Health Care

AFSCME's Plan: Health Care for America

AFSCME members have urged fundamental changes in America’s health care system. At recent International Union Conventions, AFSCME members have developed a health care reform blueprint and an Rx for the Health Care Crisis. In the broadest sense, there are five basic elements to our plan:

1. Guarantee everyone a choice of plans, including allowing people to keep what they have now.

Many AFSCME members are satisfied with their current plans, but they are concerned about high costs and the continuing erosion of benefits. The union’s position is that we need more choices, not less, and that creation of a public plan option will provide everyone with a high quality option that will help maintain affordability while not forcing a one size fits all approach.

2. Require employers to pay their fair share.

Our health care system is based on employer provided benefits. Yet some employers are shirking their responsibility. AFSCME supports a “pay or play” approach where employers either provide a comprehensive set of benefits or make a substantial payment towards the costs of those benefits so their workers can purchase a plan. The fact that some employers do not provide health benefits or make a meaningful payment towards their cost creates an uneven playing field that puts responsible employers at a competitive disadvantage. In the case of AFSCME members, the companies that seek to privatize our jobs often do not pay for quality health benefits and that puts our jobs at risk. AFSCME proposes a significant fee on all employers who fail to provide benefits.

3. Government must be an advocate to control costs, ensure quality, and keep the insurance and drug companies in check.

Some argue that the “free market” is the best approach to health care but AFSCME rejects this view. It’s over-reliance on the current market system that has created our problems. AFSCME believes we need a greater government role to control costs and make health care affordable. We need the government to negotiate prescription drug prices so we pay no more than people pay in Canada or Europe. Government should set standards so computer systems can communicate with one-another in order to increase efficiency and reduce errors. Government must also work with doctors to fund research so we can develop the most effective treatments of disease and discover how to better prevent people from getting sick in the first place. Our government must be a leader and an advocate for people in the health care system. Right now, the government role is largely limited to paying for care. We need the government to be more active in working with the health care providers to create a better health care system. Only the government can do this; it cannot happen by market mechanisms alone.

4. Create a public plan option, modeled on Medicare, available to everyone.

People in the Medicare program report high levels of satisfaction. They get to choose their doctors and hospitals, the claims process is easy to understand and is almost always trouble-free, and the program is the most cost efficient in America. AFSCME believes a program like Medicare, but with benefits adapted to a younger population, should be made available to everyone. No one would be required to take the option, but the fact that it is available will put pressure on insurance companies to improve their performance and become less profit-driven and more focused on their customers. The creation of this option will be an opportunity to demonstrate the effectiveness of the program and could ultimately lead to the creation of a single-payer system by choice, rather than by legislative mandate.

5. Guarantee high quality coverage for everyone.

In America, no one should go without health care. Reducing and ultimately eliminating the lack of reliable health coverage for 47 million people is both a moral and financial imperative. Lack of coverage means people get care in emergency rooms. When these people cannot pay their bills, the hospital raises charges for the rest of us to make up for the shortfall. It is estimated that this practice, known as cost shifting, results in family insurance policies costing $1,000 more a year than they would in the absence of cost shifting. In addition, even if younger and healthier people are voluntarily going without coverage, that negatively affects health care affordability for everyone else. A major problem with our insurance system is that some people opt into it only when they’re sick. This is contrary to the whole idea of insurance because financial risk should be spread out among the entire population because, at some point, everyone will need health care. If health insurance is purchased by only the older and sicker population, than no one will be able to afford it.

Lack of health care coverage in America is not a matter of lack of money. We spend far more than any other country, on a per person basis, yet we have a higher percentage of uninsured people than any other developed country. And, the statistics show that our health status is no better, and in many ways worse, than in other countries. The World Health Organization ranks the US healthcare system 37th; just behind Costa Rica and just ahead of Slovenia.

It is also not sufficient to fight for health care coverage when millions of Americans lack access to quality preventative and remedial care.  There are far too many medically underserved areas in America and we must create greater equity in health care access, treatment, research and resources to all people and communities across the nation.

Print Version