Why Not Health Care?
by Jeff Crosby
AFL-CIO Weblog
Feb 22, 2008
Andy, an IUE-CWA Local 201 member, looked at his pension check from General Electric as he sat in my office at the union hall. The local vice president and the president of the retirees association usually respond to benefit questions like this. But they were both on vacation, and I was struggling to catch up and be of some help.
“I got the $40 raise you told us about in December” he told me. “Then in January, I lost it again, plus another $6. What good was it? What happened?”
A conference call or two later, and we both knew three things had happened. In December, his pension went up $40. In January, his health care went up $46. So when the dust settled, his pension check dropped by $6. And keep in mind that he is one of the lucky ones: The share of employees offering any group health insurance at all to their retired workers dropped from 66 percent in 1988 to 33 percent in 2007.
We fight and fight, but health care costs are killing us. And you can’t bargain your way out of this mess. Understandably, getting the labor movement on the same page on a specific plan to fix health care is no easy task. I can’t even get all the local unions in my labor council to support the same person for school committee!
Still, we hope for another chance for health care reform in January 2009 if we do well in the elections this fall. The buzzwords are flying for health care reform: “Secure,” “Affordable,” “Universal” and “Quality.”
The “universal” part will peel off a Republican or two. They just think that people make bad health care choices; it’s their fault if have lousy health care. As some mainstream economists would have it, bad choices in the health care market by uneducated consumers are the root of the problem. (Check out a “solution” that targets consumers and providers—and not coincidentally leaves the drug companies and insurers off the hook—as offered by the former head of GE’s medical center in Lynn, Mass., and Newt Gingrich.)
There are winners and losers, right? Someone explain that to Andy the next time he drops by the union hall.
The problem is this: Practically everyone uses the same words when they talk about reforming health care. What elected official is against “secure, affordable, quality” health care? If you use buzzwords that are that broad, or a list of good principles 70 words long, you leave a lot of wiggle room for the next president and Congress to provide lousy answers under the same umbrella. Principles and buzzwords can mean a lot of things to a lot of people.
We have to be very sharp to make an impact.
First, we have to identify what we are for—specifically. The best laws, like Kennedy-Dingle that would expand Medicare to those between ages 55-65 and children under 20, and the Conyers single payer bill (H.R. 676) that would overhaul health insurance completely, are included in our AFL-CIO campaign. Even the proposal to expand Medicare has problems, since in its current, increasingly privatized form, Medicare costs themselves are increasing rapidly. The single-payer approach should be upfront—anything short of that we can deal with later, if necessary, as a compromise.
Second, we have to take head-on the issue of “government” control of health care. We can expect the right wing and health care profiteers to fund a zillion ads suggesting that some government apparatchik will be snuffling through our medicine cabinet and yanking IV’s from our aunt Ethel—even if we say we are talking about government in a “watchdog” role and not “in control”.
The right wing is not moved by fine distinctions, and being on the defensive won’t help us. It’s either the government or the insurance companies and drug companies that make the rules and run health care. And the latter have to get out.
I know, people are wary of big government. The problem of rebuilding support for the public sector in general as a campaign for the public good is more than I can go into here, but it’s arguably the key task of the labor movement today. Sure, building trades folks have problems with the city inspectors when they do side jobs. A buddy of mine got screwed by the zoning board when he tried to remodel his garage. It has taken my brother months to figure out the “Aid and Attendance” benefit from the VA for my dad. Nobody wants to pay taxes, and everybody thinks the governor and the mayor (apparently all of the mayors, everywhere) and his buddies are ripping us off. On the other hand, we know that 82 percent of union members want government to do more on health care. So we think conflicting things, side by side. It’s called confusion. The answer to confusion is clarity, even if it takes a while to get there. It is suggested that if we are asked if we support something like the Canadian health care system, we denounce the question as “scare tactics.” Yet even an article by Stanley Greenberg in the American Prospect last June, which is sometimes circulated as a cautionary note on why we have to soft-pedal government’s role in health care reform, says: “A majority goes so far as to say it’s time to establish a Canadian-style health care system.” If a majority of the American people already support it, why should those of us fighting for health care reform not defend it?
According to our own research, three times as many people think health care in Sweden is better than ours, as compared to those who think we have a better system than Sweden. Sounds like a rejection of the market-driven health care flop in favor of those Volvo-driving socialists.
Give me a chance to argue the guv’mint against the insurance companies and drug companies, and I’ll deliver you the majority every time.
In a catastrophic illness, the insurance companies are appreciated. But I fought my insurance company for five months to get them to pay for treatment of my son’s broken collarbone when he fell snow-boarding at Sunday River in Vermont—the last two months because they would not pay for $5 worth of ibuprofen. I fought my insurance company again when they wanted me to pay for my wife’s mammogram out of my own pocket. The hospital gave the insurance company the wrong Social Security number for my wife (even though she used to work there!), and by the time they corrected it, the insurance company said the bill was submitted too late. So the hospital put collection agencies on me. These were high-level negotiations. As in, “Hey, have you ever broken your collarbone? Well, IT HURTS!”
People like Andy get a little cranky when William Van Faasen, CEO of Blue Cross Blue Shield of Massachusetts, walks off with $16.4 million in retirement benefits—and then, oops, doesn’t quite retire after all and continues to pull down $3 million a year in salary and bonuses as chairman. And we call BC/BS a “nonprofit”.
Quality health care? The American Academy of Dermatology reported you can get an appointment for Botox to get rid of those pesky wrinkles on your face in eight days—but it takes more than three times as long to find someone to evaluate a potentially cancerous mold on the third wrinkle from the left. Free-market health care follows the money. And the insurance companies only want to offer health care to people who don’t need it. Is this some kind of a revelation?
The next time your prescription drug “co-pay” creeps up, remember that the drug companies are making three times the profit rate of the average corporation. Still want your co-pay to foot the bill for the 80,000 full-time salesmen who knock on doctors’ doors to offer “incentives” to push the latest pill?
Medical “free-market efficiency” has one hand in my pocket and the other on my throat. I don’t need another focus group; I need a Louisville slugger.
We’re trying to break out of the “neo-liberal box” of privatization, deregulation and free trade that has been choking us for the last several decades. There is no ducking the argument of government control vs. market-based health care. There’s no shortcut. Health care is not just another commodity.
This is a street fight. We can win, even if it’s not in January. And sooner or later, we have to win this one.
Jeff Crosby is president of IUE-CWA Local 201 in Lynn, Mass., where he also heads up the AFL-CIO’s North Shore Labor Council.