Hope for Healthcare on the Horizon

Recording Vice President's Report

Volume CVIII, No. 6June, 2008

Bill Dennison

As Allegro went to press it seemed clearer than ever that the Democratic presidential nominee will be Barack Obama. The primary campaign may finally be over. While it has seemed tortuously long and, at times, divisive, it has produced an unprecedented turnout of new voters and an equally unprecedented hope that we can actually turn our country in a new direction. 

I recently attended a meeting of the New York City Central Labor Council, which has already begun gearing up for the November election. Our council, along with the national AFL-CIO, is going to do everything possible to educate union members and their families about the positions of Barack Obama and the presumed Republican nominee John McCain. 

To that end, the AFL-CIO has already prepared and begun distributing material on one issue that we are all too familiar with: health care. It’s a good issue to begin with because it demonstrates how dramatic the differences are between these candidates and their respective parties.

There are two figures that tell the story of the current national health care crisis: 47 million and $15 billion.

Last year the number of uninsured Americans — those with no health insurance at all — grew to 47 million.

Last year the health insurance industry reported $15 billion in profits.

Keep those figures in mind as you examine the candidates’ plans.


Senator McCain’s health care plan was unveiled only a few weeks ago. It seems designed most of all to protect the insurance industry profits.

First of all, McCain would tax the health care benefits of those who currently obtain health care insurance through their job. Either you or your employer would pay taxes on the IRS’s valuation of your insurance coverage. This would increase the cost of employer-provided health care with the likely result that more employers would either drop coverage or pass the added cost on to employees. It is likely that both the cost of coverage and the number of uninsured would rise. 

For those currently uninsured, the McCain plan would provide a tax credit for the purchase of coverage. The tax credit (paid for by the new tax on those who have insurance), is projected to be $3,000 to $5,000 per year, a fraction of the $13,000 to $16,000 cost of private family health insurance. Because there would be less incentive for group plans (particularly large multi-employer plans) and because more people would be pushed into the insurance market as individuals, there would be no brake on increases in premium costs. (The McCain plan includes no mechanism to restrain these costs.)

For those with pre-existing conditions who insurance companies refuse to sell coverage to, McCain would “work with the states” to help establish a high-risk pool, presumably subsidized by the states with higher state taxes to pay the added premium costs of those at high risk of illness. 


Obama laid out his health care plan at the beginning of the primary season. It has three key components.

  1. It would create a public insurance plan similar to the Federal Employees Health Benefits Program, the plan that is available to government employees, including members of Congress. Individuals or employers could buy into this new public plan, which would compete with private insurance plans.
  2. It would establish a “National Health Insurance Exchange” that would set standards for participating insurance plans to ensure fair and stable premiums, require that pre-existing conditions not disqualify someone from coverage and require that these private plans provide the same comprehensive coverage and have the same standards for quality and efficiency as the public plan.
  3. It would require that all employers pay a meaningful percentage of the cost of coverage for their employees or contribute a percentage of payroll towards the costs of the national plan.

While Obama’s plan is not a single payer national health care plan, it moves in the right direction. Most importantly, his plan challenges the private insurance industry’s monopoly and control over health care. 

These are the two competing visions of how to deal with the nation’s health care crisis. The Obama plan is unquestionably a big step forward. The McCain plan simply continues what has gotten us into the current crisis.

Health care has to be considered a basic public service, akin to the supply of clean drinking water or a national highway system. Sure, we have to pay tolls or a monthly water bill. But, because everyone pays and because these are public services and no one is siphoning off profits, it’s also good deal — in fact it’s a very good deal!

This brings us back to the numbers 47 million and $15 billion.

Forty-seven million aren’t paying anything into the health care system. And the health insurance companies are siphoning off $15 billion in profits.

In short, any plan that is to be successful must:

  • Require that everyone and every employer make some level of contribution.
  • Provide everyone with coverage.
  • Take the “profit” out of health care and use that money for — duh — health care!