Unions Call for ‘Fair Share Health Care’ Laws
By George Anderson
The AFL-CIO says the healthcare system in the U.S. is broken and it’s up to legislators to make sure that large companies such as Wal-Mart do their part to fix it.
The union’s president, John Sweeney, says every year taxpayers pick up a $21 billion tab for healthcare costs because companies such as Wal-Mart are not providing their workers with affordable coverage.
Mr. Sweeney’s union launched a campaign yesterday to get states to enact so-called “fair share health care” laws modeled after a bill introduced in Maryland that was vetoed by the state’s governor.
The Maryland law has also been called the “Wal-Mart bill” because the company is the only one in the state that would be affected by its passage. The bill would require businesses with more than 10,000 employees to spend at least eight percent of their payroll on healthcare.
Sarah Clark, a spokesperson for Wal-Mart, said, “These bills will do nothing to address the enormous number of uninsured or control the soaring cost of healthcare in America. (Union leaders) should focus on solving our nation’s healthcare challenges, not attacking a company that’s providing working families with access to affordable health insurance.”
Bruce Josten, executive vice president of the U.S. Chamber of Commerce, also believes the unions are focused on the wrong target.
“Why are we going to put this yoke on corporate America’s neck?” he said. “This is a problem for everybody in the country.”
Moderator’s Comment: If access to affordable healthcare “is a problem for everybody in the country,” then what is the answer? Is there ground for unions
representing retail workers and employers (unionized and not) to agree on this issue? –
George Anderson – Moderator
To Ryan: Most people don’t pay as much as I do for health care. I think the average for a family is about $10,000 a year. My premiums are about $9k plus $5k for a Health Savings Account. Regardless of what percentage that is of the average household income, it really doesn’t matter because someone else is generally paying the tab (an employer) and that amount is not added into those average household income figures. The fact is people are paying these premiums, either directly or indirectly, and therefore they can afford it. Since most people do enjoy the benefits our of healthcare system, I don’t think we are ready for socialized medicine. Universal healthcare might be the fairer or more compasionate way to go. I don’t disagree that the system is broken. But for most people the system works just fine and dandy. Whether family coverage costs $5,000 or $25,000 a year, as long as most people have the means to have health insurance, nothing is going to change. It’s just like when gas went to $3 a gallon. We need it, so that’s what we paid.
It’s not the employers’ fault that health care costs are rising as much as three times the rate of inflation. Certainly, much of it is due to the phenomenal growth in technology and standard of care. Still, I am struck by the relative inefficiencies in the entire health care administrative side of the equation. Every industry has been forced to become more efficient and streamlined in the face of ever-increasing global competition. Health care has been insulated from this, so far, because the largest health care provider groups basically have a captive audience. Moving an entire company’s group to another plan every year is difficult, and they know that. Meanwhile, they continue to build more buildings and add more administrative staff and, at the end of the year, pass those costs along in the form of increased premiums — hiked over 25% for us this year alone! Cost shifting to the employees will work only so long, until people decide that it’s cheaper to risk going uninsured. What has to happen is that consumers (read employees) have to have the ability to do what they do every day in other areas of their lives: they need to be able to really shop and buy where they get the best value. That hasn’t happened in health care, yet. But it will. (Is that Wal-Mart calling?)
With all respect to David, his $14,000 a year (the amount he spends on healthcare coverage)is roughly 35% of the GROSS income of the average American HOUSEHOLD. We can’t make the mistake of confusing our personal circumstances with the national condition. And, when benefits are cut, salaries AREN’T increased — just look at the story that broke today about IBM suspending future pensions.
The AFL-CIO is certainly correct in their contention that the healthcare system in the U.S. is broken. Only 60% of businesses currently offer health insurance for their workers, significantly lower than just 5 years ago, and those that do receive it struggle with ever increasing costs and ever decreasing benefits.
However, the Fair Share Health Care law goes considerably farther and would require that “large profitable corporations with over 10,000 employees would pay at least 8% of their payroll to cover their employees’ health care costs.”
