The Labor Movement and the Fight for Single-Payer: a Response to Robert Fitch
by Jerry Gordon, Secretary,

The December 28, 2005 issue of the New York Times carries an opinion piece titled, "Big Labor's Big Secret" by Robert Fitch (the article was previously posted to the SPAN State Council activists list). Fitch's "Big Secret" is his claim that most unions oppose universal health care.  

In my opinion, the Fitch article presents a distorted and one-sided view of where the labor movement is at on this question. Moreover his article employs outdated concepts and fails to deal with certain crucial new realities. 

Fitch writes, "But perhaps the most important factor keeping an overhaul [of the health care system] off the national agenda is one that few Democrats acknowledge: most of Mr. Gettelfinger's [president of the UAW] fellow labor leaders don't support a single-payer system either.

"The reason comes down to simple self-interest. The United Auto Workers is one of the few private-sector unions that doesn't run its own health plan.  Rather, most have created huge companies to administer their workers' plans, giving them a large and often corrupt stake in the current system.

"Opposition to a national health care plan is as much a part of the American trade union tradition as the picket line. It goes back to Samuel Gompers, the founder of the American Federation of Labor, who railed at early Congressional efforts to pass a law mandating employer coverage as Britain had done, which he said had 'taken much of the virility out of the British unions.' 

"This line of thinking led to the notorious decision in 1991 by the A.F.L.-C.I.O.'s health care committee to reject a proposal that the federation support a single-payer plan. The majority said a national system simply had no chance in Congress, but others saw a conflict of interest: government-supplied health care would put union-run plans out of business.... 

"Let's face it: union-administered health insurance funds provide irresistible opportunities for labor leaders. First there's patronage: hiring friends and relatives. Then there are the conventions, junkets and retreats provided by the plans and the providers. And for those willing to cross the line of legality, there's the chance to take kickbacks from health care vendors....   

"Despite shrinking membership, organized labor still has enough money and muscle to get behind a campaign for national health insurance. Last month, public-sector unions in California came up with tens of millions of dollars in a successful campaign to defeat a ballot measure that challenged their right to use union dues for political purposes.

"The problem is getting American unions to fight for common concerns as opposed to narrow institutional interests.  It may just be that a broad-scale union overhaul will have to precede one in American health care." 

The fact of the matter is that with few exceptions, union-run health and welfare funds are conscientiously and honestly administered. In fact, nearly all are jointly run by unions and employers (Taft-Hartley plans) and are subject to strict auditing procedures and oversight. Of course, it is the exceptions that grab the headlines and are grist for the mills of people like Fitch. 

But let's put that aside and go to the fundamental question: Do unions reject single-payer because they prefer to perpetuate union health care plans? 

The answer is that labor is not monolithic on this question and different unions answer it differently. But the trend among unions today in support of single-payer is unmistakable. 

For decades, labor has been divided as to whether to support national health care/single payer. In fact the AFL-CIO's health care committee during the 1980s and early 1990s was evenly split on the issue -- eight in favor and eight opposed. When Clinton proposed his Health Security Act in 1993, the national coalition in the U.S. that had been formed years earlier to campaign for single-payer, which included representatives from several unions, split apart, with some union leaders urging support for Clinton's plan on the ground that "It's better to get half-a-loaf than to end up with nothing." 

Among unions that in the past have taken single-payer positions or spoken out for national health care are the UAW; AFSCME; Steelworkers; Communications Workers; Teamsters; Oil, Chemical and Atomic Workers (now part of the Steelworkers); and Ladies Garment Workers (now part of UNITE HERE).  

Today we have a fast-changing and evolving situation, making obsolete a number of concepts that are reflected in Fitch's column. In the first place, the current health care system is unraveling with ever greater rapidity leading more unions to abandon hopes that the system can be reformed. Second -- and related -- is that unions' health care plans are under savage assault as insurance companies demand ever higher premiums and employers demand that workers pay ever higher deductibles and co-pays. At the same time, many companies are discontinuing benefits altogether, especially for retirees. Employers' attempts to shift costs of health care onto the backs of workers is today the number one cause of strikes in this country.  

So more and more unions are coming to the conclusion that health care benefits should be taken off the table in favor of universal health care if such benefits are to be accessible to their members. And this position is bottomed on another factor which is now becoming pivotal: preservation of pensions

The struggle to maintain pensions and the fight to protect health care benefits are inextricably linked. Unions are compelled to battle on both fronts simultaneously, an enormously difficult challenge given the impact of globalization, competition, and the "race to the bottom." Unions organizationally are under great pressure to grant concessions, while union members want to keep what benefits they have and improve them. Today more and more unions would like nothing more than to get health care benefits guaranteed through public funding so that they could more effectively concentrate on safeguarding pensions. And, of course, union employers would themselves profit if health care were publicly funded. 

SPAN Ohio is greatly appreciative for the support we have received to date from unions. The fight to secure health care for all and protect pensions will be strengthened as more Ohio unions see enacting the HCFAOA as a central priority.

Just Health Care link