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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

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