterizes for-hire arbitrator Martin Scheinman’s December 15, filing in favor of the Medicare Advantage switcheroo a “non-binding report.”

Pizzitola is more blunt, calling it “paid propaganda.”

”The December 15th Scheinman report is not a “ruling”, it’s an opinion,” Pizzitola said in a statement released this week. “It’s paid propaganda and they’re hoping the city council falls for it. It is not a decision, it is not a ruling, it is not an award…and yet everyone fell for the biggest play in history…a paid opinion piece!”

Municipal retiree groups have already identified at least $300 million in savings to the City of New York — and none of it necessitates pushing them into a disastrous for-profit Medicare Advantage plan that progressive lawmakers in D.C. say ought to be abolished.

“OMB knows about some of these savings options, and has not implemented them,” Pizzitola says. “Nor have they informed the city council they exist. OMB was unaware of others we suggested in a recent meeting! Which is worse? And yet they told the Mayor’s office there is only one path forward! How can the mayor or the council make a decision if they are not being properly informed by OMB?”

Those leading the charge for Medicare Advantage are some of the most powerful people in the City of New York today. Elderly Municipal retirees are among the weakest and most vulnerable. But they are all hard-working trade unionists who’ve spent their entire working careers in education, the Fire Department, building trades, law enforcement — you name it. Corporate-owned, anti-labor media outlets in this town, as they did in Delaware, are trying to dismiss them all as a small group of crotchety old cranks. We should all remember that and consume our media accordingly.

New York City municipal retirees certainly remember the 2014 pact between former Mayor Bill de Blasio’s administration and UFT President Michael Mulgrew — the faustian deal that allowed $1.3 billion from the city’s Health Stabilization Fund to be used to cover needed raises following a decade of austerity under billionaire Mayor Mike Bloomberg.

They’ve connected all the dots and refuse to be steamrolled by anyone. They simply can’t afford to pretend to live in a Medicare Advantage information bubble. And neither can any of the “retirees in training” following right after them.

NYC Turns Down Three Success Academy Co-locations - Via Ravitch

 

NYC Turns Down Three Success Academy Co-locations

dianeravitch Jan 25

At ex-Governor Cuomo’s urging several years ago, the Legislature passed a law requiring the New York City Department of Education to provide free space to charter schools, and if no space was available, to pay their rent in private space. This requirement gave rise to the dreadful practice of “co-location,” in which a new charter school was crammed into an existing public school. The public school typically lost space for class size reduction, performances, special education services, and everything else that was not designated as a classroom. Meanwhile, the charter school got fresh new furniture and the best of everything. There was no collaboration between the schools under the same roof.

A few days ago, charter advocates were stunned when the Department of Education rejected three requests for co-location by the rich and politically powerful Success Academy charter chain. The Wall Street Journal immediately published an editorial blasting Mayor Eric Adams (whose campaign was bankrolled by charter billionaires) and who put charter advocates on the city’s school board. The decision was made by Chancellor David Banks and never reached the pro-charter city board.

For Eva Moskowitz of Success Academy, this was a surprising rejection. She is accustomed to cowing politicians (she has her own PAC) and getting her way.

Charter fans and the pro-charter media blame “the unions,” their usual enemy, but this isn’t correct. Parents and educators in these communities contacted their legislators and won their support. And the legislators and local officials killed the deal.

Congressman Jamaal Bowman stepped up to oppose the co-location in a school that he knew. He wrote a thread on Twitter (@JamaalBowmanNY) that began:

The @NYCSchools proposal to open and co-locate a new @SuccessCharters school in Building X113 is absolutely outrageous. The Panel for Education Policy has to vote against this plan, and I urge my colleagues and neighbors to get loud in opposition. Here’s why:

As a former educator & principal of a middle school in the same district as X113, I’ve seen up close how the educators there have done a tremendous job serving their students & families. Our community is incredibly grateful for the love they pour into their work every day.

I’ve also seen how charter schools can harm students, educators, and traditional public schools in our communities. We can’t let that happen at X113.

Big charter networks have a history of draining students & funds from traditional public schools, and violating the rights of their students. Last year, Success Academy had to pay out $2.4 million in a federal court settlement for pushing out students with disabilities.

The plan will decrease available space for the existing schools at Building X113 – both district-run public schools – and prevent them from lowering class sizes adequately. Class size matters. We’ve got to demand schools get the resources & physical space to meet student needs.

As many charter school expansions do, this destructive plan will also disproportionately harm students with disabilities. The plan does not include sufficient analysis of what intervention rooms are necessary to provide students with IEPs with the services they need.

Another surprise: the Rupert Murdoch-owned New York Post got the story right. The story recognized that the pressure to block the co-locations came not from the union but from parents. The Post has been a vocal supporter of charters, and Murdoch himself has contributed to them.

Elected officials helped kill a plan to open three new charter schools in existing public schools or other city-owned buildings — after hearing fierce opposition from local parents.

Bronx Borough President Vanessa Gibson — who last week spoke at the ribbon-cutting ceremony for a new DREAM Charter High School in Mott Haven — suggested Tuesday that her hand was forced against the planned Success Academy in Williamsbridge.

“Parents of School District 11 spoke to us loud & clear. The deep rooted history of disinvestment at the Richard R. Green Campus must be recognized. So much progress has been made,” she tweeted.

A City Hall insider also cited “a lot of pushback” from community members opposed to the new charter schools.

“They vote and they hold folks accountable,” the source said.

Schools Chancellor David Banks’ unexpected withdrawal of the proposal came even though Mayor Eric Adams packed the board in charge of the decision with pro-charter allies.

UPS and the Package Wars - New Yorker

 

https://www.newyorker.com/magazine/2023/01/16/can-ups-still-deliver-a-middle-class-life

UPS and the Package Wars

The company offers old-fashioned middle-class jobs and is enjoying record profits. So why is a strike looming?

