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The AFL-CIO and Universal Health Care
Former union official urges Sweeney to press for single payer system
by Jerry Gordon
Until 1978, the AFL-CIO opposed tying health care to employment. The labor federation recognized that employer mandate programs essentially ratified a multi-tiered, inequitable health care delivery system. Then, in 1978, over the heated objection of many local and international unions, the AFL-CIO officially reversed course and embraced the very system it had previously denounced. What accounted for this remarkable turnabout?
The main factor was the belief that labor was too weak to win genuine universal health care. By endorsing a health care delivery system that keeps commercial for-profit insurance companies at the center, labor hoped to be part of a winning coalition.
According to Marie Gottchalk's excellent book, The Shadow Welfare State: Labor, Business and the Politics of Health Care, the AFL-CIO's health care committee was split down the middle between single-payer advocates and employer mandate supporters. Things came to a head in early 1991 at a critical and contentious meeting of the committee when officials deadlocked eight-to-eight over whether to endorse the single-payer option. Both Lane Kirkland, who was president then, and John Sweeney, who is president now, were clearly committed to the employer-mandate system.Today the AFL-CIO, together with many of its international affiliates, is part of the National Coalition on Health Care. Other members of this coalition include representatives of big corporations. While the coalition's program calls for "Health Insurance for All," it endorses a system that "builds upon the American tradition of providing private health insurance through the workplace." It is time for labor to recapture its past and again embrace an idea whose time has come. There is much greater sympathy and support for the single-payer position in the labor movement than existed even months ago. In Ohio where I live, a campaign to get the legislature to pass publicly funded universal health care has been endorsed by unions, churches, members of Congress, state and local politicians, and community and health care advocacy groups.
Conversation with Sweeney
In September I spoke to President Sweeney to find out if there had been any change in his position regarding single-payer universal health care. I told him about the Ohio campaign calling for a publicly funded health care system to replace the employment-based one that has clearly failed. Sweeney argued that we won't get a single payer system until we change the composition of Congress. I argued that people are angry enough to join a coalition to press for state legislation. Then I asked him whether he now favored a single-payer plan. He said yes. I asked him if I quoted him as being a single-payer advocate, would that be accurate. He said yes. That was the end of the conversation.
The Florida, Washington and Ohio state AFL-CIO's have now taken positions calling for a publicly funded universal health system. Major internationals like AFSCME, the UAW and UNITE hold strongly to single-payer positions. More unions can be won over to this burgeoning movement in support of one of the great social justice issues of the new century.
Jerry Gordon was a staff representative of the United Food and Commercial Workers Union for twenty-three years.
