Why Labor Needs Improved And Expanded ‘Medicare For All’

[This is the text of a booklet published in January 2006 by the New York Metro Chapter of Physicians for a National Health Program. It was prepared by Joanne Landy, M.P.H., Executive Director of PNHP-NY Metro. For a free single copy of this pamphlet, or to ask about bulk prices, write pnhpnyc@igc.org. For an attractive, downloadable pdf version, go to the website of the New York Metro Chapter of Physicians for a National Health Program.]



Our nation’s health care is in crisis. This affects not only the 46 million uninsured, but also the insured — including those with health benefits under collective bargaining agreements.


There’s nothing natural or inevitable about the costly, employer-based health insurance system we have in the U.S. In fact, we’re the only major industrialized nation that doesn’t provide health insurance for all.





• The U.S. spends more money per person on health care than any other nation, yet there are more than 46 million people without health insurance.


• 15-30% of private insurance companies’ premiums are wasted on marketing, CEO salaries, profits, paperwork and bureaucracy rather than health care services.


• Drug prices in countries with national health systems are a third to a half lower than in the U.S.


• Hospitals and doctors spend billions of dollars dealing with insurance companies, money that could be spent instead on health care.


• 18,000 Americans die every year because of no or insufficient health insurance coverage



The “United States National Health Insurance Act,”
(“Expanded & Improved Medicare For All Act”) H.R. 676


Congressman John Conyers, Jr. (D-MI) (joined by more than 60 co-signers) has introduced HR 676. This single-payer health care program proposes an effective mechanism for controlling skyrocketing health costs while covering all 46 million uninsured Americans and improving health care for everyone.


HR 676 would cover every person in the U.S. for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, chiropractic and long term care. HR 676 ends deductibles and co-payments. HR 676 would save billions annually by eliminating high overhead and profits of the private health insurance industry and HMOs, as well as excessive and unnecessary billing expenses of hospitals and doctors’ offices.


In country after country, labor took the lead in championing universal health insurance. Unions here in the United States need to do the same. Labor’s participation is essential for achieving needed health care reform.





• Employers’ attempts to cut back existing health benefits are the leading source of conflict in labor negotiations today.


• Out-of-pocket health care expenses for insured people are rising while their coverage is dwindling.


• Health care costs rise each year at the rate of 10% or more, far above the rate of growth of other things we buy.


• A single payer health care system would save $300 billion annually.


• Under our employer-based system, if you lose your job, you lose your health insurance too — just when you may need it the most!


• Half of U.S. bankruptcies are attributable to illness and medical bills.


• Employees all too often stay in jobs they dislike because they are afraid to risk losing health insurance coverage.


• Labor can win respect and gain support from those who are not in unions by defending not only its own concerns but also the needs of the whole population. Working for universal health care is a very effective way to do just that.


There are those who argue that labor shouldn’t advocate national health insurance because universal coverage would take away a major incentive for joining unions. But countries with universal health insurance have a far higher proportion of the working population in unions than the U.S. Unions can gain better wages, pensions, and working conditions if they aren’t sidetracked into bargaining to retain essential health care benefits.


Some union members fear they would lose the level of benefits they’ve won if we had national health insurance. In fact, under the current system labor’s health benefits are eroding with every contract negotiation. Union members would have a much better chance of keeping decent benefits, even improving them, if they could form alliances and coalitions with others to insist that the government provide coverage for comprehensive, high quality health care for all. Moreover, unions would always retain the right to bargain for benefits not covered by national health insurance.





A single national health insurance system would provide coverage for all residents of the U.S. Such a single payer system would replace private insurance premiums and out-of-pocket co-pays and deductibles with payroll taxes and additional funding from those with very high incomes.


Several unions and union leaders have come out in favor of U.S. Representative John Conyers’s United States National Health Insurance Act (“Expanded and Improved Medicare for All Act” — see a partial list of labor endorsers on pages 6 and 7). But labor’s voice needs to be strong and clear, inviting the American people and U.S. employers to join in the effort to bring a realistic, fair and efficient solution to today’s health care crisis: single payer national health insurance.





• Urge your local and international union, as well as state and local councils, to endorse H.R. 676, and let us know when you’ve succeeded.


• Check to see if your member of Congress has co-sponsored HR 676. A list of current co-sponsors, plus the summary and text of the bill, is on U.S. Rep. John Conyers’s website: http://www.house.gov/conyers/.


• Join PNHP and receive our regular email updates


• Inform your friends, members of your union and community groups about the urgent need for national health insurance (Medicare for All), and ask them to get involved.


• Visit http://www.pnhp.org and http://www.pnhpnyc.org for more information and data.


