Socialist Viewpoint

Recently, International President Leo Gerard of the Steelworkers Union hosted a Pennsylvania gathering of the National Health Care Coalition. “The health care system in the U.S. is racist and class conscious,” Gerard told an audience of doctors, nurses, labor leaders, small business people, clergy and rank-and-file members of several unions, reported the April 20 People’s Weekly World. “Gerard said, citing the numbers: 49 percent of U.S. workers earning $20,000 a year or less have no health coverage; 28 percent earning $20,000-$34,000 lack health insurance; 45 percent of Hispanics residents and 27 percent of African-American residents do not have access to health care. In the fastest growing segment of the U.S. economy, small business, 59 percent of the workers cannot go to the doctor.”

It wasn’t reported if Gerard also told his listeners that thousands of industrial workers with union-negotiated health benefits are losing them, as their corporate bosses continue to cut their work forces. And no group of workers knows that better than the steelworkers. A recent steel union report told of the devastation that tens of thousands of steelworkers, retirees and their spouses are confronting. The union said “more than 127,000 USWA members, retirees and their surviving spouses…already lost…health care coverage due to 17 steel company liquidations since 1998. [Further] a total of 600,000 retirees and surviving dependents [are] ultimately at risk of being confronted by this dilemma.”

It’s not clear how much backing the Steel Union is giving the national health care coalition. But it is clear that the union is still hoping to win government-backed health care benefits for its retirees (who are still union members), separate from all other workers. The union is lobbying for the passage of legislation introduced by U.S. Senator Jay Rockefeller (D.WV) that would cover the health and death benefits that they lost when steel companies failed to meet their contractual obligations.

Even if the steel workers union wins its fight for Federal subsidization of health care benefits for some of its members, millions of other workers, unionized or not, will still be confronted with an ever more costly private health “system” that, as president Gerard rightly says, is “racist and class conscious.”

It’s staggering to realize that workers who have built a ten-trillion-dollar-economy haven’t figured out how to get enough of those dollars devoted to building a reliable health care system that doesn’t victimize workers for being workers or for their skin color. It’s not that workers in other major industrial nations suffer the same indignity. Decades ago, workers in the major European economies won national cradle-to-grave health benefits that cover everyone, the employed and the jobless, the young and the old, as a matter of right, not of wealth or race. Without a doubt, American workers could have won the same health care security or better. Instead, their leaders—their top trade union leaders, that is—took them down another path; a path that has led many workers down a tragic blind ally that seems to be where many more workers and their dependents will wind up.

During the same general period when European workers were fighting for and winning national health care, American union leaders were sectioning off their memberships from the population at large and constructing company-based, or limited industry-based medical plans that were renewed or modified as contracts expired and were subject to the vagaries of the national economy and the specific economic condition of their members’ employers. The results were highly uneven for workers, even unionized workers. Minority and women workers who were largely excluded from many of the higher-paid occupations could not be proportionately represented in the better plans. And, of course, workers who were the last hired and the first fired even in seniority-based cases were unequally provided for. In truth then, even during better days the nation’s health care was rationed by income and was gender and class-based and obviously racist.

In 1945, labor analysts probably would not have predicted today’s health care crisis, a crisis for the working class, anyway. At that time, organized labor looked strong. At the end of World War II union workers partly fired up over the loss of real wages during the war launched a strike wave that eclipsed the strikes of the Depression era. Shortly after, organized labor reached its highest density in U.S. labor history. During the Great Depression, only a few years before, workers’ pressure had led to the introduction of the Social Security program. Surely after the war years, the unions could do much better and force the creation of nation-wide social programs based on the same principle that justified the creation of Social Security. Furthermore, the very important CIO industrial unions had a social welfare political agenda that included civil rights, housing, and national health care.

But by 1955, when the CIO merged with the AFL to form the present national labor federation, a big change had taken place, as related by Kim Moody in “An Injury to All.” Business unionism among union officials, especially at the highest levels, in both the AFL and the CIO, blossomed during the war years under hothouse conditions, fostered by the government. During the war years, the unions traded-off the right to strike in exchange for the concession of acquiring members without organizing them, along with the automatic dues check-off. Quickly, many union officials became contract administrators and bean-counters, not the fighting organizers they previously had to be, if they were to succeed. Further, as Moody correctly wrote, “the benefits bargaining that substituted for the expansion of the welfare state following World War Two became a trademark for the expansion of modern business unionism.”

Today’s health care statistics are painful. Although the U.S. spends far more than any other nation for health care, 42 million Americans have no health insurance. Unemployment and rising premiums and co-pays are undermining health care for millions more. While some hospitals are shutting down wings, others are closing all together. Medical professionals are under increasing pressure to speed-up; get their patients out the door and on their way. The union-negotiated health plans that cover only “their” workers are increasingly short-changing those workers, as companies and industries “down-size,” in response to increasing domestic and international competition and the race to reap profits.

No wonder then that Steelworkers president Leo Gerard is talking about a national health care for everyone. “You cannot be the richest country in the world and not provide health care for your people, all your people.” Even though the steel union officials are still going their own way, seeking medical coverage for their members under contracts and government coverage for some of their members who are without coverage through no fault of their own, national health care advocates have to be pleased that the union may be moving resources to their fight. We’d like to believe that the Steelworkers Union fully intends to join the fight for a national health system. If so, it may mean that other unions, especially the industrial unions, will also meaningfully join that fight. The Steelworkers recently formed an organizing alliance with the California Nurses Association. The nurses association is no latecomer to the effort to establish a national health system, as it was an initial union sponsor of the Labor Party, which has a major programmatic plank in favor of nationalized health care and has won several non-binding local referendums on the issue.

Under the present circumstances, the establishment of a national health system would be as big a change for the nation’s workers as was the introduction of the social security system that came about when the labor movement had an improving relationship of forces, in comparison with corporate America. It’s hard to imagine that a national health system, at least as comprehensive as many European systems, can be won while union strength is ebbing. That would seem to mean that organized labor would need to conduct a fight for national health care in such a way as to increase their support from the many more workers who are not in unions. But that be cannot be done with hallway lobbying and seeking concessions from corporate politicians in exchange for election votes, as is the prevailing practice. The only way a national healthcare program, fully covering every man, women and child, will be built is by a movement as dynamic as the forces that restored organized workers’ power during the depths of the Great Depression. In that case, a fight for a national health system may also be a fight to end what Moody called “modern business unionism.” Now wouldn’t that be something to fight for?