Blog

Mike Hall

By Mike Hall
AFL-CIO Senior Writer

Between 2007 and 2009, with increasing unemployment and workers losing their employer-provided health coverage, along with declining incomes, the number of uninsured non-elderly Americans increased from 45 million to 50 million, according to a new report.

The report, in the journal Health Affairs, also examines changes in health insurance coverage over the past decade and found that even in years of economic growth, the number of uninsured climbed as more and more employers dropped health coverage for their workers.

The study, by John Holahan of The Urban Institute for Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) also found that while the number of children with health coverage grew, even as employer-provided insurance declined, most of that was due to increased coverage by Medicaid and the Children’s Health Insurance Program (CHIP).

Throughout the past decade, even in good economic times, the number of Americans with employer-sponsored insurance has fallen, and the number of uninsured Americans has increased. This finding underscores the importance of planned coverage expansions under the Affordable Care Act. (more…)

Leo W. Gerard

By Leo W. Gerard
International President

Let’s go back, just for a minute, to a time before screaming teabaggers, before Republicans decided to kill health insurance reform as a means to politically destroy this country’s first African-American president.

Try and remember what it was like before discussion of health insurance reform raised voices, a time when instead it raised concern. Recollect Aug. 7, 2007, during the Democratic primaries, when then-60-year-old retired and disabled steelworker Steve Skvara stood at a microphone during a political debate and told his story with tears in his eyes and a catch in his throat.

He’d worked more than 30 years at LTV Steel in East Chicago, Ind., and assumed like many who earned pensions and retiree health coverage that those benefits were guaranteed. But then LTV went bankrupt and ditched its obligations. Skvara told the candidates:

“Every day of my life, I sit at the kitchen table across from the woman who devoted 36 years of her life to my family and I can’t afford her health care. What’s wrong with America, and what will you do to change it?”

Skvara asked that question two years ago when 45 million Americans lacked health insurance. Now 46.3 million are without it.

And yet, teabaggers and Republicans are bent on preventing reform. They want to ensure only one thing – that another million Americans suffer no health coverage two years from now.

President Obama invoked Skvara’s name at the AFL-CIO convention in Pittsburgh on Sept. 15 in a speech about the middle class.

Mostly Skvara is a symbol of health insurance failure. But to Obama, he’s an emblem of something much bigger. It is a struggle of economic philosophies. For the past 20 years, the winning view has been that government should give breaks to big corporations and rich individuals. Obama told the AFL-CIO he believes in something different — an economy built on a vibrant and wide middle class.

Here’s what he said:

“For over half a century, the success of America has been built on the success of our middle class. It was the creation of the middle class that lifted this nation up in the wake of a great depression. It was the expansion of the middle class that opened the doors of opportunity to millions more. It was a strong middle class that powered American industries, propelled America’s economy, and made the 20^th Century the first American Century.

And the fundamental test of our time is whether we will heed this lesson; whether we will let America become a nation of the very rich and the very poor, of the haves and the have nots; or whether we will remain true to the promise of this country and build a future where the success of all of us is build on the success of each of us.”

Because of the extraordinary cost of health care in this country, insurance is a middle class issue. Health insurance can make or break a family – place it firmly in the middle class if an employer provides a good plan or bankrupt it if a family loses coverage during a serious illness.

Obama said as much to the AFL-CIO: “We’ll grow our middle class by finally providing quality, affordable health insurance in this country.”

Just this week, the Kaiser Family Foundation released a report showing premiums for family coverage rose 130 percent over the past decade. They now average $13,375, which is about the same as the entire annual take-home pay of a minimum wage worker.

Coverage is not affordable. The price of it is pushing families down the economic ladder. Look what it did to Skvara.  He had been a middle class steelworker and remained in the middle class after retirement. But he moved toward poverty after the LTV bankruptcy cost his wife her health insurance coverage. Loss of health insurance and the ensuing medical bills robs families of their life savings, their homes, everything until they’re bankrupt.

Skvara asked the candidates what was wrong with America and what would they do to fix it. Obama’s plan for fixing health insurance would forbid dropping or denying coverage because a person is sick or has a pre-existing condition.

He wants the public option to provide competition so that rates are affordable. That public option would cover Skvara’s wife – at a reasonable cost. So he could remain in the middle class and not find himself asking heartbreaking questions at public meetings.

The teabaggers are apoplectic because this isn’t just about health care. This is about the values of a government.

The Obama administration fails to fawn over the affluent.

Instead, Obama talked of downtrodden workers in the former Jones & Laughlin Steel mill in Aliquippa. Bosses there fired a dozen workers shortly after the National Labor Relations Act passed in 1935. The workers, mostly union organizers, challenged the dismissals all the way the U.S. Supreme Court, securing a landmark win that not only got them their jobs back, but also affirmed the constitutionality of the labor law that led to the burgeoning of union organizing, and the growth of America’s large, stable middle class.

To win that case, Obama told the AFL-CIO convention, workers of different ethnicities and faiths had to work together and stick together. That will be necessary to win this struggle to reform health insurance as well. But that reform is only the first part of Obama’s plan for the middle class:

“We will make possible the dreams of middle class families and make real the promise of the United States of America.”

That’s worth fighting for.

Leo W. Gerard

By Leo W. Gerard
International President

Just days ago, America celebrated her birthday with fireworks, spontaneous renditions of the Star Spangled Banner and chants of, “We’re Number One!”

