Steve Early Speaks With Us About Labor and Single Payer Healthcare
September 4, 2014 by Ben
Filed under Healthcare-NOW! Updates
Early worked for 27 years as an organizer and international representative for the Communication Workers of America. He is the author of a new book from Monthly Review Press titled Save Our Unions: Dispatches from a Movement in Distress. He is working on a book about political change and public policy innovation in Richmond, California.
Question 1: Both your new book Save Our Unions: Dispatches From a Movement in Distress – and your previous one, The Civil Wars in U.S. Labor – draw on your experience as a union negotiator and longtime single payer activist. In 2008, liberal foundations, major unions, and the AFL-CIO created and financed Health Care for American Now! (HCAN). This lobbying coalition had a name similar to ours but it soon distanced itself from the goal of single payer. In retrospect, what impact did HCAN have on labor’s quest for a better health care system?
I think HCAN “settled short” and was too compliant with Obama Administration goals. It also went in the wrong direction by embracing the notion that our system could be substantially improved by mandating and subsidizing the purchase of private insurance, maintaining employer plans where they still exist, and offering a “public option” as a not-for-profit alternative for the millions of new customers now shopping for coverage in our state-based insurance exchanges.
Even after the “public option” was eliminated from that package, HCAN over-sold Obamacare to its labor constituents. In retrospect, we would have been better off if the smaller bloc of pro-single payer unions and the more influential (but always overly pragmatic) organizational players in labor’s mainstream had united around the more modest goal of defending and expanding existing forms of publically-funded healthcare.
Labor’s top priority should have been reversing the partial privatization of Medicare–through the costly and inefficient Medicare Advantage program–which Obama criticized as a presidential candidate in 2008. Lowering the eligibility age for Medicare would have been a good incremental next step in the direction of single payer. Unions and their allies could also have tried to insure more of the low-income uninsured through Medicaid expansion—without the option of privatizing it, which the Obama Administration is now permitting in Arkansas, despite the bad track record of Medicare HMOs.
Labor should also have pushed for more federal support for state level experiments with single-payer—which the ACA has now complicated and delayed. Pre-emptive improvements and better funding of the VA system five years ago—instead of the current emergency intervention—might have strengthened that model of public healthcare delivery, which operates as a kind of British-style national health service for those eligible…
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