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Trying to Put It in Words

Mon, 26 Jun 2017 15:41:56 +0000

Trying to Put It in Words

The Republican Senate members have laid another egg in their attempt to "repeal and end Obamacare." As with the House Republican bill, polling data shows the majority of Americans reject the Senate version. The elephant in the room is what makes the whole exercise stink. That elephant is the unwavering faith in the private marketplace to decide who gets what in our society. Americans sense something is fundamentally wrong but search for words to express this problem.

The Tea Party Republicans objected to the Affordable Care Act as an unwarranted expansion of government. Honestly, they were not concerned with addressing the problem of the large and growing stress on American households to access health care without going bankrupt. In their tiny-minded world, lack of anything, from housing to education to health care, is a matter of personal priorities and market choices. Therefore, if people do not have health insurance, it is because they do not want to buy it.

Trying to negotiate with that extreme view, then-President Barack Obama struck a compromise position on health care, invoking a public interest in health and declaring health insurance a personal responsibility. The ACA strikes the middle ground in softening the Tea Party's approach to caring about the high cost of health insurance and, therefore, has the government either buying insurance for those with very low incomes (by extending eligibility for Medicaid) or subsidizing those of modest incomes in meeting their "personal responsibility."

The initial revolt against the ACA was against the government creation of a new personal mandate, which to the Tea Party was an intrusion to force people to buy something they did not view as a high enough priority to forgo other wants like housing or education. Moreover, while the exchanges were a private marketplace, the Tea Party objected to taxes subsidizing people buying health insurance.

What stinks in all this is that access to health care really does not belong in the marketplace. Too much of health fits into the normal space of a public good. In fact, the portion of health care that belonged in the public good space made the ACA such an ugly compromise, angering both the right and the left, by making it an individual mandate to buy health insurance.

A public good has several characteristics. One common problem is the free rider problem, resulting from providing a good where it is difficult to exclude usage. Examples include clean air and proper functioning roads. If you live in a nation with people who are healthy because of proper infrastructure investments like proper sanitation, then certain diseases are not going to be very common, like cholera. But how would you exclude someone from the sanitation system? Second, when the externalities of a good are positive, then people will tend to under consume them because people other than the purchaser will benefit. Living in a society of well-educated people helps democracies function and makes it easier to start a business needing highly trained or trainable workers for instance. But because education can be personally expensive, left as a private good, many people would not get enough education to help economic growth or support democratic institutions. Health is similar. If people get their children inoculated against childhood diseases like measles and whooping cough, the diseases become less prevalent and your children will be less likely to get them. Third, some goods are rights. You have the right to life, which means personal safety, so we accept police as a public good. Many people think that the right to life also means access to health care, the ultimate in the necessity of a right to life. All modern advanced industrialized economies, except the United States, assume health care is a publicly provided human right.

When something is a private good, and we leave it to the market to allocate, then price is the signaling device and the rationing mechanism. The price of a good, as a popular automobile, sends a signal to automakers which type of cars to build. In addition, the price rations who will get the automobile and who will not. If your income is too low, or if you do not care that much about the specifics of any particular automobile, you will not buy a high-priced popular car. In health, this can have the two drawbacks mentioned. Some people will not contribute, because they will get some of the benefits of living in a healthier advanced economy, even if they do not themselves spend their own money to get healthy. Further, some people will not buy enough health insurance, leaving it to others to support our health infrastructure. Imagine how we could have adequate emergency room space if no one had health insurance and, instead, assumed that hospitals would exist and be properly staffed when people needed an emergency room if they had an appendicitis. Worse, some people will be priced out of the market. Health insurance will be too expensive, and their health will likely suffer from it. The results are death by poverty. These results are not equivalent to Janis Joplin’s prayer for the Lord to buy her a Mercedes-Benz.

The United States relies, more than other advanced economies, on private, market-based provisions of major human capital investments like education and health and personal investments like housing. The result is that a higher share of U.S. GDP (gross domestic product, the value of all the new goods and services in a country) is consumption (items bought by private households). In a middle-income nation, such as the United States through 1986, where the majority of income is earned by the middle 60% of the population, this has a lot of virtues. One of which is that providers aim to please this income group because they are the majority of the economy (in a market-based system where price is the rationing tool, it is "one dollar one vote," hence the majority of the economy is where the majority of the income lies). And, it means that the rise in prices will follow the income growth of the economic majority, assuring they can continue to be customers. However, today, the majority of income is with the top 20% of income earners, and in a few short years will be the top 10% of earners. That means prices and goods and services today tilt to the top 20% and will soon follow the incomes of the top 10%. Think about why it is never difficult for middle-aged men to buy their little blue pill, but sometimes your doctor may run out of flu shots.

From 2000-2009, the share of Americans getting private health insurance through their employer declined from 63.9% to 55.8%. Employer-based private health insurance had provided the bedrock of the American health care system. Medicaid was introduced in 1965 to fill the void for low-wage workers whose employers tended not to provide health insurance. This is the typical U.S. policy response when price rations portions of people out of the market. From 1965-1986, while America was a middle-income nation, the average wage of production and non-supervisory workers increased by a factor of 3.6, while health care costs increased by factor of 4.3. But, from 1986-2008, health care costs increased by a factor of 3.3 while the average wage went up by only a factor of 2.2. Health care costs were rising much faster than wages for the middle class. The increase in health care more resembled the increase in income for the top 20%, the economic majority. As a result, not just the poor, but middle-class workers were being priced out of health care, too.

