LABOR'S BLURRED VISION

...Under the proposal, a progressive surtax on individuals and corporations would fund a governmentally administered health service...

...What appears to be missing from this plan—and from labor's campaign for health-care reform in general—is an effort to encourage serious debate among union members about the kind of system they want...

...For one thing, insurance companies are major corporate investors: The top fifty had investment income of more than $58 billion last year...

...She says the aim of the plan is to spread the cost of health care to everyone who can afford to pay...

...One of the most prominent healthcare reform proposals under consideration comes from a corporate-government-labor coalition called the National Leadership Commission on Health Care, nominally headed by Richard Nixon, Gerald Ford, and Jimmy Carter...

...The bill would require employers with more than twenty-five employees to provide insurance for those who work more than 17.5 hours a week...

...The Government would negotiate annual payments to hospitals and clinics to cover costs...

...Some union leaders have, in fact, been sitting on health-care reform commissions for years—side by side with corporate representatives...

...He also talked to a hospital official who explained why there were only two full-time employees in the hospital's accounting department...

...Iacocca says health insurance costs add $700 to the sticker price of every new car...

...One by-product of the government's concern about cost efficiency is a greater emphasis on preventive care than we usually see in the United States...

...Gordon is a graduate of a program sponsored by the National Association of Working Women that tries to help women on AFDC find jobs...

...Rick Coe says the Canadian system seems to provide a built-in incentive for containing costs...

...But where is organized labor...

...The United Electrical workers' union (UE), which is not affiliated with the AFL-CIO, hasn't yet settled on a particular plan, but leans toward a Canadian-style system, according to UE legislative director Bob Kingsley...

...This corporate-labor group, in existence since 1968, came up with a plan last year that would empower states to contract with private health-insurance companies to provide coverage to the uninsured...

...That employers have to pay so much for health insurance, the AFL-CIO argues, "exacerbates foreign competition...

...Unionized workers, like the unorganized, are being pushed to the wall by employers over health-care benefits...

...Paperwork is minimal...

...But most reform proposals would leave the basic system intact...

...After the operation, I was told I had to go back into surgery because they had to make the cut above the bone...

...They gave me a rookie doctor who had to try eight times to get a needle into my leg, to find a vein...

...Because at its best the American system is the best in the world...

...If I didn't have the $75, they weren't going to help my daughter...

...Grace, and a long list of other business interests...

...Many unions still nominally support the Kennedy-Waxman health-care reform bill, the leading piece of reform legislation...

...His bill came to $60,000, and though his union provides him with a good insurance plan, he still wound up owing $4,000...

...Still, the Canadian system could be a model for U.S...

...Since Canada phased out its private insurance industry in the early 1970s, its medical care has become cheaper and more accessible than in the United States...

...We'll have to amputate the whole foot,'" the Laura McClure, a free-lance writer in New York City, specializes in labor issues...

...It costs almost twice as much per capita as Britain's nationalized health care (although Canada still spends much less than the United States...

...man said...

...All any Canadian has to do to get medical attention is flash the health-care card provided to every citizen...

...It would also put limits on discrimination by private insurance companies...

...Let's not import a system from another country," says National Leadership Commission Executive Director Peggy Rhoades...

...This whole financial thing suddenly intruded," he said...

...The bulk of the population, however, would continue to rely on employer-provided private health insurance, such as it is...

...We put them into the price of our products...

...Although the AFL-CIO has not yet endorsed any one reform proposal, its affiliates have generally clustered around corporate-supported plans that aim to ameliorate but not overhaul the system...

...This continuing effort to find common ground with industry threatens to limit the health-care reform debate to that narrow range of proposals acceptable to the U.S...

...Just as they were preparing to fly home, his daughter came down with an earache...

...More and more corporate leaders, most notably Lee Iacocca of the Chrysler Corporation, have been complaining about the expense—to them—of the current system...

...Like the unorganized, they are being forced to pay more and more for insurance deductibles and co-payments...

...Canada spends about thirteen cents of each health-care dollar for administration...

...The corporations' solution, in general, is to ask for a taxpayer bailout in the form of an expansion of publicly funded health care...

