July 24, 2007

I want to join President Sweeney in thanking you for your support of the Employee Free Choice Act.

Many of the critical problems we face as a society could be resolved if we could fix the problems at work-from stagnant wages and inadequate benefits to high turnover and protecting the rights of workers, to a voice, to bargaining, to fair contract-the essentials for creating the good jobs that are the foundation of stable families and communities.

We may have been temporarily blocked by an aggressively anti-worker minority in the Senate, but with your help we are on track to restore the right of workers to make a choice for a union.

I also want to thank all of you who have taken up the challenge of confronting the health care crisis. For more than a decade, Republican control of Congress has stifled debate-and suppressed action-for comprehensive national reform.

As the number of uninsured increased, benefit levels decreased, and America's working families faced growing insecurity, financial turmoil and bankruptcy from health care costs, and as they lived in fear of losing their insurance, the Republican leadership in Congress stood silent, unconcerned and inactive.

Only discussion, debate and action at the state level kept health care reform alive and active in the public mind and, on the political radar screen. State-level proposals have been the engine of health care reform. I believe that state-based reform must continue to drive the movement for comprehensive reform.

We cannot sit back and simply wait for another election or another Congress or another president to raise the issues and search for the solutions to the health care crisis.

We must move the reform agenda forward. We must build the pressure so no president, no interest group, no Congress, no Senate filibuster, can deny the American people a health care system that is effective affordable and universal.

We must accelerate the momentum for change. We must forge a broad reform consensus. We must build an unshakeable grassroots base for comprehensive reform.

Union members and the labor movement are your partners in building the grassroots base, forging the consensus, and generating the public pressure for reform.

We share the same problems and we have the same concerns. You look at your state budgets, and you immediately see the impact of the uncontained and uncontrolled rise in health care costs.

We look at our contracts and see potential wage increases, advancement opportunities, training programs, all consumed to cover ever increasing health care costs.

In collective bargaining, every major labor dispute for more than a decade has been over health care. Many of the largest involved UFCW members.

In 1993, thirty thousand workers went on strike in New Jersey in one of the opening rounds of our current health care crisis.

And, in 2003, more than 60,000 UFCW members in California were on strike-or locked out-for more than four months. Workers were willing to lose their homes and their life savings rather than lose their health care benefits.

Health care benefits for working families are the difference between the middle class and poverty. Health care benefits are the difference between basic economic security and living in the state of constant economic risk from an unexpected injury or illness.

Working families are willing to organize for-fight for-and vote for affordable health care.

Over the past year, the UFCW has been conducting focus groups and conducting surveys on issues of worker concern. No other issue has the impact of health care. Workers do not live in fear of terrorism. They live in fear of losing their health insurance.

There is rising economic anxiety among workers-with almost three fourths identifying economic security as their chief concern. The three leading sources of the insecurity were health care related: losing health insurance, rising health insurance costs, and the threat of an illness not covered by health insurance.

Working America is ready for health care reform. And working America believes that government-not the market-has a key role to play in reform.

I served on the nonpartisan Citizens Health Care Working Group-a group sponsored by Senators Wyden and Hatch and established by Congress.

We conducted citizen forums across the country. We had thousands of participants and received tens of thousands of comments.

America wants health care reform. America wants universal health care coverage.

America wants government and business-as well as individual citizens-to take responsibility.

America is looking for leadership.  

Together, I believe we can build the base for reform. We can give Americans hope that reform can work.

But we must be guided by two principles. First, "do no harm." That is the guiding rule of health care and it must guide reform proposals.

When state-based reform programs are developed, we must look at the impact on the current employment-based system. Despite the pressure on the system from rising costs and the growing number of uninsured, the system has remained remarkably stable.

Almost two-thirds of American workers get their health insurance at work. And the number of workplaces offering insurance and the number of employees signing up for the insurance remains the same as 2 decades ago.

Reform must recognize the importance of the current system to working families and must reinforce rather than weaken the system of employment-based insurance.

A primary source of the problem in the employment based system are the employers who do not provide adequate health benefits. And that problem impacts all of us!

When employers do not participate in the current system, when employers do not pay their fair share, they shift their costs to your state Medicaid program, and, to us and our employers through rising insurance costs to cover the treatment of the uninsured.

We estimate that about 20-30% of the costs of UFCW health care plans-plans that cover about a million and half people-result from cost shifting from employers not providing health benefits.

Employers not providing benefits also get a competitive advantage over responsible employers and in effect can destroy jobs that come with benefits.

We face that situation everyday with Wal Mart. The nation's largest employer fails to provide adequate health benefits and shifts hundreds of millions of dollars in health care costs-and it gains a direct competitive advantage.

As Wal-Mart gains market share it destroys the UFCW jobs that come with benefits. It is not a level playing field. It is tilted against responsible employers.

Our members bear the brunt, but state governments bear the burden as well. Wal-Mart is one of the largest sources of individuals in state Medicaid programs.

Some pay or play models of state-based reform can make the problem worse. If the cost of "paying" is less than the cost of "playing" then it gives employers an incentive to abandon the system.

Reform-rather than leveling the playing field further tilts the playing field in favor of employers not providing benefits. Similarly situated employers-employers of the same size in the same industries-have to bear similar costs.

We must not give any employer an incentive to drop health care benefits. We must not put working families at risk of losing their health benefits at work.

In 1994, opponents of reform convinced millions of insured Americans that health care reform could cost them their benefits rather than secure their benefits for them.

We must demonstrate that reform will bring an improved system.

The second principle of reform goes directly to improving the system-making it more accessible, more affordable, and more effective.

We must move to a "health" system instead of a "sick" system. Our system puts resources at the back end in reacting to disease rather than in the front end in promoting health. As a result we get more sickness-and less health-and we pay the price both in higher costs and poorer outcome.

On key measures of health care outcomes-preventable deaths, longevity, and infant mortality-we lag behind most advanced nations. On the issue of preventing preventable deaths, for instance, the U.S. preventable death rate is 30% higher than countries such as Spain, France or Japan. At the same time, we spend over 15% of GNP on health care, while the average for advanced countries is around 9%.

If the system cannot prevent preventable deaths-the system has failed.

Over the past decade, we heard about market-based solutions. The theory is: force individuals to pay more and they will use resources more wisely. In reality, individuals delayed needed exams, regular checkups, and preventive care. It was an incentive to postpone health care and to wait for sick care. Market-based solutions drove up the cost of the system and generated more illness and long term disease.

We have to think differently. It is not simply about extending coverage in the current system-a system with exorbitant costs and poor results.

We cannot financially sustain, nor can the American people live with, the current system of "sick" care.

We must focus our resources on improving outcomes. If you target outcomes like improving longevity, infant mortality, and preventable death rates, and use patient-centered care management for long term illness…

If you direct your resources differently-you can actually reduce costs and give people longer healthier lives.

The UFCW is negotiating a new model of care. We are focusing our plans on outcomes.

For instance, on July 1, for retail food workers in Indiana, we put a reform program in place where all preventive care, vaccinations, screenings and checkups are provided without any co pays, deductibles or out-of-pocket expenses.

We expanded coverage, and we believe we will reduce long term costs. We are countering the trend of shifting more costs to workers. We are shifting resources to health rather than to sickness and we are developing a reform model that is a genuine reform.

It is a model that works with an employer mandate program, a single payer program, or universal Medicare.

Outcomes-based reform is a workable model for state-wide reform and can help us forge a consensus for comprehensive national reform.

I believe this is our moment. After more than a half century of delay in providing Americans with a national health care program, we can provide the vision and the leadership to guarantee every American from this time forward.

High quality, comprehensive, affordable health care.