By Jennifer Gonnerman

Jan. 9, 2023

For nearly twenty years, Antoine Andrews has been driving a UPS route in the Brooklyn neighborhood of Bay Ridge. When he rings the bell of a house one afternoon, the customer greets him with a fist bump: “What’s up, bro?” When he drops off a package at Walgreens, he recognizes an elderly man in the checkout line. The man once worked in a neighborhood bar, and when Andrews used to walk in with a delivery the man always offered him a beer—“On the house!”—which Andrews would decline. As he walks out of Walgreens, he taps the man on the shoulder and says, “Nice to see you!” All day long, Andrews waves to people he knows, and they wave back. He later jokes that, when he’s on his route, “I feel like I’m running for office, like I’m on the podium and I’m waving with both hands.”

Andrews is forty-six years old, slim and bald, with a salt-and-pepper beard, which is fairly new, because, until 2020, UPS prohibited its drivers from having beards. Before his workday ends, he has to deliver—or attempt to deliver—each of the hundred and forty parcels in the back of his package car. Hour after hour, he does the dance of the UPS driver: driving a block or two, turning off the ignition, unbuckling his seat belt, pulling in his sideview mirror, searching in the back for parcels, climbing out, delivering them to customers. He has delivered just about everything, from dog food to exercise bicycles to fake Christmas trees. Another driver might have grown tired of this job, but Andrews has not. “I take pride in servicing my customers,” he told me, “and my customers and I have a great relationship.”

Twenty-six years ago, the sort of friendly rapport that he and many UPS drivers have with their customers helped fuel public support for UPS’s workers when they went on strike with their union, the International Brotherhood of Teamsters. At the time, in the summer of 1997, the I.B.T. represented a hundred and eighty-five thousand UPS workers, and their strike was the largest labor action in the U.S. in two decades. Workers stayed out on the picket line for fifteen days, and, in the end, the union declared victory. Today, the I.B.T. represents some three hundred and fifty thousand UPS workers, and the union is threatening to go on strike again when their contract expires, on August 1st. Preparations for a strike have already begun, and Teamsters Local 804, which represents Andrews and the other UPS workers in the New York City area, is helping to lead the way.

The Teamsters’ strike threat may seem surprising. UPS drivers have the sort of job that has become increasingly difficult to find, one that does not require a college degree but offers middle-class pay, good health-care benefits, and a pension. Today, a UPS package-car driver starts at twenty-one dollars an hour; a driver with four years on the job can make about forty-two dollars an hour, with the average driver earning ninety-five thousand dollars a year. But, according to many drivers, the job is far more stressful and demanding than a customer might imagine: they describe being subject to extreme time pressures, constant surveillance, and the risk of injury from handling heavy packages. And, of the Teamsters working at UPS, only about forty per cent are drivers. The rest toil inside UPS buildings, mainly as part-time package handlers, for less than half the hourly wage of veteran drivers. “They’re the ones that are really getting screwed at this point,” Scott Damone, a business agent with Local 804, told me.

Antoine Andrews started his career at UPS as an “inside worker,” as they’re called, in 1996, and the following year, when UPS workers went on strike, he joined his co-workers on the picket line. He was a “preloader,” working four or five hours a day, starting at 3 or 4 A.M. His job required him to take parcels off a conveyor belt and load them into a package car, making certain that every parcel was on the correct shelf, organized by address. He estimates that he would load “a little over a thousand” parcels in a shift. Workers who fell behind would pile the parcels behind the vehicles, but, he recalls, a supervisor would shout, “No stacking! No stacking! Get it in the cars!”

The job gave him nightmares. Sometimes he would dream that he was standing next to the belt, and “the packages are just coming, the volume is just increasing by the second, and packages are just all over the place.” The parcels start toppling off the belt and spilling onto the floor. “You’re trying to control it, but there’s no way of controlling it,” he said. “And I would just wake up, like, ‘Oh, my God!’ ”

After he became a driver, in 2001, a different nightmare haunted him. Andrews and his fellow package-car drivers have a certain number of stops they are supposed to make per hour, and if they fall short a supervisor could call them into his office: “Why did you have that gap?” In Andrews’s nightmare, he falls asleep in his package car on his lunch break. Five hours elapse before he wakes up, and, when he realizes what has happened, he panics, desperately trying to make up the lost time. Any worker who spends his days racing against a clock might relate to his anxiety: “Trying to catch up—and I can’t catch up.”

UPS drivers deliver more than five billion parcels a year in the U.S.—an astonishing number that reflects, in part, our national addiction to online shopping. In recent years, UPS’s revenue has increased significantly—it was projected to exceed a hundred billion dollars for the first time in 2022—but the company also has much more competition. In New York City, delivery vehicles now clog the streets. Some belong to UPS’s traditional competitors, like FedEx, but many display the Amazon logo. Amazon remains UPS’s biggest customer—until recently, it accounted for eleven per cent of UPS’s business—but it is now delivering many of its own packages. In addition, UPS faces a multitude of new competitors, including drivers who use their personal cars to drop off packages for gig-economy companies like DoorDash. Amit Mehrotra, a managing director and the head of transportation and shipping research at Deutsche Bank, told me, “We’ve been in an environment in the last two or three years that anybody with spare capacity in a Honda Civic could become a competitor to UPS or FedEx.”

Among delivery services, UPS is an anomaly—its workers are covered by a union contract. In fact, the company’s contract with the Teamsters is the largest private-sector collective-bargaining agreement in North America, and its unionized workforce has been growing—between 2018 and 2021, UPS added more than fifty thousand Teamsters-represented jobs. Today, UPS workers make up almost thirty per cent of the Teamsters. As Mehrotra puts it, “UPS has been the one oasis in the middle of a vast desert that is declining union membership in our country.” (Meanwhile, Amazon is in the midst of laying off more than eighteen thousand workers.)

Last summer, on an earnings call, Mehrotra asked UPS’s C.E.O., Carol Tomé, about the upcoming negotiations with the Teamsters. She said that she wants a contract that satisfies the company and the union: “These are great jobs that we value very much. Our goal with the Teamsters is win-win-win.” If some three hundred thousand workers walk off the job this summer, the consequences for the company could be severe, with non-union competitors taking advantage of the tumult to steal customers from UPS.

