Thursday, December 10, 2009

Evaluating the Senate Health Care Compromise

by John Case

How I will be Evaluating the Senate Health Care Compromise

If the expression on "Blue Dog" Louisiana Senator Mary Landrieu's face is any indication, Senator 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% of all coverage include less than 10% administrative costs.

Many details, and questions, await the Congressional Budget Office cost scoring of the compromise. The Blue Dogs appeared to have won the "public option" battle at the cost -- it seems -- of an even bigger public sector, and even more insurance company controls. The private hospitals and wealthiest doctor groups are protesting. 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 will should be able to calculate the real expansion of Medicare and Medicaid likely to occur; the real impact of a 10% admin cap in the new private and non-profit exchange, and it management by the the US 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 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 midnight meeting to avoid mass scabs or burning the mill down, or both, takes place. The company makes 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% 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% Age 62 Retirement.

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