AFL-CIO Endorses Medicare for All

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AFL-CIO Executive Council statement
Health Care
March 06, 2007
Las Vegas

The nation is once again focused on the crisis in health care and the American people are looking for a comprehensive solution, instead of the inaction and incredibly ineffective piecemeal approach of the past 10 years.

Nearly forty-seven million U.S. citizens are uninsured. Tens of millions more worry about losing the coverage they have. Workers fear changing or losing jobs because they are at risk of losing their health care coverage. American businesses that provide adequate health benefits are at a significant disadvantage, competing in the global marketplace with foreign companies that do not carry health care costs on their balance sheets. The same is true for businesses in domestic competition against employers that provide little or no coverage.

As a society, we all benefit from improvements in public health. We are a more creative, vibrant, productive and democratic nation because of it. We are all at risk of illness, injury or poor health, and we all suffer when individuals are denied needed care. The shortcomings of the American health care system—which ignores these fundamental realities—strain our nation’s social and economic fabric.

The time for talking about this crisis is past. All families deserve the security of a universal health care system that guarantees access based on need rather than income. Health care is a fundamental human right and an important measure of social justice.

As a nation, we need to exert the political will to enact comprehensive health care reform nationwide. There is strong evidence the crisis can be solved with tools at hand and at a cost that pales in comparison to the toll in human lives the current system exacts.

It is time to mobilize America behind a concrete plan to enact universal health care and the AFL-CIO commits its full resources to asserting leadership in this historic effort.

Universal health care does not mean mandating that everyone must buy a health insurance policy and then handing them the bills. Meaningful health care reform must be measured by the following tests:

Universal Coverage

• Everyone should have health care coverage, without exclusions or penalties.

• While the market has an important role to play, our government—as the voice of all of us—must play the central role in regulating, financing and providing health care.

• Coverage should be accessible through the largest possible groups that pool risk to ensure coverage regardless of gender, age, health status or other factors.

Comprehensive, Affordable Coverage

• Coverage should be affordable and comprehensive.

• Unions and employers should continue to play a role and retain the ability to supplement coverage.

Choice of Providers

• Individuals should retain the ability to select their own doctors and other health care providers.

Financing Through Shared Responsibility

• Because everyone faces the possibility of poor health, risks should be shared broadly to ensure fair treatment and equitable rates, and everyone should share responsibility for contributing to the system through progressive financing.

• A level playing field should be provided for all businesses. Every employer must participate in ensuring health coverage and no employer should be disadvantaged because of the age or health of its workforce or number of retirees.

Effective Cost Control

• Reform efforts must include effective mechanisms for controlling costs, requiring information on provider performance and enhancing efficiency.

• Investments should be made in systems and technology to reduce medical errors and costs, streamline administration and promote best practices.

• Employees who are frontline caregivers should have a protected voice in improving health care.

Do No Harm

• Until we have a comprehensive alternative for all Americans, reform efforts should not undermine existing coverage or put people at risk of unmet health care needs.

Our approach should be to build on what’s best in American health care. At the same time, we should draw from the best experiences of other countries that have achieved universal coverage at a fraction of U.S. health care costs.

One concrete plan that meets the test of comprehensive, universal health coverage would build on our nation’s successful universal health coverage plan for seniors: Medicare.

In its 40-year history, Medicare has delivered substantial advances for the health care of older Americans and people with disabilities. Medicare has guaranteed coverage, made health care more affordable, included a form of shared financial responsibility, significantly reduced administrative costs compared with those of private plans and has been the largely unheralded financer of America’s medical science advances. Medicare also has been a leader in advancing quality care and improvements in health care service delivery in the United States.

Such an approach would require updating and expanding Medicare benefits to fit the working population and children, as well as negotiating prices with physicians and providers that families—and the country—can afford. It would encourage innovation in health care services and medical technology. Employers’ responsibility for health care financing would be broadly and equitably shared, substantially reducing burdens on all businesses and reducing disadvantages currently faced in the global marketplace. In building on Medicare to move toward a universal program, we can find a practical, achievable and affordable solution to our country’s health care crisis.

We call on congressional leaders to unite behind such a plan.

Unlike our fragmented and flawed health care system, a successful universal health care system would provide benefits and cost savings for all stakeholders. The leadership to make comprehensive reform possible, then, must come from all quarters:

• Governments will have to forge the tough consensus that commits necessary public funding while paying only for care that is effective and efficient, based on the best science available.

• Employers must provide strong political support for a transition away from the current employment-based system and be willing to provide continuing financial contributions sufficient to responsibly contribute to the new funding requirements.

• Unions and other organizations that represent users of health services must make enactment of comprehensive health reform legislation a top priority and make a long-term commitment to improving health care service delivery.

• Health care providers and practitioners need to commit their leadership and lend their knowledge and experience to achieving necessary improvements in the quality and effectiveness of care, and use their considerable political clout to support the effort.

We will mobilize our members to build support for bold, meaningful and comprehensive reform and work to pass legislation that assures everyone affordable, comprehensive coverage. We will recruit employers to join us in achieving universal coverage. And we will evaluate the health proposals of candidates for president in 2008 based on the test we have outlined and their capacity to make meaningful change to meet this urgent goal.

Until comprehensive national reform is enacted, we will continue to defend the health benefits workers have fought and sacrificed to establish over the past 50 years, and we will strongly oppose President George W. Bush’s changes in the tax treatment of existing employer-provided coverage.

We also will continue to fight to preserve and expand the State Children’s Health Insurance Program (SCHIP) and Medicaid coverage, improve the Medicare drug benefit and alleviate the legacy health care costs that threaten coverage for millions of workers and retirees, as well as the health of the economy. And we will continue to push for comprehensive reforms at the state level, with the knowledge that other nations have built the political consensus for national reform by first enacting comprehensive care region by region.