In a crucial area, health care, the chant is untrue. Many of us love the individual doctors who may have saved our lives or the lives of loved ones. But the health care system in this country is not top-ranked.  It’s not even close to number two. Its poor quality and excessive expense are sucking the life out of America. For the health of the nation, both physically and economically, we need a system with a public option – that means a government-sponsored and managed alternative. And we need it now.

First, the issue of ranking. In the year 2000, the last time the World Health Organization stacked up countries’ health systems, the United States came in 37^th, behind the likes of Chile, Morocco, Cyprus, even drug war-torn Colombia, to which the U.S. donates hundreds of millions in foreign aid. The U.S. Centers for Disease Control and Prevention pointed out late last year that the U.S. ranked 29^th in the world for infant mortality in 2004, a statistic that steadily worsened since 1960, when the U.S. ranked 12^th. Twenty-two countries’ rates were below 5 deaths per 1,000 live births. The U.S. rate was 6.78 deaths.

Similarly, the U.S. ranks 42^nd for life expectancy, down from 11^th two decades ago. Contributing to that decline is the parallel drop in Americans covered by health insurance, researchers said. While 46 million Americans lack insurance, Canadians and residents of European Union countries benefit from universal health care.

We are 37^th – Yea! We are 29^th – and falling! We are 42^nd — and dying! These are not the chants of proud Americans. These are not the chants of vibrant Americans. In fact, these are not the chants of Americans who could continue financially supporting this sick system even if they wanted to. And they don’t.

The cost of the American system, with its private health insurance industry in the business of profiting off of illness by limiting care, cutting corners and denying access to those with “pre-existing conditions,” is suffocating the U.S. economy. In this one unenviable area – spending — the U.S. is number one. Health care expenditures are a shocking 16 percent of U.S. gross domestic product (the value of all goods and services produced in a nation in a year), far ahead of the closest competitor. That would be France, where it’s only 11 percent. That’s followed by Switzerland, Germany, Belgium, Canada and Austria, where it ranges from 10.8 down to 10.1 percent. These are all countries that provide national health care.

Looking at it another way, the average expenditure per individual, America remains in the undesirable position of most profligate spender. The average for an American was $7,290 in 2007, the latest year for which comparable statistics were available. But the average for the 30 countries in the Organization of Economic Cooperation and Development was a mere $2,964, with the closest to the U.S. being Norway at $4,763.

Those costs marginalize U.S. manufacturers as they attempt to do right by their American workers while scrambling to compete in international markets. Here’s how Dr. Atul Gawande put it in his June article, “The Cost Conundrum,” in “The New Yorker:” “Spending on doctors, hospitals, drugs, and the like now consumes more than one of every six dollars we earn. The financial burden has damaged the global competitiveness of American businesses and bankrupted millions of families, even those with insurance . . . By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

President Obama warned the American Medical Association, which opposes national health care, about exactly the same thing in June when he said this: “If we do not fix our health care system, America may go the way of G.M.” Would those wealthy physicians bail out the government then?

Clearly these costs don’t contribute to quality since U.S. rates of infant mortality and life expectancy are so relatively poor. And they factor large in personal bankruptcies and delay of care as individuals are unable to keep up with medical care’s morbidly obese costs.

A Kaiser Family Foundation poll in February found that 53 percent of Americans cut health care because of cost in the previous year. A quarter reported putting off health care they needed such as doctor’s visits and surgery, and twenty percent said they have not filled a prescription. Another part of the poll explains this: “13 percent say they have used up all or most of their savings trying to pay off high medical bills in the past 12 months, and just as many say their medical debt means they have difficulty paying other bills.  A similar proportion (12%) say they have been contacted by a collection agency, while a smaller share (7%) report being unable to pay for basic necessities like food, heat or housing.”

We are Number One? This is cruel. This is wrong. This must stop.

I know that many Americans view my native land, Canada, not as a country, but as an unofficial 51^st state. But the difference between Canada and the 50 states is that Canada has national health care, thanks to Tommy Douglas, the former premier of Saskatchewan, and a party leader. One huge difference between the American system and Canada’s national health care is the extreme cost of administering private insurance in the U.S. A study published in 2003 in the New England Journal of Medicine showed that administrative costs were $1,059 per person in the U.S. but only $307 per person in Canada. That excessive $752 in administration costs paid in the U.S. for each insured person has only grown larger in the ensuing years. The study concluded: “A large sum might be saved in the United States if administrative costs could be trimmed by implementing a Canadian-style health care system.”

In 2004, the Canadian Broadcasting Company conducted a poll to determine the country’s greatest citizen. People everywhere could vote, for anyone they wanted, so an actor, like Tommy Douglas’ grandson, Kiefer Sutherland, could have won, or a famous singer like Celine Dion or Shania Twain. But Canadians chose a politician — Tommy Douglas, the father of national health care. That’s how we feel about the national health care system in Canada.

Don’t let the Republican Party-of-No stop this. Don’t let big vested interests like the pharmaceutical, insurance, and for-profit hospital corporations keep America down. In poll after poll, Americans have made it clear they want a public option. They want care as good as Canadians get. They’re paying more than twice the price for it. To ensure that America is Number One, Congress better deliver it before the end of August.