May 312013

onaschoutsmall by Bill Onasch

The Confined Space of Affordable Care
Being married to a Certified Industrial Hygienist, I’ve heard a lot of confined space injury stories. Particularly enraging are the easily preventable fatalities resulting from trench collapses. Often working alone, workers untrained, or simply ignoring safety protocols, while digging to lay water and sewer lines can become buried under the dirt they have dug–resulting in an agonizing suffocation.

Except for the working alone part, it’s a good metaphor for the Affordable Care Act, now universally called ObamaCare. Many hands–including, with a few honorable exceptions, nearly all union officials, liberals, and even some calling themselves socialists and communists–dug deep and shoveled much dirt to lay a new health care pipeline as directed by their “friend” in the White House.

Oh some of them complained now and then. AFL-CIO president Richard Trumka even drew some lines in the sand they had scooped out. But President Obama, who spent his early years on Hawaii beaches, kicked the silica back in poor Richard’s face. Suitably chastened, Trumka became the lead singer in the chorus praising Affordable Care as the greatest invention since pre-sliced bagels. They even threatened to lead Primary election challenges against any rouge Democrats who didn’t get with the ObamaCare program.

Now three years later, most of the ambiguous features of the Affordable Care Act have been fleshed out and the most substantial changes are about to be implemented. Only now, as it becomes clear that the new pipeline brings not fresh water but the toxic sludge of commodity health care, and recognizing the trench they dug is being filled over our heads, are some labor statespersons showing some too-late twinges of buyer remorse.

UFCW president Joe Hansen recently wrote,

“‘If you already have health insurance through your job — and because many of you are members of unions, you do — nothing in this plan will require you or your employer to change your coverage or your doctor. Let me repeat: Nothing in this plan will require you to change your coverage or your doctor.’ Those were the words spoken by President Obama at the AFL-CIO Convention in Pittsburgh on Sept. 15, 2009. Since then, Congress has passed the Affordable Care Act (ACA) and it has been signed into law. It has withstood a challenge before the Supreme Court. Regulations have been issued, exchanges created, and open enrollment is set to begin in a matter of months. Unfortunately, what also has become increasingly clear with each passing day is that the president’s statement to labor in 2009 is simply not true for millions of workers.”

Hansen focuses on threats to so-called Taft-Hartley non-profit health care plans negotiated directly between unions and employers. In the UFCW, many of the workers in these plans are low-wage and/or part-time. The new law allows all employers to opt-out of insuring part-time workers.

Dianne Stafford wrote in the Kansas City Star,

“Since the Great Recession began, …the proportion of involuntary part-time employment has grown, and there are signs the Affordable Care Act — Obamacare — is swelling those ranks as employers prepare to reduce their health-insurance coverage responsibility for full-time employees…. Beginning in 2014, businesses that have more than 50 full-time-equivalent employees must offer their full-time workers access to a qualified health care plan or pay a penalty of $2,000 a person. The health care law defines a full-time employee as anyone working more than 30 hours a week. That is a precedent-setting and low definition of full-time work, a member of the National Federation of Independent Business testified before Congress last month….A study released earlier this year by the University of California-Berkeley Center for Labor Research and Education estimated that 2.3 million workers nationally, or nearly 2 percent of the workforce, are at greatest risk for having their hours cut to below 30 hours a week.”

Expanding the part-time, no benefits sector of the working class is far from the only game change in store. If you are lucky enough to have a union job with really good benefits be ready to trade in your Cadillac plan for a Vespa. Reed Abelson writes in the New York Times,

“Under the law, an employer or health insurer offering a plan that costs more than $10,200 for an individual and $27,500 for a family would typically pay a 40 percent excise tax on the amount exceeding the threshold….Although the tax does not start until 2018, employers say they have to start now to meet the deadline and they are doing whatever they can to bring down the cost of their plans….the changes are right in line with the administration’s plan: To encourage employers to move away from plans that insulate workers from the cost of care and often lead to excessive procedures and tests, and galvanize employers to try to control ever-increasing medical costs.”

Apparently the President discovered those health insurance plans he promised we could keep actually were being abused by our demands for “excessive procedures and tests.” There’s certainly nothing I love more than a trip to the doctor’s office to be probed, prodded, scanned, and drained of various fluids. ObamaCare and the boss will make us more thrifty, less self-indulgent.

Many bosses didn’t need the threat of ObamaCare to demand higher premiums, deductibles, copays, and prescription charges. These give-backs have become the norm in collective bargaining and fait accompli for the unorganized.

Currently a tentative agreement for what is now the biggest national union contract is being reviewed by UPS Teamsters. Unlike most agreements today there are raises, not wage cuts. But it does include health care changes.

Currently UPS Teamsters pay virtually nothing out of pocket for anything. After some initial posturing, the tentative agreement avoids assessing  premiums but provides for modest out-of-pocket charges for services. Though the TA would maintain a Cadillac plan enjoyed by few others any more, there is understandable widespread opposition to any give-backs to a company earning  record billions in profits. It remains to be seen whether the deal can be sold.

UPS is insistent on these concessions that are relatively insignificant in the overall package because they want to tie in to the general ruling class offensive to shift the cost of health care more directly than ever to the workers. When the new contract expires, if ObamaCare is still in place, even the concessionary plan would be subject to the new forty percent tax. With the no concession barrier already breached the hammer would come down hard in 2018.

