Health care has become a flashpoint for workers, a benefit worth fighting for, as important to their economic well being as their wages and salaries.
In recent months, workers across the country have walked off the job to protest benefit cuts included in recent contract offers: Tyson workers in Jefferson, Wisc., left their jobs in February and remain on strike. Supermarket employees in California did the same in October and about 20,000 General Electric employees staged a two-day walkout in January that closed 48 manufacturing plants in 23 states.
In June in Massachusetts, the workers rights group Jobs with Justice held a statewide "Health Care Action Day" that featured rallies and the distribution of literature and stickers demanding "Health Care for All -- No Cuts in Benefits or Services."
According to the Kaiser Family Foundation, which released its annual survey of employer health benefits in September, monthly premiums paid by companies for health insurance increased by 13.9%, the third straight year of double-digit growth and the largest premium increase since 1990. The causes vary, the survey says, but seem ""to be driven by a combination of rapid inflation in the costs for health care services and insurers' efforts to emphasize profitability in their pricing."
This sharp growth in costs has led companies to ask employees to pay a larger percentage of their overall health costs than in the past, either by increasing monthly contributions, bumping up deductibles or by imposing other co-pays or limits.
Hence the conflict. But fighting benefit cuts in this way is a losing proposition -- small companies are getting killed by the rising costs and company plans only cover a portion of those who need insurance. There are, by most estimates, about 43.6 million uninsured people in America, according to the US Census Bureau.
What is needed is real reform, not just a reshuffling of the deck or a small-scale expansion of Medicaid. We need a universal system in which the government acts as insurer, funded by taxes, and sets prices for the care. Such a plan would likely have lower overhead -- Medicare administrative costs are a fraction of those in the private sector -- and would cover all Americans.
A recent ABC News/Washington Post poll shows that "Americans by a 2-1 margin, 62-32 percent, prefer a universal health insurance program over the current employer-based system," according to a story on ABC.com. The reason, according to the poll, is a general dissatisfaction with cost: 78% are dissatisfied with the cost of the nation's health care system, including 54% who say they are very dissatisfied.
And, according to the poll, "most Americans, or 54%, are now dissatisfied with the overall quality of health care in the US -- the first majority in three polls since 1993, and up 10 points since 2000."
The poll, however, also showed that Americans are far less supportive of a single-payer plan if it were to limit doctor choice, though many employer plans already do that. Support for single-payer health care dropped to four in 10 under those conditions.
But that does not mean we should consign universal, single-payer health care to some shelf in the back room. That was the Clinton administration's mistake in the mid-1990s, when it opted to push an expansion of employer-based health coverage and the bloated bureaucratic nightmare it would have created and refused to even consider broader reform. Once word of the plan leaked out, the insurance companies had a field day and the plan died a painful death.
If the ABC/Post poll is correct, now is the time to at least open up a conversation on health coverage and insurance that includes single-payer. Don McCanne, a retired physician and president of Physicians for a National Health Program, agrees.
"We need to have an open, vigorous debate over national health insurance," he said in an October press release. "This polling data is encouraging, but what if Americans knew that a single payer system would give them free choice of physicians, instead of the limited choices they have now? What if Americans knew that we are already spending enough money to eliminate the long, sometimes unlimited, waits for care that the uninsured experience, as well as the waits by people trapped in HMOs? We need an honest debate so that people can separate the myths from the facts."
There is some hope. Presidential candidate Dennis Kucinich, a Democratic Congressman from Ohio, is pushing "Medicare for All," which, in the words of the Washington Post, "would eliminate the role of private health insurers altogether." It would cost about $2.2 trillion a year and would be paid for through a combination of new taxes on employers, elimination of some tax deductions and the transfer of about $1 trillion in federal, state and local revenue now used to cover Medicare. (The current Medicare and Medicaid programs would be taken over by the new approach.)
While other candidates -- such as US Rep. Richard Gephardt -- are offering other, somewhat less ambitious plans, and others close to the issue are advocating a more measured approach, it is important that we keep our eye on the ball. Only through a fully funded, single-payer plan will we be able to control costs and ensure that every American has access to care.
"The incremental reforms of the past two decades have failed," Dr. Olveen Carrasquillo, a leading academic researcher on the uninsured at Columbia University in New York, said in a September press release from Physicians for a National Health Program. "The economic boom of the 1990's barely dented the number of uninsured. The last three years of recession has exposed the cracks in our unsound health system. The number of people without insurance is skyrocketing, while benefits for people who still have coverage are shrinking rapidly. This should be a wake-up call to all political and health care leaders, including Latino leaders, that the time for bold solutions is now."
Below are some organizations working on health care reform:
Physicians for a National Health Program, 29 E Madison Suite 602, Chicago, Ill. 60602; phone 312-782-6006; email firstname.lastname@example.org; Web, www.pnhp.org.
Families USA, 1334 G St. NW, Washington, DC 20005; phone 202-628-3030; email, email@example.com; Web, www.familiesusa.org.
For information on the Tyson strike or to contribute to the strike fund, write UFCW Local 538 Strike Fund, 2228 Myrtle St., Madison, WI 53704; email, firstname.lastname@example.org; Web, www.tysonfamiliesstandup.org.
Hank Kalet is a poet, music critic and managing editor of two central New Jersey newspapers. Email email@example.com.