The battle over the next UPS contract will take place at an opportune moment for the Teamsters, as interest in union activism is surging among all sorts of workers, from college teaching assistants to Chipotle burrito-makers to Amazon package handlers. On the earnings call, Tomé noted, “Our workforce is very different than a lot of the workforce that you hear [about] in the media every day that are trying to be organized. They’re not paid the way that our Teamsters are paid.” If the Teamsters prevail, securing a stronger contract for UPS workers, the agreement could prove to be a powerful recruiting tool for the labor movement—and a crucial asset in the Teamsters’ quest to unionize Amazon workers. Sean M. O’Brien, the Teamsters’ general president, has said, “We’re going to take that contract, and we’re going to show the Amazon workers what you get when you join the greatest organization in the world.”

The relationship between UPS and the Teamsters is highly unusual, and dates back a century. As the company put it, “We have built UPS into the world’s leading package delivery company together.” In 1907, an enterprising nineteen-year-old named James E. Casey started a message-delivery service with a friend, taking orders by telephone from a tiny office in the basement of a Seattle saloon. By 1919, Casey had switched his focus to delivering packages, expanded to Oakland, and adopted the name United Parcel Service. The Teamsters had a strong presence in the Bay Area, and Casey invited the union to represent his workers. In “Big Brown: The Untold Story of UPS,” Greg Niemann writes that Casey “convinced his partners to extend an invitation,” telling them, “I think it’s possible to be a good United Parcel Service member and union member at the same time.”

In 1930, Casey moved the UPS headquarters to Manhattan. The company’s main customers were department stores, like Lord & Taylor, which once had their own delivery operations. In 1937, the Teamsters gave a charter to Local 804 to represent UPS workers in New York, and two years later Local 804 members, enraged that one of their co-workers had been suspended, went on strike. In the summer of 1942, they walked off the job again, to protest the treatment of some three hundred drivers who had been suspended after refusing to work overtime. In 1946, the workers went on strike again, this time for fifty-one days.

The New Yorker published a profile of Casey by Philip Hamburger in 1947. Hamburger revealed how Casey’s obsession with packages and his fastidious ways had fuelled the company’s growth and shaped its culture. “Over the years, Casey has taken what might look to outsiders like the simple job of handling and delivering packages and turned it into a semi-religious rite,” Hamburger wrote. “Drivers, for example, are governed by a series of regulations that could easily be mistaken for the house rules of a Tibetan monastery.”

Hamburger introduced readers to UPS’s “Manual of Instructions,” which directed drivers to be “courteous, well-behaved gentlemen” and not to “walk or drive over the customer’s lawn or garden.” In the mid-forties, UPS employed some six thousand men, including twenty-eight hundred in New York, and the company had already instituted two of the practices that would help make it an iconic American brand: delivery vehicles were painted brown and its drivers wore brown uniforms. (In addition, Hamburger noted, the drivers at the time wore “a brown cap with a gilt badge bearing a brown eagle and the message ‘Safe, Swift, Sure.’ ”)

Recounting the 1946 strike by the city’s UPS workers, Hamburger wrote, “Casey kept in close touch with all the developments of the strike, and he even turned up one evening at a meeting of the strikers at the Capitol Hotel and made a characteristically brief speech. ‘We’ve had strikes before. We’ve won ’em when we’ve been right, we’ve lost ’em when we’ve been wrong,’ he said, and then sat down. Casey fancies himself a stern man to deal with, but he is reported to have remarked from time to time during the final negotiations, ‘Living costs have gone up; the boys have got to eat.’ ”

Joe Allen, a former UPS driver in Chicago, details the history of Local 804 in his 2020 book, “The Package King: A Rank-and-File History of UPS.” He notes that “relations between Local 804 members and the New York management of UPS have always been stormy,” and describes numerous additional strikes, including one in 1962. At the time, Local 804 members were divided over UPS’s plan to bring in fifty part-timers and pay them twenty cents less per hour than full-timers to load and unload trucks.

Today, Teamsters Local 804 is among the largest UPS Teamsters locals in the country, representing about eight thousand employees at seventeen buildings in New York City and Westchester County and on Long Island. Antoine Andrews works out of the largest UPS building in Brooklyn, in Canarsie, where he is now not only a package-car driver but also one of Local 804’s lead shop stewards. Last July 28th, Andrews and some eighty other UPS drivers showed up to work earlier than usual, before 8 A.M. The drivers, who were wearing their brown shirts and shorts, gathered in a shady spot across the street from their building, chatting with one another over the occasional rumble of the L train. The temperature was already eighty degrees; by midafternoon, the day’s “real feel” temperature would climb to ninety-nine.

On this morning, Local 804 had organized a rally for its members, and now Andrews stood at the front of the crowd, microphone in hand. “Thank you for being in attendance,” he told his co-workers. “It is my honor to introduce 804 president Vinnie Perrone.”

Perrone, a burly fifty-eight-year-old, drove a UPS package car for twenty-four years before becoming Local 804’s president. “So, what brings us here today? What brings us here today is that I’m sweating!” Perrone said. UPS, he noted, had been posting record profits in 2022, “8.5 per cent over what they made last year during the pandemic. They have a revenue of 24.8 billion dollars in the second quarter. And they are projected—off of your backs, brothers and sisters—to have revenue of over a hundred billion dollars in 2022.”

He went on, “That’s great news, because they’re a solvent company—your jobs are secure. But here’s the bad news. A couple weeks ago, a brother, Esteban Chavez, died, twenty-four years old. From the heat!” (Chavez, a UPS driver, was reportedly found unconscious in his package car while on his route near Pasadena. The medical examiner has not yet determined the cause of death.)

