January 2013 - Chicago
Cindy Young
Campaign Coordinator, Campaign for a Healthy California
Bay Area Labor Committee for Improved Medicare for All

• While there are common themes, some unions are dealing with specific issues:
• Part time workers
• Retiree H&W
• Trust Funds
• Right now, we have to deal with jobs, or the election, or, or, or, or
• Research and ask questions –
• Develop a couple of slides that will speak to your specific audience
• Tailor your presentation to the amount of time you are given
• Always ask them how they think we can move program

• Kaiser Family Foundation
• Commonwealth Fund
• California Health Care
Foundation
• California Nurses
Association
• Physicians for a National
Health Program (PNHP)
• Labor Campaign for Single
Payer
• UCLA Center for Health
Policy Research
• UC Berkeley Labor Center

Guarantee Healthcare for Every Worker by Guaranteeing Healthcare for All

Cumulative Increases in Health Insurance Premiums, Workers’ Contributions to Premiums, Inflation, and Workers’ Earnings, 1999-2012
Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012

Among Firms Offering Health Benefits,
Percentage That Offer an HDHP/SO,
2005-2012
Kaiser Family Foundation: 2011 Employer Survey

Brokers and
Consultants
“They wanted a 30% increase, but I got them down to 20%”
They throw 20% on the collective bargaining table and watch management and labor eat each other alive.
“Your group is old, fat and expensive.
That’s why rates are going up”
Why is it every other modern country has similar demographics, - pays less, insures everyone, and has better quality?
“We are going to develop a network of hospitals and physicians based on cost and quality!”
What happens to hospitals in poorer neighborhoods who serve the sick and uninsured patients?
Healthcare money gets moved to wealthy neighborhoods.
“Electronic Medical Records are going to improve care.”
A banking and IT initiative to collect our data, and corporatize our health!

30 cents of every dollar spent on healthcare goes to keep you from seeing the provider you want to see and denying you the care you need.
In a recent statement discussing the rate increases, “Blue Shield said it expects to have lost $10 million to
$20 million on its individual health plan business in 2010 and to lose
$20million to $30 million this year.
It’s costs for hospitals, physicians and prescription drugs have risen an average of 15 percent annually each of the past three years.” –

Bargaining for health insurance is a failed bargaining strategy
1980s – PPOs were going to control the cost of care
1990s – Consolidation and
Organized health systems
(HMOs) were going to control the cost of care
2012 – Accountable Care
Organizations and medical homes are going to control the cost of care
2012 Kaiser now realizes getting healthy is good for us, but is not going to reduce premiums
More fancy power points from third party intermediaries

Among All Large Firms (200 or More Workers)
Percentage of Firms Offering Retiree Health Benefits,
1988-2012
Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2012

• Calculating the obligation for postretirement benefits is not a precise science.
It’s a SWAG!
• The actuarial report is like reading The
Apocalypse

PITTSBURGH, Feb. 22 /PRNewswire/ -- LTV Steel has informed the union that the Voluntary Employee
Beneficiary Association (VEBA) trust -- which has paid for part or all of retired Steelworkers' healthcare and life insurance benefits since June 2001 -- will not be able to assure payment of health-care claims past
March 31, 2002, and all LTV hourly retiree healthcare and life insurance benefits will end on that date , the United Steelworkers of America announced here today.
STOCKTON - Franklin Advisers Inc., a global investing firm , and Wells Fargo bank ...
Bankruptcy judge: Stockton can stop paying for retiree health care - 8/6/12 ...

Stockton filed for bankruptcy on June 28 and on July 1 adopted a budget that included unilaterally reducing retiree health benefits. That illegally impaired the city's contract with retirees, the plaintiff's claimed.
U.S. Bankruptcy Court Judge Christopher Klein disagreed. The key sentence in his 40-page opinion on
Aug. 6 fleshed out a shorter ruling for the city he issued several weeks ago.: "In sum, even if the plaintiffs' benefits are vested property interests, the shield of the Contracts Clause crumbles in the bankruptcy arena.” http://blogs.sacbee.com/the_state_worker/2012/08/column-extra-judge-says-stockton-bankruptcy-canbreak-retiree-health-guaran.html#storylink=cpy

