Public Option Necessary For Health Care Reform

BY JIM CAVANAUGH, SCFL PRESIDENT

Sometime this year it appears likely that, at long last, Congress will pass a health care reform bill.

After all, President Obama has made health care reform his top priority, no less than five Congressional committees are working on the issue, and they all pledge to have a measure ready for a vote by the fall.

The big unanswered question, of course, is what will that reform look like.

Why Not Single-Payer?

Most industrialized countries have a national health care system something like Canada’s, where the government essentially serves as the insurance company for all necessary health care. This system, known as “single-payer” because it allows those who deliver health care to get paid from a single source rather than a plethora of insurance companies and HMOs, has proven to be the most efficient and reliable system.

Single-payer covers everyone and treats everyone equally. And, it costs a lot less because there’s no advertising costs, there’s only one set of insurance forms that need to be filled out, and there are no stockholders expecting to receive a dividend.

Because this system makes so much sense, most labor unions, who have witnessed dramatically escalating health insurance costs as well as many of the other problems – like non-coverage – of our current system, support a government-run, single-payer system of health insurance. (Note: This is government-run health insurance, not government-run health care.)

Michigan’s Congressman John Conyers is the chief sponsor of HR 676, legislation to implement a single-payer health insurance system in the United States. His bill has eighty cosponsors, including south central Wisconsin’s Tammy Baldwin and Milwaukee’s Gwen Moore.

Conyers’ legislation is also supported by the U.S. Conference of Mayors. Polls show that there is strong support – usually in the 60+ percent range – for legislation like Conyer’s bill. (www.wpasinglepayer.org/PollResults.html)

This legislation has also been endorsed by 39 state labor federations, including the Wisconsin State AFL-CIO, and 128 central labor councils, including the South Central Federation of Labor. It’s also been endorsed by 20 international/national labor unions, from all sectors of the labor movement – construction (Plumbers and Sheet Metal Workers), public (AFSCME, AFT, NEA), service (SEIU, CNA, OPEIU, CWA), and industrial (Steel Workers, Auto Workers, Machinists).

Despite all this support for a single-payer system, several key Congressional leaders began their deliberations on health care by declaring that “single-payer was off the table.”

Why? Well, most of them rationalized that passage of single-payer reform was “politically unfeasible.” What does that mean, if the unions, the mayors, and a solid majority of the public support it? I think what it really means is that those who are making big profits from our current, broken system – Healthcare Corporation of America, the Blues, Merck, etc., etc. – have put so much money into campaign contributions and have so much money available for “Harry and Louise” ads, that a majority of the members of Congress have either been bought off or scared off.

Single-payer supporters have made significant progress in getting single-payer “put back on the table.” However, given Congress’ fast track on this issue this summer, the odds are not good that supporters will be able to make single-payer the main course.

In that context, the national AFL-CIO, which has declared support for “Medicare for All,” a kind of a back door support for single-payer, is pushing Congress to at least include a number of bottom-line principles in whatever legislation it eventually settles on.

The AFL-CIO actually has and has had for some time a number of principles for health care reform involving cost, universality, etc., etc. (http://aflcio.org/aboutus/thisistheaflcio/ecouncil/ec08082006.cfm). Given the current status of things in Congress, however, the AFL-CIO has narrowed its message to four main points that reform must include:

• A strong public health insurance plan makes reform work because it is a necessary ingredient for bringing down costs.

• Pay or Play: every employer must pay their fair share, not just union employers.

• Health reform must deal with pre-Medicare retirees.

• No taxation of health benefits.

If those bottom-line principles are included in whatever universal plan Congress comes up with, we will definitely wind up with a much-improved health care system in this country. But, we will probably still be several years away from a really good health care system in this country.