Last summer, UPS drivers around the country were using thermometers to check the heat in the back of their vehicles; on social media, photos were circulating of temperature readings above a hundred and twenty degrees. Drivers had been demanding that UPS install air-conditioning in its package cars. The company—which had claimed that A.C. would be “ineffective,” because drivers get in and out of their vehicles so often—said that, among other measures, it was “accelerating the installation of fans” in package cars, and providing drivers with water bottles, cooling towels, electrolyte drinks, and freeze pops.

Teamsters leaders have said that UPS’s measures are not enough. Perrone mentioned another UPS driver who had recently made the news: “There was a kid in Arizona. I don’t know if you guys saw, the video went viral, where he collapsed—on the doorstep.” A doorbell camera had caught the moment, and the customer, who was not home at the time, was so disturbed by the footage that he made it public. In the video, the UPS driver stumbles toward the door with a parcel in hand, then falls to the ground, where he remains for a few moments, legs askew. The incident had occurred on a day when the temperature exceeded a hundred degrees.

“This is what I took from that video,” Perrone said. “They indoctrinate you so much that this kid got up after fainting from the heat in Arizona and rang the customer’s bell! ”

(UPS said in a statement to The New Yorker, “We have strong reasons to believe that this employee was not properly rested and hydrated prior to work that day and there may have been extenuating circumstances which resulted in the collapse.” In addition, the company said, “While there has recently been media attention on heat issues, we have always been faced with operating on hot days, especially in warmer climates. We believe that by training our people to be prepared—and by providing ample resources for support and hydration—we can continue to keep them safe.”)

Perrone told the crowd of drivers, “Today, people are going to say, ‘It’s a nice day.’ Yeah, it’s a nice day. But your package cars are still going to be way over a hundred degrees.” He talked about supervisors who tell drivers to find a “shady area,” or a “cooling station.” “But the next day, what do they do? ‘Oh, you had a gap in time.’ What do they do? They call you in the office and ask you, ‘What happened?’ ” he said. “Do not kill yourselves over this company when to them you are nothing more than a hand truck.”

Perrone handed the microphone back to Andrews. “I know some of you guys start at eight-thirty-five—just be sure to get in before then. I’ll make this short and sweet,” Andrews said. “Working with this company as a driver for twenty years, every single summer in the extreme heat, we all know the question from the customer: ‘Do you have A.C. in the vehicle?’ Right? Obviously, the answer is no. And the same response would be from the customer: ‘Well, that’s a shame. UPS makes tons of money.’ And they’re a hundred per cent right.”

He announced a moment of silence “for our brother Chavez.” Andrews bowed his head, and his fellow-drivers joined him. For a few seconds, the crowd was silent.

Andrews did not permit the silence to last too long. “Thank you,” he said, lifting his head. The drivers gathered for a group photo, and soon afterward they hustled off to work, a blur of brown uniforms crossing Foster Avenue.

There is a slogan on the wall of Local 804 headquarters: “Home of Ron Carey.” Carey started as a UPS driver in Queens in the mid-fifties, then went on to be elected president of Local 804, in 1967. In Steven Brill’s “The Teamsters” (1978), his seminal book about the union, Brill devotes an entire chapter to Carey, depicting him as an honest reformer, the antithesis of many of the men then wielding power within the union. (Its longtime leader Jimmy Hoffa, known for his clout and Mob connections, served time in federal prison for jury tampering, wire fraud, and other crimes.) In 1988, the Justice Department brought a racketeering lawsuit against the Teamsters, in an attempt to stamp out the Mob’s influence, and in 1991 the union held its first democratic elections for its leaders. Carey won, defeating five men, including Hoffa’s son, James P. Hoffa. When Carey took over, he got rid of the union’s private jet and cut his own salary from two hundred and twenty-five thousand dollars to a hundred and fifty thousand.

On August 4, 1997, four days after the Teamsters’ contract with UPS expired, Carey led the company’s workers in their first national strike. (By then, Jim Casey was no longer leading UPS. He died in 1983, at the age of ninety-five.) UPS’s increasing reliance on part-time employees to work as package handlers had become one of the union’s main issues; Carey decried these roles as “part-time throwaway low-wage jobs.” The strike halted UPS’s operations. Peter Jennings, of ABC News, declared it “the most dramatic confrontation between industry and organized labor in two decades.” Airline pilots and autoworkers, as well as Senator Paul Wellstone and the Reverend Jesse Jackson, showed up at UPS workers’ rallies. On the picket line outside the UPS hub in Maspeth, Queens, John Richiusa, a package-car driver, told an interviewer, “There’s enough money to share, and we’re going to make them share it.”

The Teamsters cast their strike not only as a battle against their employer but as a fight for decent jobs for all Americans. Their slogan was “Part-Time America Won’t Work.” Polls showed that a majority of the public supported the workers, and, in this P.R. battle, UPS found itself in a bind. “Rhetorically, it would have been easier for UPS to vilify the workers and to argue that they were greedy,” Deepa Kumar writes in her book “Outside the Box,” an analysis of media coverage of the strike. But “UPS could not do this, because the drivers are its public face.”

By the time the strike ended, the Teamsters had won significant raises and ten thousand full-time jobs. Richiusa recalled, “When we came back after the strike, they were applauding us in the street”—along Queens Boulevard—“and that’s not hyperbole. Because they know how hard we work. They see us covered in sweat, with salt lines striping our shirts.”

At Local 804, workers’ euphoria did not last long. Carey lost his position shortly afterward, amid a scandal related to the financing of his reëlection campaign, and James P. Hoffa became president of the I.B.T. He held the position for twenty-three years. In 2021, Sean O’Brien, the leader of a local in Boston, won the election to succeed him, defeating a Hoffa-endorsed opponent. “This is a moment that Local 804 members have waited for, and worked for, for a long time,” Perrone wrote in the local’s newsletter. “We finally put a fork in the Hoffa era.”

