Horse-and-Buggy Health Coverage

>From The Wall Street Journal
By Andy Stern
July 17, 2006

There is no subject that gets more discussion, analysis and 
lament than healthcare in America. Enough already. It's time to 
assert one simple fact: The employer-based system of health 
coverage is over. This may sound shocking, coming from a union 
leader whose members bargain constantly with employers for 
healthcare benefits. But the system is collapsing, crushed by 
out-of-control costs, a revolutionary global economy and masses 
of uninsured.

CEOs know this best: They dread the meeting with HR managers 
who tell them, once again, that their healthcare costs are 
through the roof. So they look for any way to control costs. 
Co-pays go up, subsidies go down, coverage is dropped all 
together. In the last five years alone, the percentage of 
businesses offering health benefits has plummeted to 60% from 
69%. Here's how bad it will continue to get: McKinsey & Company 
projects that by 2008, the average Fortune 500 company will 
spend as much on healthcare as they make in profit. How can we 
possibly compete in the global economy with that kind of 
burden?

I understand why CEOs are afraid of healthcare costs. What I 
don't understand is why they are so timid about doing something 
about them. These are the people who revolutionized medicine, 
communication, technology, entertainment and investing. And yet 
when it comes to addressing the biggest economic issue their 
companies and their country face, they resort to bookkeeping. 
Where are the visionaries? The tough-minded magnates who make 
billions for shareholders? Stuck in the 20th century, that's 
where.

To fix healthcare in America, we have to accept that we're 
living through the most profound transformative economic 
revolution in the history of the world. It's happening so fast 
we can barely keep track of it. Intense global competition. 
Contingent work. The explosive economies of China and India. 
Technology in the workplace. Outsourcing. By the time they are 
35, young people entering the job market today will already 
have worked in eight to 12 jobs. Employers will be pit stops 
for them, not permanent homes. In other words, we are rapidly 
moving from employer-managed work lives to self-managed work 
lives, in which workers must figure out on their own how to 
maintain things like health insurance and retirement.

A new national policy framework is the easy part. There seems 
to be broad consensus that we need a universal system that 
provides affordable coverage, choice of doctors and insurance 
plans, core benefits, and shared financing among employers, 
employees and government. There are a couple of thousand 
position papers out there to choose from. The problem isn't 
policy, it's leadership. And I don't mean Washington, D.C. The 
political class in both parties is full of words and bereft of 
action. They are not going to provide the answers until they 
are forced to. That force must come from the business 
community.

Today I sent a letter to every CEO in the Fortune 500 asking 
them to make healthcare their national priority. I urge 
corporate leaders to come forward. Our union members -- your 
employees -- will work with you. The old idea that business and 
labor can't work together for the common good is as outdated as 
lifetime jobs. The Service Employees International Union is the 
largest healthcare union in the country. Our membership 
includes nearly one million nurses, doctors, hospital staff, 
nursing home and home care workers. We know healthcare. You 
know business. Together, let's build a new 21st-century 
American economy.

Mr. Stern, President of the Service Employees International 
Union, is author of "A Country That Works," forthcoming from 
Free Press.

______________________________________________________________

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