How I will be evaluating the Senate health care compromise

If the expression on "Blue Dog" Louisiana Sen. Mary Landrieu's face is any indication, Majority Leader Harry Reid may have scored a major victory in the rumored compromise that hopefully will secure the needed 60 votes for health care reform. She looked whipped, like she had just been a guest at a vampire banquet.

While weakly expressing satisfaction at disposing of the "public option," she then had to confess the sacrifice: making age 55 and over eligible for Medicare, making Medicaid open to all comers under 300 percent of poverty, and mandating that 90 percent of all coverage include less than 10 percent administrative costs. Plus retaining essential reform provisions like coverage of pre-existing conditions, and loss of coverage due to caps.

Many details, and questions await the Congressional Budget Office cost-scoring of the compromise. The Blue Dogs appeared to have won the official "public option" battle at the price - it seems - of an even bigger public coverage sector than the House version would have provided, and even more insurance company controls. The private hospitals and wealthiest doctor groups are protesting the huge potential Medicare expansion because they say it is "under-reimbursing," compared to private insurance - which only shows that they know that Medicare, despite itself needing many reforms, is in fact the most efficient and most cost-effective large-scale insurance administration.

This is the time in contract negotiations when we need to count the costs and benefits - the real money on the table - closely, and be careful of abstractions. When the details are released, we should be able to calculate the real expansion of Medicare and Medicaid likely to occur and its impact on workers; the real impact of a 10 percent admin cap, and of the new private and nonprofit exchange proposed for all other uninsured workers, including its management by the U.S. Office of Personnel management; the remaining number of uninsured, including its impact on undocumented workers. Also important, and still undisclosed, are any agreements on how the coverage will be financed.

Am I covered? Who pays? - the two questions every competent local union president or chief steward I ever knew always dug into!

It's important to be wary of "absolute principles" that can cloud your ability to count the real money and benefits in play in negotiations.

I once worked with UE Local 258 in Windsor, Vt., on a strike that was provoked by a company demand to take back a full retirement at 62 provision. Such a provision had been hard-fought and hard-won by the local in previous contracts. It gave machine shop workers a real incentive to retire at 62 without any early retirement penalty. Defending it was a principle on which some local officers had campaigned for bargaining committee leadership.

Company intransigence on this, although they did not tell us this until afterwards, was due to their having changed their pension insurance to a carrier that did not support the 62 retirement benefit. Ill will grew; negotiations reached an impasse; mediation failed; a strike ensued.

Meetings with the company continued during the strike. Eight weeks into the strike the inevitable midnight meeting to avoid mass scabs, or to prevent strikers from burning the mill down, or both, took place. The company made a tentative offer to up the regular, age 65 pension pay to a point where, even with an early retirement penalty, the age 62 retirees would STILL get a 15 percent raise, even though "full retirement at 62" would be removed from the contract. The most committed to "principle" resisted the deal. But the local president said: "So you are willing to explain to the members, who are walking the line, to keep their families on strike without income in order to fight for a 15 percent age 62 retirement cutback to full retirement at 62?"

I will be thinking of that local president - Douglas Whitcomb - when the details of the Senate compromise are released.


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  • One of the major reasons that the U.S. pays more than double what other rich countries pay for health care while leaving 48 million people uninsured and another several tens of millions without adequate coverage is the power of the health insurance industry. This year, big insurance has spent $20 million in lobbying and propaganda not only to retain that power and wealth, but even to expand it, if they can get away with it.
    One measure, then, of what is and what is not a step forward in this struggle is: Does it strengthen or weaken the stranglehold of the private health insurance industry over financing and delivery of health care? The push by the GOP and the Blue Dogs amounts to an increase rather than a reduction of the power and influence of the health insurance industry to not only rake in the profits, but obstruct the attanment of a more rational and humane system.
    Therefore, there has to be tipping point in the rightward development of the legislative proposals, after which we conclude that more harm than good will result from them in the long run. I am not one who believes that a complete defeat is better than a partial or qualified victory. But one has to define "defeat" and "victory" before one can tell which is which.

    Posted by Emile Schepers, 12/17/2009 2:16pm (6 years ago)

  • Bottom line: Working people will continue to suffer under the House and Senate healthcare plans.

    We need healthcare reform that begins with what working people require.

    We should force the House and Senate to scrap their plans and get back to what most people in this country want. Single-payer universal health care.

    Obama and the Democrats abandoned working people on healthcare reform. Union leaders also sold us out on healthcare reform. So did all these organizations like the Campaign for America's Future.

    Sam Reese UAW member Minneapolis

    Posted by Sam Reese, 12/14/2009 2:31pm (6 years ago)

  • The art of compromise as practices by some democrats puts the economist trade unionists to shame. Of course the main prblem here is who sats at the bargaining table for the millions who will get left out and the millions more who want the public option. The collective bargaining process as practiced by unions is not in play in the Senate process. What is in play is the multi-million dollar lobbying campaign which is seeking to get the "best" compromise money can buy. What is clear to me is that the ultra right is forcing politicians into the corner of compromise to the extent where health care as a human right is not even on the table. Fighting to end the death of over 40,000 people a year is not exactly fighting for an abstract principle.

    Posted by Frank Chapman, 12/14/2009 10:06am (6 years ago)

  • Mr. Butler, have you ever been on strike? I'm just curious, because your romanticized idea of it seems to be in stark contrast to just how much it sucks in real life. If you think workers who have gone without pay for 8 weeks should turn down a settlement, which is actually 15% better than their original demand, on a technicality because that's "selling out", maybe you need to spend a little more time out on the picket line.

    Posted by Jesse Jack, 12/12/2009 12:05pm (6 years ago)

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