(Reuters) - Bankrupt Eastman Kodak Co said on
Wednesday it was ending retiree healthcare and survivor benefits at the end of the year, allowing it to resolve a $1.2 billion liability, one of its biggest obligations.
The benefits , which include medical, dental, life insurance and survivor income benefits, will end
December 31.
Reuters 10/10/2012 8:13:32 PM ET 2012

• Not much help for union negotiated plans:
– Taxes “Cadillac” plans starting in 2018
– No cost control
– Union negotiated plan will compete with high deductible plans on the Exchange
– Employer penalty - $3,000 per year
– Even the ACA experts project 3 – 4 million uninsured by 2019

By building from the bottom,
• I live on a minimum means we keep for those wage, why shouldn’t that are what’s on top!
you?
• I don’t have a pension, why should you?
• I don’t have health insurance when I retire.
Why should you?
Worse, why should I pay taxes for yours?

AFL-CIO 2009 Convention
RESOLUTION 34
The Social Insurance Model for Health Care Reform
Submitted by Alameda Labor Council (Calif.), California Nurses
Association/
National Nurses Organizing Committee and International
Longshore and Warehouse Union
“Whatever the outcome of the current debate over health care reform in the 111th Congress, the task of establishing health care as a human right, not a privilege, will still lay before us. We continue to believe the social insurance model should be our goal, and we will continue to fight for reforms that take is in that direction.”

Source: OECD Health Data 2011 (June 2011).

Overall Ranking
Country Rankings
1.00
–2.33
2.34
–4.66
4.67
–7.00
OVERALL RANKING (2010)
Quality Care
Effective Care
Safe Care
Coordinated Care
Access
Patient-Centered Care
Cost-Related Problem
Timeliness of Care
Efficiency
Equity
Long, Healthy, Productive Lives
Health Expenditures/Capita, 2007
AUS
3
4
2
6
4
2
6.5
6
6
2
4
1
$3,357
CAN
6
7
7
5
5
5
5
3.5
7
6
5
2
$3,895
GER
4
5
6
3
7
3
3
3.5
2
5
3
3
$3,588
NETH
1
2
3
1
2
6
1
2
1
3
1
4
$3,837*
NZ
5
1
5
4
1
1
4
5
3
4
6
5
$2,454
Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).
Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International
Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians;
Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for
Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).
1
2
6
$2,992
1
4
7
2
UK
2
3
1
2
3
4
6.5
7
5
7
7
7
$7,290
US
7
6
4
7
6

“I don't believe there's any problem in this country, no matter how tough it is, that Americans , when they roll up their sleeves, can 't completely ignore .”
George Carlin

Competition:
Which insurance company is competing for ill patients?
Hospitals-
For profit –avoid care
Not for profit (fancy tax avoidance accounting game)
Physicians – new payment arrangements allow them to keep what they don’t use
No health planning!
Do we build hospitals where we need them, or where they can profit, or have enough insured lives to survive?
Are we going to allow Wall Street to control our health?

Unions in other countries have figured out the only way they are going to keep what they have is by advocating everyone get it!

Are we going to keep nibbling around the edges attempting to fix a system that can’t be repaired?
OR
“Significant social change comes from the bottom up, from an aroused opinion that forces our ruling institutions to do the right thing”
Senator Paul Wellstone

• Lead with a moral message of
• Health Care is a Human Right or we need
Guaranteed Health Care for All

•Everyone should be treated by a medical professional if they are ill
•Medical care should be returned to the hands of medical professionals, not insurance company bean counters
•Everyone should pay their fair share
•No one should profit from people’s suffering
•Pricing for medical services should not be a secret. We need public disclosure
•There should be no barriers to our health – everyone is covered

•Unions can’t deliver healthcare or a wage increases until we get everyone under one plan and control costs
Join Bay Area Labor
Committee and support
Campaign for a Healthy
California or other like minded groups (insert your ask)
•Start an education campaign with your membership

A Proper Sense of
Priorities
DC - 1968
“On some positions cowardice asks the question, it is safe?
Expediency asks the question, is it politic?
Vanity asks the question, is it popular? But conscience asks the question, it is right? And there comes a time when one must take a position that is neither safe, nor politic, nor popular, but must take it because conscience tells him it is right
.”