People Are Not Beer Cans

The struggle is not just about health care.
It's about how this country treats its
citizens, its workers and its unions.

By William Lucy

Three years ago the 104th Congress pulled the plug on health care reform, and today we are stuck with the market solution to sickness, a mess called managed care. It features diagnosis by accountants, drive-through mastectomies, childbirth on the run, hospital closings and the drastic loss of quality.

While the health care system burned, the 105th Congress fiddled with the problem but ended up dumping it on state and local governments. Not all of what Congress did was bad. For example, it created a $24-billion block grant for child health care. But it also tore more holes in the health care safety net, further jeopardizing public hospitals and mental health institutions.

Now it’s up to AFSCME to take the fight for health care reform to the state and local levels. Fortunately, we have some experience in that. When the 105th passed the buck on welfare, the grassroots activism of AFSCME locals and councils played a major part in softening the radical right’s war on the poor.

As things stand, both patients and health care workers are getting clobbered. That’s why the President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry proposed a consumer’s Bill of Rights, and that’s why AFSCME held a summit conference on health care in early December.

We’re taking the fight to the next step, and our goals are not modest. We want a health care system in which people are more important than profits, a system in which the bottom line is measured in quality, a system that treats its workers as assets instead of liabilities. Above all, we want health care that is not limited to those who can afford it but which is accessible to everyone, rich or poor.

In its hunger for profits, the managed care industry axed 163,000 workers between 1993 and 1995. About three-quarters found new jobs within a few months, but jobs that were more demanding — say, caring for 16 patients per shift instead of 12, or filling 250 prescriptions instead of 150 — and paid on average 12 per-cent less. That may produce bigger profits but quality goes out with the bedpans.

What we’re out to do is tough but not impossible. We beat Rick Scott, the former CEO of Columbia/HCA, when he tried to take over Blue Cross of Northern Ohio. We beat Sharp HealthCare in California, organizing the biggest unit of registered nurses in the country. We beat the Thomas-Davis Medical Centers in Tucson; when it tried to dictate diagnoses and treatment, its doctors and staff joined AFSCME.

Now, on behalf of the public, we have to get Congress to codify the Health Care Consumer’s Bill of Rights and Quality of Care. And on behalf of health care workers sacrificed to profits, we have to demand national retraining and adjustment policies.

We have to pursue these same objectives in state legislatures and county councils. We will not settle for treating either sick people or the workers who care for them like so many empty beer cans.

This struggle is not just about health care. It’s about how this country treats its citizens, its workers and its unions.

You know what we’re up against; you know it better than anyone else. You’re there every day, working in those places where decent public services and quality health care can literally be the difference between life and death. At the grassroots. On the front lines. In the hospitals and clinics.

It’s too late to unprivatize the hospitals that used to be dedicated only to serving the public; it’s tough enough for many public hospitals just to keep their doors open. But it is not too late to help the great hospitals that still serve the public, defy the profiteers, survive their assaults, and come out on top.

We can — and we will — win because this union has a couple of rare qualities: the members’ flexibility and creativity. These are among AFSCME’s greatest strengths.

Environmental activists have a slogan: Think globally, act locally. That is precisely what we are doing. Whatever we do to bring about real reform in health care, whatever we do to put a stake through the heart of privatization, whatever we do to halt the efforts to gut the laws protecting working families, whatever we do to preserve government of, by, and for the people has to start at ground zero, and Sisters and Brothers, that’s where you live and work.