...We have to set forth a vision that is a common-sense answer to the crisis in health care in this country, and build support for it...

...Late last year, the union sent a delegation of activists across the border to see the Canadian system for themselves...

...The Canadian system cuts down on bureaucracy because they don't have to bill all these health insurance companies," Meyers points out...

...According to the General Accounting Office, nearly half of all uninsured workers are employed by companies with fewer than twenty-five employees...

...Kingsley says although he is glad the AFL-CIO has launched a campaign for health-care reform, he believes the federation is too conciliatory to centrist Democrats on this and other issues...

...One member of the audience told how he had waited in the Kings County emergency room from 6:30 one morning until 11:30 the next to be treated for an infected foot...

...Aserious discussion of how to reform the U.S...

...Another kind of proposal comes from the Committee for National Health Insurance, backed by the United Auto Workers...

...So far, the only AFL-CIO union calling for more thorough health-care reform is the Oil, Chemical, and Atomic Workers union (OCAW), which has endorsed a Canadian-style health-care plan and is urging other unions to do likewise...

...It has become clear to almost everyone— including union leaders—that the solution to the health-care crisis lies in legislative reform...

...When I finally got to a doctor, he told me, 'This is completely infected...

...The free service would be run by directly elected community health boards and indirectly elected regional and national boards...

...However, the reforms they want aren't likely to involve a move away from private health insurance...

...it saves the government money in the long run...

...They talked late into the night about their experiences in the Kings County emergency room...

...According to PNHP, about 23 per cent of the money we currently spend on health care in the United States goes for administrative costs—all the billing and other paperwork required to track funds coming from private insurance companies, individuals, and government agencies...

...The idea was, let's build a system for America...

...That's not a very healthy way to compete in the world market," says the auto chief...

...Government would eventually become almost everyone's insurer, replacing the 1,550 private companies that now feed off the demand for health care...

...The federation goes on to assert that "no one" (certainly not organized labor) is calling for "socialized medicine" in this country...

...Another bill, sponsored since 1977 by Representative Ronald Dellums of California, would establish a health service along British lines...

...A drawback of the regular doctor-government face-off, however, is that there are periodic crippling doctors' strikes...

...Back home, said Coe, "I don't even think about money when I go to the doctor...

...Let me show you what they did," he told the audience, as he pulled up his pants leg to reveal a stump ending at mid-thigh...

...Jobs with Justice, an initiative by some AFL-CIO unions to encourage local mobilizations and coalition-building, has adopted the need for "national health care" as its priority this year...

...But this bill is opposed by most employers, and it also seems to be losing favor within organized labor...

...In recent months, some union leaders have begun to move toward OCAW's position, though officially there has been no change...

...They finally took me upstairs to cut off my foot, and then they tell me they have no bed, and I had to get back into the wheelchair until they found a bed...

...FAILING HEALTH Labor's Blurred Vision BY LAURA McCLURE Rick Coe, who moved to British Columbia from the United States fifteen years ago, took his infant daughter with him on a short visit to New York last year...

...The way I feel about health insurance companies, they're in business to make a profit, and the more people you have trying to make a profit on the health-care system, the higher your prices go...

...health-care system...

...Canadians spend 30 per cent less per capita on health care than we spend in the United States, and yet they receive universal care that is, on average, better...

...They aim to preserve the private health-insurance industry and the private health-care delivery system, which together are responsible for making health care in the United States the most expensive and inefficient in the industrialized world...

...Says Mel Glasser, the committee's director: "What this plan does is preserve the private insurance system, providing that it has a state-approved plan as to its efficiency and responsiveness to consumers...

...In the face of the deepening crisis, the AFL-CIO last year announced a national campaign for health-care reform...

...However, many of the already insured don't feel so lucky...

...Its members include leaders of the Service Employees International Union, the Communications Workers of America, and other union people, along with Blue Cross/ Blue Shield, the American Medical Association, AT&T, IBM, W.R...

...The union produced a manual to help its members organize for the Canadian-style plan, and has held local meetings to discuss the issue—in addition to sponsoring the one-day tour to Canada that Pete Meyers joined...

...Pete Meyers, a local union officer from Lititz, Pennsylvania, was on the fifty-member OCAW delegation...