Considering that 99.7% of all firms have less than 500 employees, and less than 1000 companies in total have more than 10,000 the number of companies that would even fall under this new law shows that perhaps this proposal is a PR gimmick, not something truly intended to improve the healthcare system of the U.S. And I’m sure looking forward to seeing how “profitable” will be defined.
Providing health care to workers is not a requirement of business, the bargain is a “fair day’s wage for a fair day’s work.” Companies that choose to provide health care for their workers should be lauded for their efforts, not demeaned that “it isn’t enough.” The current level of company sponsored healthcare has only been around for 30 years.
Healthcare is a benefit, not a right. Requiring companies to pay 8 cents of every payroll dollar to cover health care costs will just lead these same companies to reduce payroll to decrease health care expenses.
Reluctantly, I have to agree, re: Mrs. Clinton. Had we had a real discussion and a knockdown debate about this, we would have been 10 years closer to a solution and probably half way through the transition phase. So here we are now, having shelled out billions of dollars for coverage (employer and employee) billions in co-pays (employer and employees) and covering the uninsured (taxpayers and everyone else) and where are we?
We are deeper in the morass; talk about a quagmire. We need to go to the base closure model, since Congress is unwilling to take it on. Get a balanced commission, have hearings, get the data and reach some kind of consensus, that says in effect, everyone is going to have feel some pain, suck it and let’s get on with it. Waiting is only going to make the pain worse.
We are spending so much time, effort and money on either getting the latest Supreme Court nominee to agree to continue to allow abortions or not. Great, we can have that freedom, but no one can afford it. What good is a right you can not exercise?
Everybody wants to pass the buck on health care and make someone else pay for it rather than the individuals themselves. We are victims of our own successful technology. I would love to have some big corporation pick up the tab for my health care premiums. Currently I don’t mind paying nearly $14,000 a year for family health coverage. I get quick first class treatment and don’t have to wait in line. My prescriptions are ready at the Walgreens drive-tru and are never more than just a few dollars. If your company is picking up the $10,000 per year tab on your premiums, you are still paying that because otherwise the company would be giving you an extra $10,000 in salary. Many companies will give employees bonuses of several thousand dollars for agreeing not to have insurance. We as a country need to decide if we want universal health coverage run by the government or have individuals fend for themselves. Currently it appears we are not yet ready for socialized health care, and perhaps never will. Most people seem to easily be able to afford $10,000 to $15,000 per year premiums, either directly or indirectly through their employers. Money talks and socialism walks.
I don’t think the health care system is broken in this country it is the COST of the system that’s out of whack. Health care costs are increasing every year at a double digit pace, when overall inflation is miniscule. But why put this on the backs of employers? In a competitive marketplace employers wishing to attract the best employees will offer solid health coverage. Others won’t.
The solution is ultimately going to be a government-imposed one, unfortunately, because health care providers, including doctors, hospitals, drug companies, and insurance companies have not been willing to work together towards improved effectiveness and efficiency. And, the litigious nature of today’s society has hampered things as well. But, in no way is this an issue that should be dealt with just by employers. They didn’t create the mess and can’t fix it.
This is a great topic, George, and I wish I knew more about it to really provide valid insight. It happens that one of our partners is one of this country’s experts on the financial aspects of the healthcare system, and his studies show that what is called a “single payer universal coverage system” seems to be the best solution for solving most of the rapid and endless cost increases and for providing coverage to all. His studies also show, however, that current ideas of how to move to such a system are unable to address the less publicized issue which will ultimately defeat all efforts to make change: under the current system, too many organizations make too much money, and they will not give that up.
We seem to be faced with the same issue that every organization of every type and every size faces when change needs to be made: there are those who profit greatly and in many ways from the status quo, and these people are always those in power; and unless these people can be made allies of change, CHANGE WILL NOT HAPPEN.
Other studies we have done show that 100% of those who are in power and profit from the status quo have organizational needs that are not being met. This makes sense logically, because a dysfunctional system is not going to be completely functional anywhere — NO ONE can get all their significant needs met from a dysfunctional system. Interestingly, the dysfunction these power-profit people face in the organization is the same dysfunction that the change will address. All this is to say that in every single one of the hundreds of situations we have studied, in the end, the holders of power could easily be made allies of change.
