Labor Unions Abandon Healthcare Coalition

Barbara Lock, MD
March 09, 2009

Two labor unions, the American Federation of State, County, and Municipal Employees, and the Service Employees International Union, have withdrawn from a healthcare reform coalition, the New York Times reports

The so-called Healthcare Reform Dialogue is led by Richard J. Umbdenstock, the president of the American Hospital Association, and includes representatives from all stakeholders in the debate.  a medical staff entering an abandoned hospital

Two participants, one of whom asked not to be named because the talks have been conducted in secret, seemed to suggest that the withdrawal of the labor unions was related to a concern that the final recommendation of the coalition will reflect the 'lowest common denominator,' instead of a 'robust, expansive' agreement that the unions were looking for. 

The defecting labor unions' stance on pushing for meaningful reform is in contrast to that of unions generally during the single-payer debate of the early 1990's; most favored a perpetuation of the employment-based system of health benefits.  This stance has left many American corporations, such as General Motors, in serious financial straits. 

The concept of 'health expenditure saturation', traditionally used by academics such as Graham Scambler to refer to an oversubscription of publicly available and no or low-cost healthcare available in European social democracies, can now refer to the oversubscription of employer-provided no or low-cost healthcare available in the United States.  Market forces cannot right this problem under current circumstances because the consumers of health care, the patients, unless they pay out of pocket, have no incentive to seek highest quality, lowest cost care.  This applies to both recipients of entitlement program benefits such as Medicare and Medicaid, and to users of private health insurance.  Increasing the personal burden of health care costs, with a substantial safety net, is bitter but necessary pill in the treatment of the healthcare crisis.   



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