Labor Campaign for Single Payer
January 2013 - Chicago
Campaign Coordinator, Campaign for a Healthy California
Bay Area Labor Committee for Improved Medicare for All
Preparation for your presentation -
Think about your audience
• While there are common • Research and ask
themes, some unions are questions –
dealing with specific • Develop a couple of slides
issues: that will speak to your
• Part time workers specific audience
• Retiree H&W • Tailor your presentation
• Trust Funds to the amount of time
• Right now, we have to you are given
deal with jobs, or the • Always ask them how
election, or, or, or, or they think we can move
Some Sources for Information
• Kaiser Family Foundation
• Commonwealth Fund
• California Health Care
• California Nurses
• Physicians for a National
Health Program (PNHP)
• Labor Campaign for Single
• UCLA Center for Health
• UC Berkeley Labor Center
Guarantee Healthcare for Every Worker
by Guaranteeing Healthcare for All
What’s the Climate and Future for
Cumulative Increases in Health Insurance Premiums, Workers’ Contributions
to Premiums, Inflation, and Workers’ Earnings, 1999-2012
Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012
The Downward Pressure is Tremendous!
Among Firms Offering Health Benefits,
Percentage That Offer an HDHP/SO,
Kaiser Family Foundation: 2011 Employer Survey
“They wanted a 30% increase, but I got
them down to 20%”
They throw 20% on the collective
bargaining table and watch management
and labor eat each other alive.
“Your group is old, fat and expensive.
That’s why rates are going up”
Why is it every other modern country has
similar demographics, - pays less, insures
everyone, and has better quality?
“We are going to develop a network of
hospitals and physicians based on cost
What happens to hospitals in poorer
neighborhoods who serve the sick and
Healthcare money gets moved to wealthy
“Electronic Medical Records are going to
A banking and IT initiative to collect
our data, and corporatize our health!
30 cents of every dollar spent on
healthcare goes to keep you from
seeing the provider you want to see
and denying you the care you need.
In a recent statement discussing the
rate increases, “Blue Shield said it
expects to have lost $10 million to
$20 million on its individual health
plan business in 2010 and to lose
$20million to $30 million this year.
It’s costs for hospitals, physicians
and prescription drugs have risen an
average of 15 percent annually each
of the past three years.” –
Bargaining for health insurance is a failed
1980s – PPOs were going
to control the cost of care
1990s – Consolidation and
Organized health systems
(HMOs) were going to
control the cost of care
2012 – Accountable Care
Organizations and medical
homes are going to control
the cost of care
2012 Kaiser now realizes
getting healthy is good for
us, but is not going to
More fancy power points
from third party
Some Research for Unions on
Among All Large Firms (200 or More Workers)
Percentage of Firms Offering Retiree Health Benefits,
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012
• Calculating the
obligation for post-
retirement benefits is
not a precise science.
It’s a SWAG!
• The actuarial report is
like reading The
Retiree H&W is not a mandatory
subject of bargaining
PITTSBURGH, Feb. 22 /PRNewswire/ -- LTV Steel
has informed the union that the Voluntary Employee
Beneficiary Association (VEBA) trust -- which has
paid for part or all of retired Steelworkers' healthcare
and life insurance benefits since June 2001 -- will not
be able to assure payment of health-care claims past
March 31, 2002, and all LTV hourly retiree
healthcare and life insurance benefits will end on that
date, the United Steelworkers of America announced
STOCKTON - Franklin Advisers Inc., a global
investing firm, and Wells Fargo bank ... Bankruptcy
judge: Stockton can stop paying for retiree health
care - 8/6/12 ...
City of Stockton
Stockton filed for bankruptcy on June 28 and on July 1
adopted a budget that included unilaterally reducing
retiree health benefits. That illegally impaired the city's
contract with retirees, the plaintiff's claimed.
