Is Medicare for All Bad for Union-Negotiated Healthcare?
February 26, 2020

The argument that Medicare for All will hurt workers because it abolishes hard-earned healthcare benefits of unionized workers has repeatedly been used against Sanders and Warren. But does the criticism have any basis?

Story Transcript

This is a rush transcript and may contain errors. It will be updated.
Greg Wilpert: It’s The Real News Network. I’m Greg Wilpert in Baltimore.

As Bernie Sanders surges ahead in the race for the Democratic Party’s presidential nomination, many of the attacks against him have honed in on how his Medicare for All plan would supposedly hurt unionized workers who have good health insurance. During the ninth Democratic debate in Nevada last week, moderator Chuck Todd summarized the issue as follows.Chuck Todd: I’m going to stay on this topic, on this issue with the Culinary Union. Obviously, their leaders are warning their members about … that your healthcare plan will take away their healthcare plan, take away private insurance completely. There are some Democrats who like you a lot but worry that this plan, Medicare for All, is going to take away private insurance and that it goes too far. Are they right?Greg Wilpert: Chuck Todd was referring to the Nevada Culinary Workers Union, which had criticized Sanders’ Medicare for All plan and which several other candidates used as an opportunity to attack Sanders as being anti-union. But what’s behind this? Why are unions such as the Nevada Culinary Workers opposed to or lukewarm in their support for Medicare for All? And would Sanders’ Medicare for All proposal really be a problem for workers with good employer-provided health insurance plans?

Joining me to explore this issue is Mark Dudzic. He is the National Coordinator with the Labor Campaign for Single Payer. Also, he is the author of an article published in the journal of New Politics titled Take My Benefits—Please!, which explores how unions would benefit from Medicare for All and why so many of them remain reluctant to endorse the plan. Thanks for joining us today, Mark.Mark Dudzic: Great to be with you.Greg Wilpert: Let’s start with a relatively common argument, which Joe Biden, Peter Buttigieg, Amy Klobuchar, Mike Bloomberg also raised during the Nevada debate, that Medicare for All, by eliminating private health insurance plans, would get rid of hard-fought union benefits and would thus hurt unions and workers. What’s your reaction to that argument?

Mark Dudzic: Yeah, well, I think first of all that that is now actually a minority view within the organized labor movement, that there’s been a real sea change in perceptions about employment-based healthcare, and it’s a growing consensus that it turned out not to be a very good idea to link healthcare to employment. And we’re dealing with a, basically, an unsustainable system here. We have to bargain more and more money every contract, we have to sacrifice wages and other benefits in order to maintain payment into the world’s most expensive and inefficient healthcare system, and it’s not working for us. It’s causing strikes, lockouts, concession bargaining. It’s driving wage stagnation for both union and non-union workers. And we need to transition into a Medicare for All solution in order to take healthcare off the bargaining table and strengthen our bargaining power both as individual workers and as unions.

Greg Wilpert: Now, one of the arguments or concerns that are often raised in connection with how Medicare for All would affect the employer-provided health insurance that unions managed to get is that that it might not be as good as those plans, the existing private plans. What’s your response to that concern?

Mark Dudzic: Look, I would challenge anybody to show me a union plan that is as good as the level of benefits proposed in both the House and the Senate legislation in terms of comprehensive coverage, in terms of lack of out-of-pocket payments, copays, deductibles, coinsurance, et cetera, in terms of the freedom to access care, and in terms of the continuity of coverage. There’s not a single union plan in the country that can can match that level of benefits.

So I think that that’s kind of a false equivalence. I think because we call it Medicare for All, there might be a tendency to compare what the proposals are in the current legislation to the actually existing Medicare system, which has been severely compromised for over 50 years of cuts and attacks and reductions in payments. But this would be an expanded and an improved version of the current Medicare system and would in fact vastly improve Medicare for senior citizens who are currently on Medicare.

Greg Wilpert: I think that’s a very important point because by calling it “Medicare for All,” people always think of the usual Medicare. It used to be called single payer, actually, which perhaps would have been not necessarily clear, but at least it wouldn’t confuse the issue. But let me move to another issue.