The last UPS contract that Hoffa’s team negotiated, in 2018, is still a source of rage and bitterness among many Local 804 members and other UPS workers across the country. It created a two-tier system for package-car drivers; those new to the job—known as “22.4s,” after the contract provision—occupied the bottom tier, with lower pay and less control over their schedules. Fifty-five per cent of the UPS workers who voted rejected the contract, but the I.B.T.’s leaders still imposed it on their members. (They invoked an archaic clause that was then in the Teamsters constitution, which permitted them to ratify a contract if less than two-thirds of the members had rejected it, and if less than half the members had voted.) “That gave the International Union leadership power to shove the contract down our throats and they did it,” 804’s newsletter stated.

Scott Damone, the Local 804 business agent, told me that, for decades, the I.B.T.’s leaders had favored the drivers, who are more active in the union, fighting hard for raises for them while paying less attention to their part-time co-workers. About the leaders’ past treatment of part-timers, he said, “They kept watering down the compensation, and, when they couldn’t water down the compensation any more, they went to benefits.” In the coming contract negotiations, he said, “it’s going to be very important to right some of those wrongs.”

This year, the I.B.T.’s list of demands at the bargaining table will include improving part-timers’ pay and securing more full-time positions. It will also include the elimination of the 22.4 provision, because those drivers “do the same job every single day as our regular package-car drivers but get paid less, have less protection under the contract,” O’Brien told me. “So that will be a strike issue.” He also mentioned addressing “the six-day punch,” when UPS workers are forced to work six days a week, which is not an issue for Local 804 but is elsewhere. The Teamsters plan to raise other workers’ concerns, too, including the lack of air-conditioning in package cars.

This past summer, the Teamsters adopted a tactic that worked well prior to the 1997 negotiations. Instead of waiting to see what UPS’s first offer will be at the bargaining table, the union launched a “contract campaign” a year ahead of time, with more than a hundred Teamsters locals holding rallies at UPS buildings and union halls around the country. During three days in early August, Local 804 held fourteen rallies. One of the largest took place outside the UPS hub in Maspeth on a Tuesday at 7:30 A.M. The crowd was mostly drivers. It also included one member of Congress, the left-wing Democrat Jamaal Bowman, who represents parts of the Bronx and Westchester County.

“Listen, this is serious,” Perrone said at the Maspeth rally. “This is something that could happen. Not that people want it to happen next year, but we have to let them know the time of the downtrodden worker is over. They’re going to tell you, ‘You make a good living.’ We’re going to tell them, ‘We need, want, and deserve more!’ ”

UPS drivers are paid essentially the same amount no matter where they live—a fact that, in Damone’s view, helps explain the militancy of Local 804. In a city like New York, with exorbitant housing costs, ninety-five thousand dollars a year does not buy the same comforts that a driver who lives elsewhere might enjoy. “There’s a lot more reticence to toe the line in New York, and I don’t think it’s just because we’re all obnoxious New Yorkers,” Damone said. “We’re not affluent off the job. Guys are just getting by.”

The event did not last long, and, afterward, inside workers staggered out of the UPS hub as their shifts ended. Their appearance told the story of their job’s rigors better than any union leader’s speech: they looked bleary-eyed and depleted. A sixty-three-year-old man emerged wearing a black T-shirt and faded, dirty jeans. He’d been working here for almost three years, he said, before trudging off. A slender twenty-nine-year-old was finishing a shift that had begun at 4:30 A.M. To commute here from his home in the Bronx, he said, he had to leave at 1:30 A.M., then take two buses and two subways. The starting pay at the Maspeth hub is typically $15.50 an hour for jobs like preloader—just fifty cents more than New York City’s minimum wage.

The fact that the starting pay is so low particularly rankles veteran inside workers, like Chris Williamson, Local 804’s vice-president. Williamson started working at the Maspeth hub as a preloader in 1988, when he was twenty and living in East Flatbush, Brooklyn. “My start time was four o’clock. I would have to leave my house like one o’clock in the morning,” he told me. “The reason I stayed was because minimum wage in 1988 was three dollars and thirty-five cents. UPS started me out at nine dollars.”

Mike Roberts, a longtime inside worker, walked out of the building a little after 9 A.M. He has what many inside workers want: a full-time job. His shift had started at 11 P.M. the previous day. He had worked at a machine that puts parcels into bags, he explained: “I have to zip them and put the sticker on them, and put them on the belt for their continued journey.” In Roberts’s view, the level of camaraderie within Local 804—between inside workers and drivers—is largely determined by whether a driver previously worked inside a building “versus came from the street.” About those drivers who never held an inside job, he said, “They kind of look at the part-timers or the insiders as if we are, quite frankly, their waiters. They definitely act like they are better than people on the inside.”

Perrone has been trying to stamp out this way of thinking. “There should be no package-car driver that would say that their job is harder than the preloader, because it’s not,” he told me. To succeed in their contract battle this year, the Teamsters will need to keep a united front—between inside workers and drivers, between veteran drivers and 22.4s, between “feeder” drivers (who drive tractor-trailers) and everyone else—and Perrone has been insisting on total solidarity. When seventy shop stewards packed into Local 804’s hall last fall, he told them that they needed “to start really pissing in people’s ears that we see on a daily basis about the pay inequities for part-timers, what we’re fighting for in the next contract, getting rid of the 22.4s. Because I’m not going to have package-car drivers or feeders or thirty-, forty-year inside clerks”—some of the highest-paid members of the local—“telling me, ‘Well, I’ve got it good, fuck everybody else.’ That’s not an option on this one.”

The main UPS hub in New York City is in Manhattan, at Forty-third Street and Twelfth Avenue, overlooking the Hudson River. It’s a squat brick structure, eight stories high and encompassing an entire block. Since it opened, sixty years ago, glass skyscrapers have risen around it, making it look, in the words of a company spokesperson, “like a little thumb.” The building once housed UPS’s national headquarters, and it’s not hard to figure out which top-floor office belonged to Jim Casey. His picture hangs by the door, along with a framed sign that reads “Jim Casey Occupied This Office 1962-1975.”

