The experience of my daughter and grandson offers a telling example
of what is right and what is wrong with our health care system in this
country — and a reminder of how careful we should be when it comes
to overhauling a public-private system that is critical to the financial
well-being of working families.
Three years ago, my grandson, Antonio, was born with a severe case of
cerebral palsy.
Antonio is a delightful boy with a beautiful smile, but he may never
be able to walk or talk or care for himself. He has had numerous surgeries
and battles frequent seizures. And my daughter has had to scale back her
college studies as she cares for her son and navigates the health care
system.
Still, we were lucky to have health insurance for both my daughter and
my grandson at the time of his birth and in the months that followed,
when his medical bills approached $300,000. That insurance was provided
by my former employer until my daughter turned 21 and could no longer
maintain her status as a full-time student. Now we gladly pay $900 a month
to maintain coverage for her and Antonio. Otherwise, Antonio’s medical
bills would have wiped out my daughter’s college savings and a good
portion of her parents’ assets as well.
When it comes to health care, my family has a lot to be thankful for.
Thanks to a generous employer-paid health plan, Antonio’s post-natal
care was covered in full.
Thanks to a government mandate called COBRA, my daughter could continue
that coverage on her own when she lost eligibility for my employer’s
insurance. And, thanks to family savings from living-wage jobs, we can
probably help my daughter pay her health insurance premiums until she
or her future husband gets a job with dependent health care benefits.
But, if my daughter didn’t have the help that came from her family’s
good jobs with good benefits, she’d be in the same boat as tens
of thousands of other parents of children with disabilities and disabled
young adults in this country. I attended a workshop on disability benefits
with several of these parents and young adults last year. Many are eager
to work as best they can, but they will have to stay relatively poor to
qualify for health insurance paid by our government.
In order for Antonio to qualify for Supplemental Security Income (SSI)
and the Oregon Health Plan, my daughter can have no more than $2,000 in
assets beyond a home, furnishings and a car. Antonio can’t qualify
for Social Security disability benefits because neither he nor my daughter
has prior employment covered by Social Security.
This is what has happened to our government’s health and welfare
systems. Unlike the social insurance programs offered in other wealthy
nations, many social programs in the U.S. serve only the poor. Middle-class
workers pay the bulk of the taxes that support these programs, such as
SSI, but then they have to spend down their assets in order to collect
those benefits when they need them.
It is worth keeping these realities in mind as we join the debate about
health care reform in this country.
Former Governor John Kitzhaber wants to establish universal health care
by ending tax subsidies for employers who provide health insurance for
their workers and reducing Medicare benefits for higher-income seniors.
In effect, he’d raise taxes on employers who provide health insurance
and spend less on health care for older people in order to give government
the resources it needs to extend coverage to the uninsured.
But the employers who would pay those higher taxes provide health insurance
to 60 percent of Americans. That’s what paid the bills for my grandson’s
post-natal care. And, if we shift more responsibility to government for
providing health care, I’m concerned that lawmakers will limit benefits
to those who are poor or nearly poor — a group that I hope will
never include my daughter.
To his credit, Kitzhaber’s plan would cover the uninsured. But
many of the uninsured are working people whose employers shirk their responsibility
for providing health insurance. I’d rather force those irresponsible
employers to provide health insurance for their workers before we ask
good employers to pay more for their workers’ health care or ask
seniors to forgo some of their promised Medicare benefits.
Senator John Kerry offered different ideas about health care reform
in 2004. He wanted the government to guarantee health care for all children
and help good employers who provide health insurance by having the government
cover the bulk of their catastrophic costs. His approach would have reduced
employer-paid health insurance costs that are largely circumstantial or
hard to control, e.g. the costs attributed to the number of kids enrolled
in a given plan (by the way, union plans cover far more children than
non-union plans) and the incidence of catastrophic events (like my grandson’s
post-natal care).
Kerry’s ideas would be a lot more helpful to my daughter and grandson
and to most middle-class families, because they would bolster the health
benefits paid by employers.
Good health insurance is a bulwark of the middle class, as important
as a living-wage job, home ownership and a good retirement plan. If we
start to remove supports for our employer-financed system of health insurance,
we will see more employers abandon their responsibility for their workers’
health care and more middle-class families tumble into poverty. Then the
taxes we pay on our paychecks will be stretched even thinner to help the
growing ranks of the poor without health insurance.
Don’t get me wrong. We need government to solve our health care
crisis. Our union movement can’t do it just by organizing more workers
and bargaining better contracts. But we have to make sure that we demand
solutions from government that encourage employers to continue their financial
support for their workers’ health care and provide affordable benefits
for all working families, all income groups and all generations, from
grandparents to grandchildren
Tim
Nesbitt is a former president of the Oregon AFL-CIO. For more information,
check out the Oregon AFL-CIO online at oraflcio.unions-america.com