Our partner tells me that one of the big benefactors of the current healthcare system in this country is the large insurance companies and their executives. He has found that these organizations and these executives want to see change in the healthcare system (they have unmet needs), but conventional analysis has said that these wants contradict the changes needed to move to the single payer universal coverage system. This partner’s analysis, amazingly, shows an otherwise unseen connection between the wants of the insurance system and the needs that point to the single payer universal system; and he has found a way that both can be met. It seems that no significant change in America’s healthcare system will occur until that connection is understood and leveraged.
Yes, requiring health care spending would eliminate some jobs. The minimum wage also eliminates some jobs. OSHA safety standards eliminate some jobs. Banning the sale of assault weapons eliminates some jobs. Requiring withholding taxes eliminates some jobs. Sometimes a decent society makes laws that are not intended to eliminate jobs, but have that impact as a side effect. If employers have to pay something towards health care, then other health care subsidies would decline. The decline of those other subsidies (higher taxes, higher insurance premiums) would help create jobs.
Many of the organizations opposed to broader health care coverage have no credibility on any labor issues. I am sure that the US Chamber of Commerce would vote in favor of reducing the minimum wage to $1 an hour, if they could get away with it, so why is their stand on medical coverage part of a worthwhile dialog? To solve ANY problem, it helps to start with parties committed to solving the problem.
Healthcare and managing healthcare costs will be the defining issue for both corporate America and the nation as a whole for much of the balance of at least the first half of this century. The truth — scary as it is for everyone — is that Ms. Clinton had the right issue when her husband first took office, just the wrong answer. This isn’t a Wal-Mart fix, or an industry fix — it’s the stuff of transformational political and socio-economic agendas. A couple of things we do know. Healthcare costs are going to continue to climb and nobody is going to want to pay them. That will leave tens of millions of Americans uninsured or under-insured and that’s a politically unstable situation. So everything –not just some things — is going to have to change and the sooner we start the better off we’ll be.
Has anyone mentioned the biggest cost of healthcare???? Lawyers, and plenty of them – ready to sue for any hangnail someone gets. There are doctors who have given up OB-GYN practices because the liability insurance costs more then the revenues. 87% of all lawyers live in the U.S., so until we tighten the screws on frivolous lawsuits, the cash cow will continue. I don’t see it getting better, because the legislature is full of… Oh yeah… More lawyers….
I’m wondering what the real cost of the new Medicare prescription will be. The figure will be staggering, because once the cookie jar is open, everyone will have their hands stuffed in trying to extract their share.
Good luck to all trying to stop this locomotive crash that will happen in the very near future.
Folks –
This proposed legislation does not address root causes and will ultimately do little to address health care costs and outcomes.
There have been numerous credible studies that show that anywhere from 35% to 50% of health care systyem costs are waste (i.e. “muda”) that add cost but no value at best and destroy value (e.g. prescription filled at the wrong dose or with the wrong drug). In the health care arena, ‘value destruction’ can mean death or serious injury.
If employers, insurers, government, medical providers, unions, and the media want to seriously address the unsustainable increase in costs, they need to quit sparring in legislatures and address root causes a la the Toyota Production System (TPS) approach.
It’s waaaaaaaaaaay past time to keep talking and trying to score points against the other stakeholders in the health care ‘system.’ Lowering health care costs, improving outcomes and improving the quality of work life of health care providers is eminently doable – once we get on with actually doing it (as opposed to talking about doing it).
As an outsider who can hopefully be somewhat objective, without being too prescriptive or bossy, it seems that we are not looking at the right solution here. Endless debates about who should pay are less than constructive. What would be more helpful, at least in my opinion, is to look at why costs are so high and see whether there are ways of reducing them.
I have heard many many people on your side of the Atlantic refer to socialised medicine with a sneer in their voice but I say, yet again, it can and does work. As long as there is profit involved, anywhere along the healthcare chain, there will be incentives and competition and an imbalance of priorities. The British system is far from perfect and some of the problems at the moment in some parts of the country are, in fact, caused by the introduction over the past few years of a curtsey to market forces i.e. profitability. Many of us are less than happy about that and the negative effects are being seen already. But it isn’t too late to fix it on our side and there are many sensible, practical lessons that can be learned on your side. You certainly don’t have to adopt our system in its entirety but it can and should be examined for signs of best practice which could go some way to solving the problems encountered by Americans.
