1 Gerry Shea, AFL-CIO SOS Rx Meeting April 2, 2008.
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Transcript of 1 Gerry Shea, AFL-CIO SOS Rx Meeting April 2, 2008.
1
Gerry Shea, AFL-CIO
SOS Rx MeetingApril 2, 2008
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AFL-CIO Health Care Campaign Goals Preserve the comprehensive benefits built over decades
Constrain costs
Improve quality and efficiency
Provide health care to everyone
Make government an effective watchdog on cost, quality and fairness
Keep a significant role for workplace-based benefits
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The Path to Health Care Reform Runs Through the 2008 Elections
Overarching AFL-CIO Health Care Campaign
Goals:
1. Educating and Mobilizing Members for
Candidates for President and Congress
Committed to Comprehensive Federal Action
2. Building an Army of Activists for the 2009
Congressional Debate.
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Workplace-Based Coverage Is the Backbone of Health Care in America
• Covers 71% of all Americans ages 18-64
• Pays nearly half of all health costs
• Sets a standard of comprehensive benefits built in decades of union negotiations
• Despite cost pressures, workplace-based coverage has proven resilient because:– It has clear strengths
– It is virtually the only affordable coverage for working and middle-class Americans
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• Natural risk pools
• No underwriting
• Easy to join and choose coverage options
• Resources to advocate for consumers
• Valuable health initiatives– Prevention and wellness
– Chronic care programs
– Comparative information on health quality
Advantages of ESI Over Individual Insurance
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High Health Costs & Employers Who Refuse to Pay Are
Eroding Workplace-Based Coverage• Since 2000, insurance costs have doubled and workplace
coverage has dropped five points
• Caring for the uninsured adds $922 to cost of family coverage
• In 2007, non-union contractors UNDERSPENT union employers by $2.49 per hour (BLS)
• In a 2007 AFL-CIO survey of union members, 35% of union members in multi-employer plans rated cost as their top health concern – compared to 29% of all union members.
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Employer-Sponsored Insurance Is Eroding, But Not (yet) Collapsing
• Premium payments for family coverage in Employer-Sponsored Insurance (ESI) doubled for both employers and workers from 2000-2007, leading to
• A decline in the number of workers offered health care at work and higher contributions demanded of workers, producing
• A five point drop in coverage from 2000-2007
• But 70.9% of workers still have ESI, because
• ESI is highly valued by both employers and workers
• Comprehensive health reform is essential for the survival of ESI
Without comprehensive health reform, the erosion of workplace-based coverage will only accelerate
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Health Premiums Rising 3 Times Faster Than Wages and Inflation
0%
20%
40%
60%
80%
100%
120%
140%
1988 1996 2002 2006
HEALTH INSURANCE PREMIUMS
OVERALL INFLATION
WORKERS' EARNINGS
Percent Change 1988–2006
Kaiser Family Foundation Employer Benefits Surveys
Out-of-pocket costs are going up, too
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We’re Feeling It — And So Are Our Employers
$1,620 $1,800 $2,136 $2,412 $2,661 $2,713 $2,973 $3,134
$4,731 $5,253$5,818
$6,656 $7,289 $8,167 $8,508 $8,972
2000 2001 2002 2003 2004 2005 2006 2007
EMPLOYEE CONTRIBUTION EMPLOYER CONTRIBUTION
Annual Premium Costs for Family Coverage
Kaiser Family Foundation Employer Benefits Surveys, 2000-2006
$6,351
$12,106
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Working Middle Class Losing Coverage
Fastest of All
47%50%
48%
52%48%
39%
35%
44%
33%
21%
15%18%
25%
8%6%9%
11%
2%5%
4%
5%
0%
25%
50%
1987 1989 1991 1993 1995 1997 1999* 2001 2003
Lowestquintile
Second
Third
Fourth
Highestquintile
*In 1999, CPS added a follow-up verification question for health coverage.
Source: Analysis of the March 1988–2004 Current Population Surveys by D. Ferry, Columbia University, for The Commonwealth Fund.
Percent of working adults who are uninsured, by income quintile
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What’s Wrong?
High drug costs,& non-competitive
market
High costs deepen
disparities
Lack of government oversight
Structure is wasteful, inefficient
Costs of care for uninsured adds to costs for
everyone else
Unfair competition from companies that don’t provide
benefits
Arbitrary eligibility decisions by insurers
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Quality & Safety Problems
180,000 people die each year from medical
errors and medication mistakes
No independent information available on new
drugs or medical technology at introduction
Low nurse to patient inpatient ratios
substantially raise mortality risk
Lack of transparency
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Which Path Are WeGoing to Take?
YOU’RE ON YOUR OWN
• Limited plan with high price tag • No watchdog role for
government!
WE’RE IN IT TOGETHER• Choice to keep what you have or
improve on it • Government doesn’t control
but is a watchdog • Shared responsibility—employers,
government and individuals work together
False Solutio
ns
False Solutio
ns
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“People have access to health care in America. After all, you
just go to an emergency room.”
President George W. BushCleveland, OhioJuly 10, 2007
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Health Care for America:Our Principles
• Care that is High-Value and Patient-Centered
• Pooled Risk instead of “Go-It-Alone” Individual Market
• Guaranteed Coverage through New Program built on Medicare
• Continuation of Employer & Union Sponsored Benefits
• Shared Responsibility in Financing & Health Status
• Government is Watchdog on Costs, Quality and Fairness
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Health Care for America: Pathway to Reform I
High-Value and Patient-Centered– Requires reporting on quality standards developed by health professionals,
health researchers, policy experts, consumers and purchaser– Provides comparative performance information on physicians and
hospitals so consumers can make informed choices– Adequate staffing and ban on mandatory overtime– Funds preventive care and screenings to reduce use of expensive
emergency room and chronic care– Addresses staffing squeeze and mandatory overtime– Standardizes billing and claims payment– Automates transactions
Pooled Risk instead of Individual Market
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Health Care for America: Pathway to Reform II
Guaranteed Coverage through New National Program– Makes sure everyone gets good health care—as good as you have now or
better– Guarantees choice of plan, physician and hospital
– Choice of a public alternative to private insurance
Continued Role for Workplace-Based Benefits– Supplements Benefits in National Plan
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Health Care for America: Pathway to Reform III
Shared responsibility among employers, government and individuals– Employers contribute and make screening, consumer information and
advice available at the worksite. – Everybody contributes on a sliding scale, based on ability to pay or
negotiated contribution
Government is watchdog on costs, quality and fairness, and offers – Lets public know about hospital and physician performance on standards– Offers option of strong public or private plan– Prevents claims denials for preexisting conditions or status
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Scare Tactics!
You’ll lose the good coverage you have
‘Government-controlled health care’
Covering the uninsured will drive up your health costs
You’ll have to give up your own doctor and go to a government-issued provider
‘Socialized medicine’
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AFL-CIO Health Care Campaign
• Define McCain on Health Care – McCain is more of the same. This will be
the third Bush Presidency.• Watch out for lies and confusions • ACTIONS
– Keep the heat on all candidates.• Get Out The Vote!• Fight for Reform in 2009 and beyond!
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AFL-CIO Health Care Campaign 2008 Action Plan
• March – SF/CLC Regional Conferences • April - Health care at every CLC meeting
nationwide: 117 currently signed up.• May - Take it to union locals, shop floors,
Labor 08 walks• November - Vote to Turn Around
America• 2009 – Legislative fight to Make Reform Real
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AFL-CIO
Labor ’08 Health Care & Economy Neighborhood Walks – May 17
112 Sites…And Counting
23AFL-CIO