Working Together: Real Health Care Reform Within Reach — If We Fight for It

Years ago, CWA and other unions were able to negotiate gradual, steady improvements in health protections for our families, along with gains in wages, retirement security and working conditions in contract talks from one round to the next.

In recent years however, health security has emerged as the great battlefield of bargaining.  CWA and other unions must plan to fight tooth and nail, often preparing to strike, to beat back the worst concession demands and to hang on to benefits for retirees.  What happened?

To the degree that the United States ever thought about a real national approach to providing health care, it was when our government decided in the post-World War II era to promote an employment-based system by making employer health care benefits tax free.

It was a way for employers to hold wage costs down by offering other compensation in the form of health care that in effect was government subsidized.

It was never an ideal system, but at a time when 35 percent of Americans in the mid-1950s had collective bargaining coverage, about 70 percent of the workforce — both union and non-union — achieved paid health coverage as a job benefit.  Unions set the bar for benefit standards, and non-union employers had to match them to attract workers.

That system has been breaking down as the percentage of workers with bargaining rights has plummeted to 12 percent and union power to maintain good health coverage has been sharply weakened.  Today, only 55 percent of private sector workers have job-based health coverage, and most are paying increasingly more out of pocket in premiums and co-pays.  (Since 2000, the average worker contribution to employer-provided health care has grown by 143 percent.)

And for pre-Medicare-age retirees, coverage has dropped even more steeply, down from 66 percent coverage 20 years ago to 33 percent today (see More Employees Taking Aim At Retiree Health Benefits).

That direct linkage between falling collective bargaining coverage and shrinking health benefits (and pensions too) is why we are stressing the need to bolster organizing and bargaining rights through the Employee Free Choice Act as well as pressing for comprehensive health reform in our Labor 2008 political program.  We have a window of opportunity to build a real movement for political change in  '08 — one that may not open again for many years.

Hastening the breakdown in our health system, those employers who have done their part to provide medical coverage for their workers are now looking at their mounting health care obligations as a "jobs tax" that is putting them at a disadvantage against competitors.

It's well known that health benefits add $1,500 to the price of an American car — a burden that automakers in Japan, Germany and Sweden don't have to build into prices of the cars they ship here because those countries all have national health care systems (see Europeans Take Pride in Health Care for All).

Employers in every industry can point to a similar growing burden and competitive disadvantage.  AT&T, Verizon and Qwest all pay soaring costs for active workers and pre-Medicare retirees while competitors like Comcast and Time Warner Cable, with very low union representation, pay much less toward health care.

Rather than clash with us at each round of bargaining over health care concession demands, we're urging our major employers to join with us this year in pushing for a national solution that will break this cycle of labor confrontation and gradual crumbling of the overall health system.

The framework for any real solution must be one that calls for a large public plan to pool medical risks, and we will insist that every employer must participate in ensuring health coverage and no employer should be handicapped because of the age or health of its workforce or number of retirees.

Everyone should share responsibility for contributing to the new system through broadbased, progressive financing.  Effective cost controls must be built into any reform system, such as eliminating duplication of hospital services, allowing for negotiation of drug prices and reducing administrative costs. It's a shocking fact that our current $2 trillion health system includes 15 percent in administrative costs.  In comparison, all of the other advanced democracies around the world spend only about 1 percent on administering government health programs.

And no matter what, we will insist on a continuing role for unions and employers to be able to negotiate supplemental coverage.

This year's elections present a rare opportunity to elect a president and a Congress who will champion and adopt reforms in workers' organizing rights and a comprehensive, national health care program with universal and affordable coverage.  But it will only happen if CWA members are engaged in the election process this year as never before, and ready to lay it on the line to fight for workers' rights and our families' health security in the years ahead.