Health care costs are out of control because of two factors: (1) insurance (2) attorneys. Don’t get me wrong, both are good ideas when operated wisely, but deadly when the processes run amok. Insurance has insulated the consumer from the charges incurred when using the health care system. We have all heard about the $100 aspirin BUT have any of us ever questioned the charges on a hospital bill? I mean really questioned the charges, like in refused to pay, asked for a hearing before the hospital board, sought legal help? No, we don’t question charges as long as the “insurance is going to pay.” Doctors typically get short changed by insurance companies in that they are forced to accept reduced payment for services. In addition, many doctors are further “held up” by insurance companies by being offered reduced settlement of claims in exchange for quick payment. Insurance companies will actually tell a doctor “we know we owe you $10,000 and we’ll get around to paying you in 60 to 120 days but, if you agree to accept $5,000 as payment in full, we’ll mail you a check tomorrow.” If you don’t believe me, just ask a doctor. OK, what difference does this make – well, if your doctor is going to have to discount his services to insured patients, then he is forced to increase his fees to receive the net payment he is due. This is referred to as “increasing the reasonable and customary charge.”
If payment was not made by insurance companies but by individuals, then cost would be examined more closely and complaints would become loud and frequent. They would become so loud and frequent that politicians would have to get involved; laws would be passed maximizing the price one could charge for an aspirin, etc.
Attorneys have fanned the flames of medical cost by jumping at any chance to sue doctors. (You see, they all carry malpractice insurance with high limits.) This, in turn, has forced doctors to order tests and consultations that are often not needed as a means of supporting diagnosis. If one comes into the office with lower abdominal pain, is 14 years old and is running a fever, then
the probability of appendicitis is great. One confirming test might be necessary. An MRI at $2500 a shot is not BUT it is often prescribed as a means of gathering evidence before a suit is contemplated by the patient and his attorney.
Employers have NO obligation to provide any benefits to employees. Benefits have resulted due to a competitive marketplace and successful employers. If conditions require employers to reduce cost by reducing benefits in an effort to remain successful, then employees have the choice of finding employment elsewhere or working to help the employer better manage benefit cost. I have never seen labor assume any of the responsibility of managing cost. If a system was advised that required patients to pay their own medical bills and receive reimbursement 90 days later, it would encourage the patient to question charges. If doctors were to bill at the contracted reimbursement rate instead of the fake “reasonable and customary” charge, it would be beneficial as actual cost for service could be determined. If insurance companies would pay all bills within 10 days of receipt in full, then doctors wouldn’t be pressured to bill higher and higher. If politicians would regulate attorneys and find some arbitration process to determine a suit’s merits prior to allowing a trial, they would be careful. Unfortunately juries cannot be expected to render consistently good service. Juries don’t have the education and ability to examine evidence in most malpractice suits.
Folks, we have a huge problem. We can’t legislate it out of existence. I would suggest that solutions will be found when we all work together and not waste time blaming each other for the problem.
In Canada we have a national health care system. It is financed through a combination of tax revenues, employer taxes and some direct payment by the individual for certain services.
The system isn’t perfect, but we have:
– a lower incidence of child mortality than the US
– more affordable drugs
– a single tier system where anyone can have access to any doctor or service they wish regardless of income and station of life.
– a robust employment picture, companies are not going out of business because of the health tax.
Don’t believe everything the HMOs and lobbyists tell you – a national health care system allowing equal access paid for by all stakeholders does work!
I agree with Ryan: Ms. Clinton had the right issue but the wrong answer. The issue has not and will not disappear. With the baby boomers set to begin retiring this year in large numbers and the number of years people live predicted to increase, the government will have to address health care at some point. With the number of companies downsizing, outsourcing, and encouraging former employees to start their own companies, health care coverage will become an even greater issue. With the number of working people unable to afford health care coverage increasing, health care is a critical issue. Will a state mandated law solve the problem? Probably not. However, since industry representatives have not been able to voluntarily work together and solve the problem, some type of government imposed solution will not be far behind.