Health Care on Life Support
By Susan Ellen Holleran
Rising costs and lack of access to health care coverage is a national problem needing a national solution. Yet the Bush administration continues to ignore it.
MINNEAPOLIS
President Bush has made the nation's health care crisis even worse by failing to address the needs of the huge number of Americans who are caught in an ever-tightening squeeze between increasing medical costs and decreasing health insurance coverage. While the Democratic candidates are debating which of their health care reform proposals is better, Bush does not even have one.
Hundreds of thousands of AFSCME members face rising costs and declining coverage. The government and private agencies for which they work, under severe budget pressures, are trying to shed their obligations to provide health coverage — leaving some members with few if any alternatives to care for themselves and their families.
Jess Sundin and Vanessa Vasquez are two of those members. They joined their co-workers from Local 3800 and Local 3801 (Council 6) in a 15-day strike against the University of Minnesota because they didn't have any choice (see back cover). Just the increases in the premiums and co-pays the university demanded would have eaten up about $2,000 — six weeks' take-home pay — for each of the clerical support workers! Management's proposal offered no pay increase, and it dismantled the step system that the unions had struggled so hard to win in their first contracts.
Sundin has an immune-deficiency disease. She is very vulnerable to infections like bronchitis and pneumonia and has severe osteoporosis. She struggles to keep ahead of her medical problems and stay out of the hospital. Her health care bills are already high, and she doesn't see how she can pay even higher ones. But Sundin is also concerned for her fellow employees: "We're the university's lowest-paid workers. I'm afraid that many will opt out of the insurance plan because they can't afford it. The U has not seen health care as a priority."
Vasquez is the single mother of a two-and-a half-year-old daughter, who has had a number of health problems since birth and needs expensive prescription medicines. Vasquez already has a second job to cover child care expenses. She loves her work, but the university's proposals are making her consider other, higher-paying jobs.
"Why is it that the lowest-paid employees get hit the hardest?" she asks. "For the president of the university, $142.50 bi-weekly probably seems like small change. The higher ups aren't suffering: They're getting raises."
The strikers didn't get everything they wanted. Management will implement its health care plan, but the employer will contribute $200 to medical expense accounts — and reopen the contract for health insurance — in 2005. The union won pay increases to help cover the added costs.
WHAT'S GOING ON? According to the 2000 Census, almost 44 million Americans have no health insurance. Most of them are workers and their children. Another 62 million have inadequate coverage.
The Commonwealth Fund reported that, as of 2001, the uninsured rate for large employers — with more than 500 workers — had grown to 32 percent. More than one in four of the nation's uninsured worked for those corporations or were dependents of those workers.
For years, unions and progressive organizations have spoken out about the need for national health care. President Clinton developed a plan but couldn't get it through Congress. Since then, the problems have gotten worse: More workers and retirees have lost coverage; the population is getting older and will need more care; and prescription drug costs have skyrocketed. Unfortunately, Congress in late November passed an administration-sponsored Medicare "reform" bill that only makes many of the existing problems worse.
WAL-MARTIZATION. When General Motors was the country's largest employer, other corporations felt the pressure to compete for workers and offer benefits similar to those the United Auto Workers (UAW) negotiated. Today, Wal-Mart has the nation's largest workforce, and it is leading us in a race to the bottom, that is, to lower wages and very few benefits. Over the past two years, hundreds of thousands of workers have struck — or threatened to strike — when the corporations they worked for decided that cutting employee health benefits helped turn a profit.
UAW members at the Big Three automobile manufacturers and employees at telephone giant Verizon, who are represented by the Communications Workers of America and the IBEW, were pushed to the brink of striking when their very profitable employers tried to gut their benefits. General Electric and Hershey Foods' employees did strike.
Wal-Mart's impact on today's health insurance negotiations is clearest in Southern California where more than 80,000 members of the United Food and Commercial Workers, employed by four grocery chains struck — or were locked out — in October. Corporate managers, citing competition from Wal-Mart, demanded wage reductions, increased out-of-pocket health care costs and made simultaneous cuts in coverage.
Nationally, fewer than half of Wal-Mart's workers actually enroll in its plan. Participation requires a six-month waiting period — up to a year for pre-existing conditions — and retirees get no coverage. Deductibles range up to $1,000 a year for individuals, a budget breaker for workers averaging $8 an hour. Preventive care like flu shots, well-child checkups and inoculations is not included.
Wal-Mart encourages its employees and their families to use government-run programs. More than 10,000 children of Wal-Mart workers were enrolled in PeachCare, Georgia's health insurance program for children, at a cost of about $6.6 million to federal and state taxpayers. In Washington state, Wal-Mart is the employer with the largest number of employees' children in Medicaid.
SIMPLY WRONG. Developing the type of health care system that ensures affordable access for all will take national leadership. George W. Bush does not see health care as a priority, so it will take a new President to make the needed changes. In the meantime, AFSCME activists must fight to protect our coverage.
When Minnesota tried to implement a health care plan that would have increased some state employees' out-of-pocket costs by more than $6,000, Council 6 fought back with an aggressive, grass-roots campaign and a message: "It's simply wrong" to balance the budget by cutting health care for families. The bargaining committee stunned management with a suggestion to tie health care costs to salary levels. The union's research had shown that the average state worker spent 110 hours of pay annually, while an agency head spent only 42 hours.
"If you earn more, pay more," explains Marybeth Juetten, Local 753 (Council 6) chief steward. "There's a big difference between a $20 co-pay for someone earning $20,000 a year and somebody getting $200,000. If we expect that 5 to 10 percent of our wages will go to health care, it should be the same for higher-paid people."
As with the University of Minnesota workers, health care expenses do take up a large chunk of the average worker's pay. According to a Consumers Union study, families with $100,000 incomes spend 3 percent on health care — compared with 6 percent for families making $45,000, and 17 percent for those struggling to get by on $10,000.
Juetten's co-workers understood the importance of the issue, and it strengthened their solidarity. "We're probably the most union that we've ever been," she says proudly. That commitment to fight for fairness changed the dynamics and forced the state to improve its offer with more lower-cost options. State employees ratified the new two-year pact by a two-to-one margin.
On the West Coast, Washington Federation of State Employees/AFSCME Council 28 has been fighting from the inside to maintain good benefits. About 10 years ago, the council won a seat on the state's Public Employee Benefits Board. Pro-active involvement has helped maintain high benefits along with the lowest possible premiums and co-pays, says Council 28 Exec. Dir. Greg Devereux. The union's presence was especially important in 2002 because the legislature had been very stingy with health insurance funding.
The WFSE made a strategic decision to focus on keeping co-pays down even if that meant compromising a little on premiums. Access for all covered workers was also a priority: Many state employees live and work outside major urban areas, and health care resources are scarce.
Member participation strengthened the union's position. Activists lobbied in person and by phone, mail and e-mail about their health care needs. On Health Care Action Day, for example, "We rallied and flooded the governor and the Health Care Authority with calls and e-mails on rising costs," says Devereux. They convinced the board to put extra pressure on the insurers — to get the best possible deal. Through tough negotiations, the state was able to keep the costs down, maintaining co-pays at a reasonable level.