“It’s not a glamorous company,” Sarah Shatan, the UPS spokesperson, told me. “But the level of importance of this building and other buildings—I mean, it is unmatched.” One recent weekday morning, Shatan showed me around the hub, greeting supervisors by first name. The company’s policy book, which was first printed in 1929 and is still given to managers, instructs them to “use first names to generate a friendly and informal atmosphere.” Shatan told me that managers will read aloud from the policy book at meetings, and that some ask UPS executives to sign their copies.

The wholesome, old-fashioned image of the company which Shatan conveyed is in line with UPS’s reputation in the industry. Marc Wulfraat, a logistics consultant who has tracked the industry for decades, explained that FedEx is “the Cadillac of package delivery”—the best option if you’re shipping an item to another country and don’t care about the cost. But UPS is better known for its ground-delivery service, which is ideal for customers who are shipping within the U.S. and have a two-to-five-day time frame. UPS, he said, is “the steady-as-she-goes master that does all this work reliably.”

Newer UPS buildings reflect the industry’s shift to automation, but the Forty-third Street building is a “dinosaur,” as one manager put it. The bottom floors are still used for delivery operations, and because this hub is vertical—unlike most hubs, which are horizontal—the parcels take an unusual route. They are unloaded from tractor-trailers on the first floor, then travel on conveyor belts to the second, third, and fourth floors. There, preloaders take them off the belts and load them into package cars; drivers then head down a circular ramp to exit the building. Despite the antiquated setup, drivers from this hub delivered a hundred and forty thousand parcels on the day that I stopped by. It seems an amazing feat. And one that’s achieved with remarkable consistency. As Shatan noted, in a recent report on delivery companies’ performance, UPS came out on top, with an on-time-delivery rate of ninety-seven per cent.

On another recent morning, I went to Long Island City, in Queens, to visit the headquarters of Local 804. The union has occupied the same two-story building for decades, and it is now extremely run-down. The roof, the toilets, the air-conditioners—everything was falling apart. Stains streaked the carpets. “Excuse the dump,” Vinnie Perrone, 804’s president, said when I walked in.

Perrone sat at his desk, vape pen in hand, a photo of Ron Carey on the wall behind him and a black Teamsters jacket hanging on a coatrack nearby. In his view, UPS’s recent successes have come at a steep cost to its workers. When Perrone began driving for UPS, in 1994, he explained, he was delivering items that customers had ordered from “the Fingerhut catalogue or the Macy’s catalogue.” In his early years on the job, he said, “you’d curse and moan if you had a Gateway computer. Remember the cow boxes? It was three or four pieces, and they were big! You’d curse and moan if you had the old twenty-inch or twenty-six-inch TVs with the big backs. That would be once in a blue moon.” In those days, he recalls, the way the package cars were loaded was more organized. “Most times, you could just walk right through your truck. Everything was really in order on the shelves.”

Once online shopping took off, however, new items began appearing in the back of his package car. “You could order fire pits, barbecues, futons,” he said. He found himself wrestling with extremely heavy items, like outdoor pool covers. Car tires began to appear in the back of his package car, too: “People got into ordering tires, because you could get cheaper tires online instead of going to Goodyear or wherever. Stacks of four tires, banded together. A mountain of tires in the trucks. It’s very hard to navigate with stuff like that.”

Perrone made it twenty years before he had a serious injury. In 2014, he was trying to move a heavy box, “and I heard my shoulder rip. It felt like stitches popping almost,” he said. “I blew out my rotator cuff.” Three years later, he had another injury. As Perrone tells it, he was in the back of his package car when a fifty-pound box fell on his knee. The knee later swelled up “like a cantaloupe,” he said, and not long afterward he lost his job.

Perrone says that he was fired “because I got hurt on the job,” but his termination letter gives other reasons, including “failure to follow methods, procedures and instructions.” (UPS said that it “cannot substantiate or share personal employee information.”) The union got him his job back, and in 2019 he became president of Local 804. In his new role, Perrone likes to say, “my job is to make management feel exactly as uncomfortable as they make our members feel.” Today, he is also a trustee of the I.B.T., as well as its Eastern Region Package Director, tasked with helping other UPS locals prepare for this year’s contract battle.

After he became president of Local 804, one of the first fights he took on involved UPS’s practice of using “personal-vehicle drivers,” or P.V.D.s. UPS has long hired seasonal workers, but in 2015 the company began hiring P.V.D.s to drive their own cars and deliver packages during “peak,” the company’s busiest season, which runs from November to January. In the fall of 2019, company officials informed Perrone at a meeting that UPS was going to begin employing P.V.D.s within Local 804’s jurisdiction. “I said, ‘What did you say? S.T.D.s? DVDs?’ I already knew what was coming. And they looked at me and they said, ‘No, P.V.D.s.’ I said, ‘Yeah, no. We’re not agreeing to that.’ ”

Local 804 filed a grievance, arguing, among other things, that the Teamsters’ national contract with UPS prohibits package-car drivers from being required to use their personal vehicles. In 2021, an arbitrator ruled that UPS had violated the union contract but limited his ruling to 2019. The practice continues—and continues to anger Perrone. According to the arbitrator’s decision, UPS’s hiring of P.V.D.s increased tenfold between 2017 and 2019. This peak season, UPS hired P.V.D.s across the country; some of these drivers were getting thirty-eight dollars an hour in areas where the labor pool is shallow, like San Francisco.

Perrone is dismayed when he sees what UPS drivers in other parts of the country have said on social media about P.V.D.s. “It sort of creeped into people’s minds that ‘Hey, maybe P.V.D.s aren’t so bad, ’cause I’m getting out earlier.’ You know, because for once these guys and girls can be home a little earlier during the holidays,” he said. “But it’s not a good message to send out, because we want to keep our work. We want to not destroy the jobs that we have. We don’t want gig jobs. We don’t want Uber Eats or DoorDash.”