Even during the worst of the recession, health care was one industry experiencing consistent job growth. That appears to be changing in response to both ObamaCare in general and reductions in Medicare payments in particular. One example is quasi-public Liberty Hospital in the Kansas City suburb of Liberty, Missouri. They recently laid off 129 staff, including many long service RNs. Their marketing director explained they were “necessary in part because of new federal mandates put forth in the Affordable Care Act that reduces money coming in from Medicare, leading to higher payments required of patients and more issues with bad debtors.” Because they are staunchly nonunion, “The positions picked for elimination were based on a mix employee performance and business necessity as it pertained to the individual position.”

And what about perhaps the most important claim of all for ObamaCare–universal coverage? From Robert Pear in the New York Times,

“The refusal by about half the states to expand Medicaid will leave millions of poor people ineligible for government-subsidized health insurance under President Obama’s health care law even as many others with higher incomes receive federal subsidies to buy insurance. Starting next month, the administration and its allies will conduct a nationwide campaign encouraging Americans to take advantage of new high-quality affordable insurance options. But those options will be unavailable to some of the neediest people in states like Texas, Florida, Kansas, Alabama, Louisiana, Mississippi and Georgia, which are refusing to expand Medicaid. More than half of all people without health insurance live in states that are not planning to expand Medicaid.”

In summary,

* Those who had plans we wanted to keep are mostly losing them while millions without any coverage before still do without.

* Health care costs for workers have been climbing and will climb more–for some much more as the Cadillac tax kicks in.

* Many providers are playing hard ball, curtailing Medicare business rather than accept cuts in payments.

* Jobs in health care are in jeopardy.

Though Administration ineptitude and Republican obstructionism are both palpable, the crisis flows from the very system of commodity health care. ObamaCare was drafted by a senior insurance company strategic planner. A more efficient implementation would mean little improvement for us.

Even single-payer, modeled on the Canadian system and supported by some unions and doctors,  is only a partial reform. It would eliminate the insurance robber barons–good riddance to bad rubbish. But we would still be in constant battle with the corporate providers and Big Pharma.

Quality, affordable health care for all is not realizable within the market economy. We need to socialize health care such as, for example, the British and Cubans did long ago.

The health care industry is an important base for the class that rules. Socialized medicine will not be won through the political Establishment of that class. The British needed a Labor Party in power; the Cubans made a revolution. Since I don’t look good in a beard, and don’t care much for camping out, I say let’s first try that Labor Party thing.

In Brief…
* In 2007, energy giant Peabody spun off Patriot Coal, launching it with 16 percent of its assets and 40 percent of its retiree liability. The following year Patriot acquired a retiree dump in a spin-off from Arch Coal, Magnum, which had started out with 12 percent of Arch’s assets and a whopping  97 percent of its retiree health-care liabilities. With three times as many retirees as active workers, no one was surprised when Patriot filed for bankruptcy and told the bankruptcy judge they would have to liquidate unless she abrogated the United Mine Worker agreements covering 13,000 retirees. Wednesday the Judge did the company’s bidding. The union, who have mobilized impressive demonstrations in defense of retirees threatened with destitution after these betrayed promises, is appealing. More about this in a future WIR.
* There have been many recent headlines proclaiming new optimism about the economy. But a sobering story in the Washington Post reminds us, “American households have rebuilt less than half of the wealth lost during the recession, leaving them without the spending power to fuel a robust economic recovery, according to a new analysis from the Federal Reserve. From the peak of the boom to the bottom of the bust, households watched a total of $16 trillion in wealth disappear amid sinking stock prices and the rubble of the real estate market. Since then, Americans have only been able to recapture 45 percent of that amount on average, after adjusting for inflation and population growth, according to the report from the St. Louis Fed released Thursday.”

Save the Dates
This coming October 11-13 there will be a conference marking the first anniversary of the passing of a remarkable labor stalwart, and mentor to many of us, Jerry Tucker. The venue will be the University of Missouri at St Louis–Jerry’s home town. A message from Mark Dudzic posted on the Center for Labor Renewal e-mail list says in part,

“This promises to be an unusual and inspiring gathering at a moment in history in which many of the gains that the working class has made in the past 100 years are being attacked. Along with his family and friends, the conference will pay tribute to Jerry’s life and legacy with music, video and personal testimony. And, following Joe Hill’s instructions to ‘Don’t mourn, organize!’(which Jerry would have heartily concurred with), the weekend will include workshops, plenaries and discussion to address the strategies of working class unity and struggle that he passionately fought for in his lifetime.  We hope to address the broad question which Jerry articulated so well, namely: How do we build a powerful social movement and exercise the collective might of the working class through true solidarity, accountability and democracy.

“If you knew and loved Jerry or worked with him on his many campaigns and projects, this conference is for you. If you are engaged in the working class struggles for justice, inside and outside of the labor movement, and are looking for thoughtful strategic discussion and debate on the direction of our movement, this conference is for you. If you are a young activist seeking to connect with a rich history of struggle and to share your experiences and ideas, this conference is for you.”

As more details about the event are available I will pass them on through this column.

That’s all for this week.


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