Health Care vs. Wages
Don’t blame public employee unions for impasse
by Marcus Widenor
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Bruce Mackey’s letter (7/23) on public employee unions and health care reform resorts to the kind of political misdirection that typifies the current debate.
He’s got the first part right. The pols, including Dems, are in the tank with the industry. And he seems to support a single payer system — something I do, too. Then he tells us that public employee unions are the villains in the current situation. Anyone who bothers to check will see that the four largest public employees unions in the country, SEIU, AFSCME, AFT and NEA — all of whom have considerable membership in Oregon — are endorsers of single payer health care options.
The strategic question for labor has been how to get to a single payer system without seriously damaging the hard-won level of worker health benefits.
Anyone who has been a union member at some time over the last 15 years knows that health care is the elephant in the room during negotiations. Unions and their members (through democratic processes I might add) have often decided to trade the size of wage increases to maintain existing health care benefits. The employers says, “That’s all there is. Put it in wages, or keep the current health care coverage” (Or more likely, “Put it in wages, or take an even larger cut in the health care coverage”). This has not been an easy decision for workers to make. It involves shared sacrifice on the part of union members, some of whom don’t need the health care benefits as much as they could use a wage increase.
The real question here is why a single group of workers should be penalized because they decided to sacrifice wage increases for health care benefits for themselves and their families. Many union members with the so-called “Cadillac” plans are not actually highly paid workers. Taxing their health care benefits is not a more progressive way to raise revenues for an alternative system if it decreases the living standards of low-middle income workers disproportionately.
Anyone (including President Obama) who believes that health care reform is not at some level a distributional exercise is going to be sadly disappointed by the reform process. Health care standards will continue to erode (including in union plans) until we stop treating it as a commodity. That is what the single payer initiative is about. In addition, we will all have to pay for the transition. Employers who haven’t been providing benefits should be the first to ante up, but higher paid workers will have to as well. However, it shouldn’t be based on the marketplace “cost” of each person’s health insurance package. Instead it should be derived from some broader, progressive measurement of an individual’s ability to pay — means testing of overall income, benefits, and assets.
Unions want single payer not just because it is more equitable, but because it takes health care off the bargaining table, where it has been corrupting the process for two decades. That would allow unions to get back to what they are supposed to do — raise the working and living standards of American workers. Real wages have been stagnant since the late 1970s, and part of the reason is the huge cost of employer paid health insurance.
Blaming the current bottleneck on health care reform on public employees unions only muddies the waters about who is in favor of reform, and who stands in the way of it.
Marcus Widenor lives in Eugene and is an associate professor at the UO Labor Education and Research Center, www.uoregon.edu/~lerc
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