health care needs reform


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AMERICAN HEALTH CARE: what we have, what we need, and why reform is important to AFTRA members

What is the state of US health care?

Simply put, Americans spend more on health care (almost twice the average of the 30 most developed nations in the world) but get less (US is ranked 38th in health care quality). Currently, we spend approximately 16% of our entire gross domestic product on health care. That number will rise to 20% by 2014 when we will have to spend one of every five dollars in our entire economy on health care, potentially causing more and more Americans to go untreated, driving costs even higher, and severely damaging our ability to compete in the global economy.

Why is reform important to AFTRA members?

Apart from getting the quality health care we need at a price we can afford, reform means that our contract negotiations will no longer be increasingly driven by the need to pay higher medical costs over which we have no control. Those higher medical costs compromise our ability to negotiate higher wages and improved working conditions. For those in the AFTRA plan, no reform means higher premiums and co-pays just to stay where you are. And if you aren’t in the plan, you are exposed to the highest costs of an already high-cost system. You face lowered wages and eroded working conditions, with the union unfairly blamed. That’s wrong.

What has AFTRA said about this?

For 16 years, AFTRA is on record, through resolutions of both the AFTRA National Convention and the AFTRA National Board, as favoring national health care reform, preferably a “single payer” system, and that such reform should be a national priority. A bill to create a “single payer” system in the US, H.R. 676 (the “Medicare for All” act), has recently been endorsed by the New York State AFL-CIO. They join 34 other state labor federations, 108 local labor councils, and 430 unions in 48 states in urging its adoption.

What is H.R. 676 and “Single Payer”?

House Resolution (H.R.) 676, the “New Expanded Medicare” bill, creates a new “single payer” or single insurer method of paying for medical services while leaving the medical system itself completely alone and intact. This will eliminate the hundreds of complicated and redundant payment plans currently imposed on the system by private “for profit” health insurance companies, saving billions of dollars in costs. Every American will be able get health care through a comprehensive, affordable Medicare-type system.

What is “real health care reform”?

Let’s start with what it’s not. It is not:

• A different kind of “insurance product,” with new rules that force you to buy policies that are inadequate, paid for with tax credits that are too small. Mandated “Junk” insurance is not a fix.

• Plans that would tax employer-provided health insurance, driving costs up even further.

• “Health Savings Accounts” as a primary way of getting us to absorb even more of the high costs of the current out-of-control health care system.

• Anything that results in more cost-shifting to individuals but sold as “reform” or, more famously, “choice.”

Real health care reform should be:

           • National in scope and system-wide 

           • Systemic – reform should be total, with all pieces instituted at the same time.

Real health care reform should include:

Universal coverage – everyone is covered, no one is left out. 45+ million un-insured and 85+ million under-insured drive costs up for everyone. Every single American must be covered.

Comprehensive coverage – coverage must be broad. It must include preventive, primary, chronic, emergency, and hospital care; drug, vision, dental, and mental health. No exclusions for “existing conditions.” It must underline the ‘health’ in “health care.” The healthier we are, the less care we need, the less pressure there is on the cost of services.

Affordability – premiums, co-pays, and out of pocket costs must be rational and reasonable to our income. 60% of personal bankruptcies are medical related. And 3/4 of those have some kind of health insurance. That’s wrong. Responsibility must be shared between individuals, business, labor and government, but shared fairly.

Personal choice – your choice of health care providers must be preserved. This most personal of decisions can not be dictated by health care bureaucrats or government fiat.

Continuous coverage and care – no “now you have it, now you don’t” plans.

Portability – it moves when you move, from state to state, or job to job.

Reasonable costs will require real cost controls.  

Enacting real health care reform will, by definition, create controls on the cost of medical services, prescription drugs, plan premiums, and out of pocket expenses by:

• eliminating the un and under-insured who add significant costs to the system because they seek care when they are sicker and in the most expensive way: emergency rooms;

• providing care, especially preventive, at the time it is needed, which is the most cost effective way of providing health care services;

• updating medical information technologies. Paper records are twice as expensive to handle. This will also decrease medical error. Fewer errors will save lives and lower costs; and most importantly,

• using the largest “purchasing pools” possible. ‘Reforms’ that drive more people into individually purchased private insurance actually shrink purchasing pools. "Single payer," for example, would create the largest pool. But other attractive approaches create large, efficient buying pools that would dramatically drive down costs.

No reform plan will please everyone. But we can and must make American health care universally available, more affordable, more efficient, and safer. 

In order to achieve this reform, we must elect officials willing to makes these changes. That is why we provide you with the document “Health Care Proposals in the 2008 Elections Affect YOU!” ( so that you can compare and evaluate current election-year proposals.

AFTRA does not endorse any political candidates or parties. AFTRA’s Legislative and Public Affairs Committee is offering this summary of AFTRA’s position on health care reform as a tool to give members a means of making their own judgments about the candidates’ proposals.