• Urge your employer to endorse and actively support H.R. 676 and single payer national health insurance.


• Ask your union to invite a representative of PNHP to speak (contact us at 212-666-4001 or pnhpnyc@igc.org).


PNHP is a national organization of 14,000 physicians advocating single payer national health insurance, with chapters and spokespersons across the country.



Resolutions endorsing HR 676

(“United States National Health Insurance Act,”

 — Expanded & Improved Medicare for All Act)
have been passed by the following union organizations
(partial listing)


  1. Duluth (Minnesota) AFL-CIO Central Labor Body
  2. American Federation of Government Employees Local 2028,
  3. Plumbers and Steamfitters HVAC, Local 188, United Association, Savannah, GA.
  4. United Steelworkers of America, Local 1693, Louisville, KY
  5. Local 2322, UAW, Holyoke, MA
  6. Washington Alliance of Technology Workers, Communications Workers of America, Local 37083, Seattle, WA
  7. Local 576, Laborers’ Int’l Union of North America, Louisville, KY
  8. United Association of Plumbers and Pipefitters, Local 630, West Palm Beach, FL
  9. Coalition of Labor Union Women
  10. Coalition of Black Trade Unionists
  11. Jefferson County Teachers’ Association (National Education Association), Louisville, KY
  12. AFSCME Local 2629, AFL-CIO, Louisville, KY
  13. Northwest Indiana Federation of Labor, AFL-CIO
  14. Paper, Allied-Industrial, Chemical, Energy International Union (PACE) Local 5-2002, Louisville, KY
  15. United Steelworkers of America, Local 6787, Burns Harbor, IN
  16. Local 506, United Electrical Workers, Erie, PA
  17. Plumbers, Steamfitters & Refrigeration Fitters, Local 393, San Jose, CA.
  18. California State Pipe Trades Council, United Association
  19. Local 576 Laborers’ International Union Retirees’ Council, Louisville, KY
  20. Nurses Professional Organization, Louisville, KY
  21. Independent State Store Union, Harrisburg, PA
  22. Local 2320, UAW, Chicago, IL
  23. Washington Chapter 10, The Retired Public Employees’ Council of Washington, AFSCME
  24. Steelworkers Active Organization of Retirees, Chgo, IL, Chapter 31-9
  25. Local 3310, Communications Workers of America , Louisville, KY
  26. St. Joe Valley Project Jobs with Justice, South Bend, IN
  27. United Electrical Workers, Pittsburgh, PA
  28. American Guild of Musical Artists  Chicago/Midwest Region
  29. California Nurses Association
  30. National Association of Letter Carriers, Branch 84, Pgh, PA
  31. Local Lodge 794, International Association of Machinists and Aerospace Workers, Albuquerque, NM
  32. South Bay AFL-CIO Labor Council, San Jose, CA
  33. Community Action Program, 3rd & 4th Areas, Kentucky, UAW
  34. Community Action Program , Southern Indiana, UAW
  35. Local 1375, United Steelworkers of America, Warren, OH
  36. Western Connecticut Central Labor Council, Waterbury, CT
  37. Local 619, Graphic Communications Conference/IBT, Louisville, KY
  38. Local 409, Plumbers and Pipefitters, United Assn, San Luis Obispo, CA
  39. Local 6355, Communications Workers of America, Missouri State Workers Union
  40. D.C. 62, American Federation of State, County and Municipal Employees
  41. Kentucky State AFL-CIO
  42. Local 6000, United Auto Workers, State of Michigan Employees, Region 1A, Retiree Chapter
  43. Local #36, Sheet Metal Workers, St. Louis, Missouri
  44. New York Professional Nurses Union, NY, NY
  45. Central New Mexico Labor Council, Albuquerque, NM
  46. Building and Construction Trades Council of St. Louis, AFL-CIO, St. Louis, MO
  47. Washington State Alliance for Retired Americans
  48. Metropolitan Detroit AFL-CIO Central Labor Council
  49. Southeast Missouri Building and Construction Trades Council, Cape Girardeau, MO
  50. District Council 5, AFSCME, St. Paul, Minnesota
  51. The Lorain County, Ohio AFL-CIO Federation of Labor 
  52. United University Professions,  Local 2190, AFT- State Univ of NY faculty and professionals
  53. IBEW Local Unions in 5 New England states, representing Verizon telephone workers: 2320, Manchester, NH; 2321, North Andover, MA;  2322, Middleboro, MA; 2323, Cranston, RI; 2324, Springfield, MA; 2325, Northborough, MA;  2326, Essex Junction, VT; 2327, Augusta, ME


List as of 1/24/06. Compiled by Kay Tillow, Nurses Professional Organization, nursenpo@aol.com


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