He might also have mentioned Amazon, whose delivery vans proliferate across the country. The drivers of those vehicles are not Amazon employees; they work for delivery services that have contracts with Amazon. There are also the drivers who work for the Amazon Flex program; they are independent contractors who use their own cars, signing up for shifts on an app. These convoluted arrangements make it much more difficult for Amazon to be held legally responsible for the drivers’ treatment. It also makes unionizing them nearly impossible; if drivers at a delivery company try to unionize, Amazon can simply cancel that company’s contract. (Amazon did not reply to a request for comment.)

The Teamsters are trying to organize Amazon’s warehouse workers, but they are limited in what they can do for Amazon’s drivers. “The sad part is that the government has allowed this independent-contractor model to basically exploit obligations of employers,” Sean O’Brien, the Teamsters leader, told me. “It’s really, truly diminished good middle-class jobs.” It’s also made it difficult for UPS, with its full-time drivers and regular start times, to keep up. Perrone told me that he recently saw an Amazon Flex driver delivering a package to a neighbor’s house at 5:45 A.M. “People are waking up to packages on their front doorstep,” he said. He imagined what might be going through the minds of UPS executives: “How can we compete with this nonsense?”

Last spring, Antoine Andrews began driving his route just three days a week, Monday to Wednesday. On Thursdays and Fridays, he now works as an organizer, part of a team of UPS drivers from Local 804. The team’s mission includes helping Amazon workers to unionize, but Andrews and his fellow driver-organizers have also joined rallies for Starbucks workers and travelled to Ohio and Kentucky to help DHL workers there who are fighting to join the Teamsters.

“He’s really going to do it—he’s going to replace the fork he dropped by stealing one from the next table. Get ready to swarm.”

Cartoon by Benjamin Schwartz

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I found Andrews one day at Local 804’s headquarters, where he was meeting with the other driver-organizers in a cavernous room. We sat down on the far side of the room to talk separately, but before long the other drivers started piping up from across the way. There seemed to be a strong feeling among them that the public does not truly understand what the job of UPS driver entails. But Andrews said, “I think the customers recognize that for two years we never clocked out. We were working every single day throughout the pandemic. While the customer stayed home and stayed safe, we delivered the packages.”

“They called us heroes,” said Antonio Rosario, who was a driver for nearly twenty years and is now a full-time organizer. “The amount of packages that were coming through the system at the time—it was like a year of peak! It was never-ending.”

“And the company made billions,” Andrews said.

“Billions!” Rosario repeated. “And we didn’t get anything. No type of hazard pay. No love.” He added, “And then, when the vaccine came out, of course we were the heroes again, because we were the ones bringing the vaccine to everyone.” (A UPS spokesperson pointed out that its contract with the Teamsters provides for pay, raises, and cost-of-living adjustments, but not bonuses.)

The conversation went on, with the men recounting stories from their years on the job. The promise of retiring with a full pension keeps many drivers at UPS for their entire careers. But the stresses of the work, both psychological and physical, can take their toll. “I’ve seen members who’ve been around a very long time,” Andrews said, “and throughout the years I noticed that the limp would become more noticeable.”

Dave Carew, a veteran driver who works out of a building in Suffolk County, has a route on Shelter Island, where his deliveries every summer include beach umbrellas and porch furniture. “My average is eight miles a day, forty-five flights of stairs. Half of that carrying something,” he said. In recent years, he had been contending with a herniated disk in his neck, which was making his arm and hand numb. Though everyone’s body breaks down with age, he said, “here at UPS your body breaks down a lot faster.”

Today, in place of Jim Casey’s “Manual of Instructions,” UPS drivers are required to follow “the methods,” the company’s set of extremely detailed directions for how to do their jobs. Some are intended to help drivers avoid injuries, with instructions like “Keep package close to your body.” The methods also include instructions about how to interact with customers (“Keep your customer contact brief and business-like”) and how to be hyperefficient (“Remember five or more stops in advance”). Drivers are told that, as they “move packages to the final selection area,” in the back of the package car, they should “visualize the actual delivery of each package.”

“The company has great methods,” Andrews said, reciting several from memory. He mentioned the “ten-point commentary,” UPS’s instructions for how to safely operate a package car. Drivers have been known to give it to their teen-age children when they get their learner’s permits. “It’s not going to eliminate accidents or injuries, but it works,” Andrews said. “But the company puts pressure on the drivers to move fast and cut corners.”

“ ‘Follow these methods—but we need you to work this fast! ’ ” Rosario said. (UPS objected to this characterization, saying that its methods “prioritize safety and efficiency. For example, drivers are trained to walk quickly and not run.”) Rosario went on, “When it comes to lifting packages over seventy pounds, you’re supposed to wait for help.” But he said that, in that situation, a driver is often told, “ ‘Oh, well, we have no driver in the vicinity that can get to you.’ Now, me, being a veteran driver, I say, ‘O.K., I can’t deliver this package today,’ and it’s missed. But there’s a lot of drivers out there that don’t know any better”—and they deliver the package anyway.

“I’ll correct you. They do know better,” Andrews said. “But they are scared.”

When I returned to the union hall a few weeks later, I met with the same group of men, and the conversation continued. Every stop is tracked, they explained, and each driver has a number that he or she is expected to hit—for example, fifteen stops per hour. With G.P.S. tracking and sensors on the package cars, a supervisor can find out just about everything: where every driver is at all times; who pressed his brake with too much force (known as “hard braking”); who backed up his vehicle ten times (backing up is discouraged, because it is more likely to lead to an accident). The company characterizes its use of sensors as a safety measure.

Not all surveillance at UPS is electronic. Sometimes supervisors will follow a driver on his route to watch him from a distance, a practice known as “on-road observation.” (UPS calls this practice a “critical part of our safe-driving culture.”) Jonathan Santiago told a story about how he and several other UPS drivers used to gather every day at a pizza shop on their lunch break. When the drivers walked in one day, the man behind the counter told them that their supervisor had just been by to check on them.