...Other countries put employee health costs into their taxes...

...So, while publicly funded protection for the uninsured is essential, the taxpayer will also continue to foot the bill for all the needless expense associated with private health care...

...That discussion has, at times, included a cursory look at superior systems in Canada, Britain, and elsewhere...

...Contrast that with the scene in Brooklyn's Kings County Hospital, where a continuous stream of sick, overdosed, or wounded individuals must wait hours, sometimes days, for treatment...

...Calary Gordon, for example, is a single mother in Milwaukee who was relieved to find a job that provided health insurance— until she discovered how expensive it was...

...Essentially the doctors' association in each province negotiates a fee schedule with the government...

...OCAW has been pushing its position among its own members...

...The plan would be funded with a tax on employers and employees, and with funds currently allocated to Medicare and Medicaid...

...And in the interest of saving money, clinics often do without high-tech equipment, causing delays for desperate patients...

...From what I've been able to find out, the insurance industry is one of the biggest opponents to national health care in the United States...

...The money, collected from employers and employees nationally, would be disbursed to states, which would then act, in essence, as public insurers for the poor...

...Jobs with Justice initiated the idea for the October 3 Health Care Action Day, and is organizing local lunch-time demonstrations and informational picketing...

...Unions have tried to fight back at the bargaining table, but with limited success...

...But for the most part, it's not...

...The Kennedy bill would be a boon to the insurance industry, since it would bring in new clients...

...The Dellums bill has won scant labor backing...

...corporate elite...

...She must pay a $200 deductible on her insurance, plus $36 a month for her asthma medication...

...It's not surprising that big business fights any move to take the profit out of health care...

...One of the weaknesses of the labor movement, especially in recent years, is its failure to define an agenda independent of the Democratic Party," says Kingsley...

...Recently, at a heated community speakout in Brooklyn's Medgar Evers College, hundreds of local residents turned out to vent their fury before city health-care officials...

...Since this is a huge part of every provincial government's total spending, they've got a real vested interest in keeping costs down...

...During the OCAW tour of a hospital in Hamilton, Ontario, Meyers talked to a woman on a kidney dialysis machine who paid nothing for years of intensive care...

...Last year, this group came up with a reform plan that would fold Medicaid into a larger fund to cover the uninsured...

...health-care reformers...

...The federation is planning a series of regional hearings on the health-care crisis in September and October and a National Health-Care Action Day is set for October 3. In its literature, the federation lays out in even-handed fashion the cost of the current system to both workers and management...

...That's $36 I cannot afford," she says...

...OCAW has probably done more than any other union to bring the issue to its rank and file...

...With her low wages and high premiums, she now questions the wisdom of getting off public assistance...

...The Canadian system is by no means ideal...

...health-care system is finally under way...

...The underlying assumption behind many reform initiatives seems to be that employer-provided insurance plans are meeting the basic needs of those they cover, and that the main challenge is to provide similar coverage for the uninsured...

...He suffered a heart attack several years ago, and is not fond of the U.S...

...Under the plan, the U.S...

...Coe took her to a Bronx clinic for treatment, and there he was reminded of some facts about the United States he had blissfully forgotten...

...For instance, says Coe, two weeks after his daughter was born, a government nurse showed up at the door to check on the health of the child and to answer her parents' questions...

...A number of unions have brought in their own Canadian members to talk about how the Canadian system works, and Physicians for a National Health Program has engaged in informal discussions with some union leaders...

...So far, even Canadian-style reform proposals have been on the margins of the debate within labor...

...People in this neighborhood make 609 visits per thousand residents each year to hospital emergency rooms, and at least 20 per cent have no health-insurance coverage...

...Most of the reform proposals under consideration in this country aim to increase the availability of health care to the poor, elderly, and uninsured through publicly financed programs, leaving the private health insurance industry and for-profit health-care delivery system almost untouched...

...Meyers's union has endorsed a reform proposal laid out by Physicians for a National Health Program (PNHP)-a plan loosely based on the Canadian system...

...The idea behind this service, Coe says, is to detect problems early on...

...As in Canada, every citizen would be issued a card that would guarantee free access to health care...