U.S. Bankruptcy Court Judge Christopher Klein
disagreed. The key sentence in his 40-page opinion on
Aug. 6 fleshed out a shorter ruling for the city he issued
several weeks ago.: "In sum, even if the plaintiffs'
benefits are vested property interests, the shield of
the Contracts Clause crumbles in the bankruptcy
Kodak to end healthcare benefits,
solves $1.2 billion liability
(Reuters) - Bankrupt Eastman Kodak Co said on
Wednesday it was ending retiree healthcare and
survivor benefits at the end of the year, allowing it
to resolve a $1.2 billion liability, one of its biggest
The benefits, which include medical, dental, life
insurance and survivor income benefits, will end
Reuters 10/10/2012 8:13:32 PM ET 2012
The Affordable Care Act
• Not much help for union negotiated plans:
– Taxes “Cadillac” plans starting in 2018
– No cost control
– Union negotiated plan will compete with high
deductible plans on the Exchange
– Employer penalty - $3,000 per year
– Even the ACA experts project 3 – 4 million
uninsured by 2019
Conservatives have captured the
public with the frame….
By building from the bottom,
• I live on a minimum means we keep for those
wage, why shouldn’t that are what’s on top!
• I don’t have a pension,
why should you?
• I don’t have health
insurance when I retire.
Why should you?
Worse, why should I pay
taxes for yours?
AFL-CIO 2009 Convention
The Social Insurance Model for Health Care Reform
Submitted by Alameda Labor Council (Calif.), California Nurses
National Nurses Organizing Committee and International
Longshore and Warehouse Union
“Whatever the outcome of the current debate
over health care reform in the 111th Congress,
the task of establishing health care as a human
right, not a privilege, will still lay before us. We
continue to believe the social insurance model
should be our goal, and we will continue to fight
for reforms that take is in that direction.”
How does our healthcare system
We spend more……..
But we get less……….
Hospital Inpatient Days per 1,000
Average Annual Number of Physician
Visits per Capita, 2009
Source: OECD Health Data 2011 (June 2011).
AUS CAN GER NETH NZ UK US
OVERALL RANKING (2010) 3 6 4 1 5 2 7
Quality Care 4 7 5 2 1 3 6
Effective Care 2 7 6 3 5 1 4
Safe Care 6 5 3 1 4 2 7
Coordinated Care 4 5 7 2 1 3 6
Patient-Centered Care 2 5 3 6 1 7 4
Access 6.5 5 3 1 4 2 6.5
Cost-Related Problem 6 3.5 3.5 2 5 1 7
Timeliness of Care 6 7 2 1 3 4 5
Efficiency 2 6 5 3 4 1 7
Equity 4 5 3 1 6 2 7
Long, Healthy, Productive Lives 1 2 3 4 5 6 7
Health Expenditures/Capita, 2007 $3,357 $3,895 $3,588 $3,837* $2,454 $2,992 $7,290
Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).
Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International
Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians;
Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for
Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).
“I don't believe there's any
problem in this country, no matter
how tough it is, that Americans,
when they roll up their sleeves,
can't completely ignore.”
Is Your Health a Commodity?
insurance company is
competing for ill patients?
For profit –avoid care
Not for profit (fancy tax
Physicians – new payment
arrangements allow them to
keep what they don’t use
No health planning!
Do we build hospitals where
we need them, or where
they can profit, or have Are we going to allow Wall Street to control our
enough insured lives to health?
It’s About Solidarity!
Unions in other
have figured out the
only way they
are going to keep
what they have is by
Are We Organizers or Bean Counters?
Are we going to keep nibbling around the edges
attempting to fix a system that can’t be repaired?
“Significant social change comes from the
bottom up, from an aroused opinion that forces
our ruling institutions to do the right thing”
Senator Paul Wellstone
Framework for Health Care
• Lead with a moral message of
• Health Care is a Human Right
or we need
Guaranteed Health Care for All
Start with agreeing on a common set
of values and economic principals
•Everyone should be •No one should profit
treated by a medical from people’s suffering
professional if they are ill
•Pricing for medical
•Medical care should be services should not be a
returned to the hands of secret. We need public
medical professionals, disclosure
not insurance company
bean counters •There should be no
barriers to our health –
•Everyone should pay everyone is covered
their fair share
Keep it simple
•Unions can’t deliver Join Bay Area Labor
healthcare or a wage Committee and support
increases until we get Campaign for a Healthy
California or other like
everyone under one minded groups (insert
plan and control costs your ask)
•Start an education
campaign with your
A Proper Sense of
DC - 1968
“On some positions
cowardice asks the
question, it is safe?
Expediency asks the
question, is it politic?
Vanity asks the question, is
it popular? But conscience
asks the question, it is
right? And there comes a
time when one must take a
position that is neither
safe, nor politic, nor
popular, but must take it
because conscience tells
him it is right.”