Even the AFL-CIO President Richard Trumka and American Federation of Teachers President Randi Weingarten have both expressed a bit of skepticism towards Medicare for All, even though both the AFL-CIO and the AFT have officially endorsed single payer. Now, if unions actually gain from Medicare for All, like you say, either because of their bargaining power and also because the plans themselves might be better or would be better, why are so many union leaders lukewarm towards it?

Mark Dudzic: Well, maybe you should ask them. I mean, I think that both of the organizations you mentioned have passed a number of resolutions that put them on record as supporting Medicare for All, so they’re not doing a very good job representing their own organizations’ positions. I think that there’s kind of two broad areas, I think, that might impact how union leaders feel about this.

The first is perhaps a reluctance to get ahead of their members, that there’s a perception that the union members themselves don’t support Medicare for All and are afraid to give up their benefits. I think to some degree, what happened last weekend in Las Vegas has disabused us of that notion, that, in fact, union members are often in advance of their leaders on understanding how Medicare for All would provide a vastly improved sense of security in their life and in the lives of their friends, neighbors, and family members. I think union members see that they’re more than just employees of a unionized operation, that they’re part of a working class that would vastly benefit from Medicare for All. So I think that that argument has begun to dissipate and will over the course of this election period.

And then the other argument or the other pull on national union leaders, I think, is a concern not to disrupt their political relationships with various groups within the Democratic establishment. And I think that that, again, will be addressed by the dynamics of this political campaign.

Greg Wilpert: So this brings me actually to my next question, which is that the US historically has actually considered a single payer bill back in 1946, at a time when union power was arguably at one of its strongest moments. So my question is, first of all, why did it fail back then? And how could it pass now when union power is actually at one of its lowest points in terms of strength in US history, and not only that, is, as you mentioned, quite intertwined with, for lack of a better word, with the establishment?

Mark Dudzic: I think that the short answer to the 1946 failure, and I wasn’t around then, but … is that in the US, unlike most of the industrialized world, capital emerged from World War II in a very strengthened position and went on the offensive in 1945 and ’46. And one of the first things they killed was the initiative that Roosevelt had promised when he was reelected in ’44 to make healthcare a right in this country, and they had moved on to put handcuffs on labor with the Taft-Hartley bill, and using anti-communism and all the other tools at their disposal to begin to weaken the labor movement. So that’s sort of the short story of what happened here.

But labor was strong enough to negotiate a second-best solution and negotiate healthcare, make healthcare a benefit rather than a right, and that worked pretty well right up into the 1970s for a lot of people, not for everyone. It created a number of disparities around race and gender within the working class in terms of access to healthcare. But beginning in the 1970s with the rise of neo-liberalism and globalization, deindustrialization, we began to experience a massive crisis in employment-based healthcare that’s just been unfolding now for almost half a century for working people.

So I would say that it’s this half-century’s experience with the demise of employment-based healthcare, which has opened up the new possibilities to win it. There’s been a huge paradigm shift in how people perceive Medicare for All. I think that that’s based on their life experience of most working-class families. Everybody knows they’re one major illness away from economic disaster. They understand how precarious it is. You lose your job, you lose your healthcare. Your kid ages out, she loses her healthcare. You go on strike, you lose your healthcare. People are ready for more, and they’re fed up with the status quo. And so that’s what’s really driving this.

Greg Wilpert: And as a campaigner for single payer, what would you say is the most important strategy to pursue in trying to make sure that this happens?

Mark Dudzic: I think we need to go very deep. I’m an old union organizer, and I think that this is kind of one of those moments like early on in an organizing drive, right before the boss finds out about the union. We have massive economic power and political power arrayed against us, and now is the time to really sit down and have the kind of kitchen table conversations with our coworkers and our neighbors about the … to anticipate the attacks that will be levied against us and the lies and the disunity and the threats and the scaremongering that’s going to be unleashed upon us as this campaign gains momentum. So I think now is the time to really go deep and challenge people to really understand this issue and to begin to take action in their own communities and their own workplaces to really reinforce and move this, their support for this issue.

Greg Wilpert: Okay, well, of course we continue to follow and to cover the issue, but we’re going to leave it there for now. I was speaking to Mark Dudzic, National Coordinator for the Labor Campaign For Single Payer. Thanks again, Mark, for having joined us today.

Mark Dudzic: Greg, wonderful to be here. Thanks.

Greg Wilpert: And thank you for joining The Real News Network.