“He parked a good distance away from the pizza shop,” Santiago recalled. But the drivers figured out where he was, and they decided to prank him. “To let him know we know he’s there, we sent him two slices of pizza,” Santiago said. “They knocked on his door—and he left out of there!” The drivers in the room started laughing.

“My argument sounds better on vinyl.”

Cartoon by Sofia Warren

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“It’s sort of funny. You laugh about it because there’s nothing else you can do. But it’s actually pretty sad, too, because guys get mental issues,” Elliot Lewis said. “I know a guy who quit the job because he was paranoid.”

Matt Leichenger explained that the job had made him paranoid, too. His supervisor drove a gray Ford Explorer, he said, and the sight of that vehicle had started to haunt him. “I was constantly on the lookout for this gray Ford Explorer, because I was, like, ‘Are they following me?’ ” he said. “Even when I was off the job, when I’d see a gray Ford Explorer I’d look to see who was driving.”

The drivers explained that their workday does not end until they have tried to deliver every parcel in their package car, and the unpredictability of this schedule can lead to tensions at home. “We always say we have a start time but no finish time,” Andrews said. He added that “a lot of people get divorces,” and soon afterward he mentioned his ex-wife. “When I would say, ‘Hey, I’m working,’ at ten o’clock, she’s, like, ‘You’re not possibly delivering a package at that time.’ But I was!” he said. “So it will definitely cause an issue at home.”

Before long, most of the men had left the room, and only Andrews and Santiago remained. “You want to hear something, bro?” Santiago asked Andrews. He began talking about his children, how he used to miss school events all the time, how they would be in bed when he got home. “I missed a lot of good things with my kids,” he said.

Andrews said, “How many times you’ll make a delivery at someone’s door at five-thirty, and they open up the door, and you see the family at the dinner table. And they’ll say, ‘Hey, you want to come in? There’s space for you.’ ”

“You know what it’s like to make deliveries in the summertime, to look at a guy on his front porch having his beer?” Santiago said. “I’m, like, ‘Wow, I wonder what that feels like.’ Not to say that I want to drink, but it’s just, like, these people live a normal life.” He added, “This job takes a lot from you.”

On a Sunday morning not long ago, Local 804 held its last general-membership meeting of 2022, at a union hall in Nassau County. Any other organization that held a Sunday-morning meeting would likely have to contend with members straggling in late, but by ten o’clock there were three hundred Teamsters packed inside—a hundred of them standing at the back. Perrone, his executive board, and business agents were seated on a dais, facing the members. “For What It’s Worth,” by Buffalo Springfield, blasted from speakers: “There’s battle lines being drawn . . .”

The meeting started with Perrone calling the union’s newest members to the front of the hall. “You guys are just starting out. These gentlemen sitting here,” Perrone said, referring to a group of older men seated in the front row, “they’re retired. They made their twenty-five, thirty, thirty-five years in this company. There’s light at the end of the tunnel.” He added, “Just do the job right.” Perrone administered the Teamsters oath, and, when the new members finished reciting it, the crowd stood and applauded them.

“This is a contract year,” Perrone continued. “It’s very, very important that we pay attention to what’s going on.” He added, “As we always say, if you don’t participate, you can’t complain. We don’t want to hear it.” He mentioned the pay of UPS part-timers—“They deserve better!”—and then segued into a favorite topic: Tomé’s compensation package. “They won’t pay our members across the country a living wage, but you know what? C.E.O.s can have a twenty-seven-million-dollar benefit package per year. That’s not going to fly in 2023!”

The room erupted in applause. (UPS said that this figure is a “significant overstatement” and gave another figure for the value of Tomé’s total 2021 compensation package: “15.2 million.”)

In recent months, the Teamsters’ talk about their coming contract fight has become increasingly militant, but the union is heavily invested in UPS’s success. Local 804’s quarterly newsletter advises workers not only on how to file grievances but also on how to be reliable employees. One example: “Maintain good attendance, report to work on time every day, and never have no call /no show unless you’re in a coma.” And, as Amit Mehrotra, of Deutsche Bank, explained, UPS’s business strategy is inextricable from its unionized workforce. He mentioned the UPS driver who delivers to his home, in Atlanta: “he’s a great guy, and he’s been doing it for many, many years.” The driver in the brown uniform is key to UPS’s success, he believes, because “the most successful logistics companies are the ones that offer the best service.”

Mehrotra added, “Essentially, UPS’s success is tied to the long-term viability of its union labor, and the long-term viability of the union labor vis-à-vis the Teamsters is tied to the success of UPS. And how refreshing it would be if folks can enter these negotiations with that mind-set of ‘Hey, let’s try to figure out a win-win situation, because my success is your success and your success is my success.’ ”

The tenor in the union hall, however, was far more combative. Perrone mentioned that some of Local 804’s clerks were at risk of being moved to other positions, and added, “We’re not going to just lay down and let them take clerk jobs away!” Perrone turned the meeting over to members to ask questions, and those who wanted to speak formed a line in the center aisle. A seventeen-year UPS veteran eventually got his turn. While everyone else had addressed their words to Local 804’s leaders, this man walked around the microphone stand so that he could speak directly to his fellow-Teamsters.

The room went silent. Many of the union members knew his story: he was a former driver who had been shot while on his route two years earlier, in Queens. (A teen-ager in a stolen car, reportedly angry about how the driver had double-parked, fired a .22-calibre pistol and hit him in the stomach.) Afterward, he could no longer work as a driver. The union lobbied for many months to get him a new position, and he now works as a porter at a UPS building.

“Vinnie did the oath for the new members,” he said. Looking out over the crowd, he exhorted his fellow union members to stick together in the coming months, to not let their managers divide them. “My question to us is: How are we going to help them”—the union leaders at the front—“get us the best contract for 2023?” he said. “That’s the question we should all go home, talk to our families, meditate on, and, Monday morning, come in and fight. Because we need better language for everyone, from driver to preloader. We got to help each other out, brothers and sisters. We will not survive if we don’t.” ♦

Published in the print edition of the January 16, 2023, issue, with the headline “The Total Package.”