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61 Million Americans Lack Adequate Health Care

GM, the UAW and US Health Care


General Motors Corp. is losing market share and money. Basically, GM’s business downturn is being driven by UAW members having made more cars and trucks than can be sold in the marketplace. Thus, the company wants to re-open its four-year labor contract with the UAW to cut employee health-care costs, unilaterally if need be.

GM says its health-care costs will be $5.6 billion to cover current employees and retirees in 2005. Deep GM discounts on many, but not all, vehicle models have increased sales by extending the "Employee Discounts for Everyone" to the general public. That discount strategy followed a zero-percent vehicle-financing program.

Health-care talks between GM and the UAW began this April. There has been no resolution. In late July, the UAW formed a group of financial and legal experts to look more closely at GM’s claims concerning employee health-care costs.

The conflict over the cost of health care between GM and the UAW creates an opportunity to deepen a discussion about a national health-care program. In my view, such a strategy would have widespread popular appeal for unionized and nonunionized workers in the U.S. Stevie Wonder can see why.

Here are some basic facts about the health-care crisis in the U.S. "There were 45 million uninsured adults in this country, [and] at least another 16 million adults were underinsured in 2003, meaning that they did not have enough financial protection to cover their health care expenses, reports the journal Health Affairs. An estimated 61 million adults — 35 percent of Americans ages 19-64 — had either no insurance, sporadic coverage, or insurance that exposed them to catastrophic medical costs during 2003" (Physicians for a National Health Program, "Uninsured and Underinsured Adults Estimated at 61 Million," 14 June 2005).

In the U.S., health insurance is based on employment. Such coverage is more comprehensive for high-wage workers like those in the UAW. Against this backdrop, UAW members and unionized workers in the U.S. airline industry, for example, are facing a corporate assault on bargained-for benefits such as health care.

At the same time, low-wage workers who labor at non-union corporations like Wal-Mart Stores, Inc. are less likely to have employer-provided health-care insurance. The employer coverage that low-wage laborers do have costs more for them and their family members. Moreover, such adult workers are increasingly turning to Medicaid (the main federal program of health care for poor folks) to cover their kids, reports the Center for Economic and Policy Research.

Let us return to UAW members employed by GM. Likely, even these workers’ company-paid health care insurance may not be enough to keep the wolf away from the door. I imagine some of these workers make up the 17.2 million adult workers with health-care coverage provided by their employers who were also burdened by medical debt in 2003. The aggregate data (not my extrapolation from it) is in a recent study by the Commonwealth Fund.

The U.S. health-care industry backs the notion of consumer self-help. In this perspective, rising costs (co-pays, deductibles, and premiums) stem from medical consumers over-using the health-care system. The solution is simple. Consumers must use less of the health-care system to contain rising costs. This is the ideology used to justify and legitimate the health-care status quo.

I use the term ideology in the sense that Marx did to describe false consciousness. This mystification of life by the ruling class can distract the laboring class. Accordingly, the destruction of this mystification is central to a reversal of the U.S. health care crisis.

The GM and UAW discord over employee health care creates a real opening for organized labor to present progressive ideas on national health care as a right of citizenship. This is an integral part of any civilized vision of national security, I suggest, and stands in stark contrast to the capitalist health care. The broader social framework so lacking in organized labor is most needed on this health-care front.

The standoff between GM and UAW over health-care coverage provides this opening. I propose that the concrete living conditions of the American people make them receptive to a national discussion to de-link health insurance from employment. Hey, GM is taking the lead on this front, albeit from the vantage point of capital!

Radicals in and out of the UAW must push the envelope on socializing health-care costs. Now is the time with GM’s predatory attack on the living standards of UAW members. Whatever the outcome of the UAW study group on GM’s claims, the S word of socialism will remain the humane alternative to business-as-usual.

SETH SANDRONSKY is a member of Sacramento Area Peace Action and a co-editor with Because People Matter, Sacramento’s progressive paper. He can be reached at: ssandron@hotmail.com

This article first appeared at the Monthly Review Zine.