The ACA solution was an extension of subsidies to those who cannot afford a necessity. The flaw was that insurance is cheapest when it is universal, including both high- and low-risk individuals in the pool to share broadly in the risks. This is why Social Security is so effective in covering workers’ families against premature death, an onset of a disability or living into old age. It is why Medicare works as health insurance for the elderly, some of whom are very healthy and some who are critically ill. Creating an adequate market for something that is a public good proved too difficult, especially in those states with Republican governors who refused to extend public health coverage by expanding Medicaid and balked at promoting the private health insurance marketplace.

While Republicans claimed it was the private market exchanges that failed, nothing in their proposed legislation addressed fixing those market places. Clearly, this was a cynical manipulation. In the first place, Republicans objected to the rules that standardized health insurance policies, providing the information to make market-based comparisons in buying health insurance. A market cannot function efficiently if consumers do not have the information to compare products. Consequently, Republicans insistence on destroying that market information will make the problems of the exchanges worse. Second, shrinking the public health coverage that Medicaid expansion provided will make the insurance markets less efficient because fewer healthy people will be able to afford health insurance, leaving more people with poor health or pre-existing health issues seeking private health insurance. This will make pricing in the exchanges uncertain, but certainly higher for people who do not have employer-provided health insurance—a group that is growing.

Republicans proved there is no market-based solution to fixing the ACA. It already was a damaged proposition precisely because it sought a market-based solution to something that was inherently a public good.

Since the Republicans did not address the shortcomings of the ACA, one can only conclude the intention was a giant tax cut for wealthy Americans. Further, in a nation where income inequality is at a crisis level, exacerbating income inequality by piling even more money on the entitled rich will hurt economic growth, a point well documented by the Organization for Economic Cooperation and Development and the International Monetary Fund.

The only solution to fix the shortcomings of the ACA is a public good approach. The most efficient way to do health insurance is not through an analogy to state-based automobile insurance mandates because, ultimately, automobiles are a private good and people can opt out of owning a car. Instead, health insurance is like Social Security. Because becoming unhealthy is a universal risk, and because people having health insurance provides so many public benefits, it is best provided as a public good like Social Security and Medicare. The only issue for debate is what form the public good should be funded and care allocated.

The ACA slowed health care cost escalation; in no small part by redefining the market for health care away from the top 20% of income toward the middle. By expanding the demand, the price point in delivery shifted. Making health care a true public good would help the United States achieve the lower per capita health expenditures of other advanced economies who treat health as a public good.

The stinking elephant in the room is an undying faith in the private marketplace. This will continue to be an ever-growing problem. When 10% of the people hold half the income in the nation, those 10% will be consuming more than half of everything produced in the United States. That does not matter that much if they are buying half the Cadillacs, but it does matter when it is half the health care, half the housing and half the education. A nation so lopsided is one that will not, and cannot, develop. Just look at the problems to be solved in Mexico and Turkey, the nations we are approaching.

Kenneth Quinnell Mon, 06/26/2017 - 11:41

What is Medicaid?

Fri, 23 Jun 2017 20:06:21 +0000

What is Medicaid?

It may be America’s biggest health plan, covering more than 70 million people, but many people do not know what Medicaid is. Here's what you should know:

Every State Has a Different Name for Medicaid: One reason few people know Medicaid itself is that each state runs its own plan and typically does not include Medicaid in its name. If you live in West Virginia, for example, you might know it as Mountain Health Trust or WV Health Bridge. In Ohio, maybe you participate in the Buckeye Health Plan or another managed care program paid for by Medicaid.

Medicaid is for People Struggling to Make Ends Meet: Whatever your state calls Medicaid, it is the health plan that provides access to health care for people struggling the most to make ends meet. States generally determine the rules for who qualifies, but all states provide Medicaid for some low-income people, families and children, pregnant women, the elderly and people with disabilities. The federal government pays most of the cost of benefits, with states covering the rest.

More People are Eligible Because of Obamacare: Under the Affordable Care Act, or Obamacare, states can expand who qualifies to include all adults who have low incomes (that is, below 138% of the federal poverty level). This year, for example, a single person with household income less than $16,643, or a family of four with income less than $33,948, would be eligible for Medicaid in Nevada. Thirty-one states and Washington, D.C., have expanded coverage in this way, resulting in 11 million more people getting health insurance they otherwise could not afford.

Benefits to Meet Personal Needs: Each state’s Medicaid plan pays for health services you usually think of when it comes to health insurance: things like doctor visits and hospital stays. These plans also can pay for other important services that other health insurance plans do not. Here are some examples of things you might not expect:

  • Help at home for children with special care needs, such as those with Down syndrome, cerebral palsy and autism, and for their parents.
  • Funding for schools throughout the country to provide services to Medicaid-eligible children and hire school nurses, counselors and speech therapists.
  • Nursing home care for seniors and people with disabilities.
  • Help with basic daily activities to enable people with disabilities, including seniors, remain in their own homes and communities.

 

 

Jackie Tortora Fri, 06/23/2017 - 16:06

What You Need to Know About the Senate Health Care Bill

Fri, 23 Jun 2017 16:41:30 +0000

What You Need to Know About the Senate Health Care Bill

Dont' let Senators take away health care in backroom deals
AFL-CIO

This week, Senate Republicans unveiled their vision for health care in America. We won't spend much time going over numbers and percentages (you can read that here), but here is what you need to know right now about this bill. It will:

1. Make millions of working people pay more for less care

2. Tax your workplace plans if you get decent health coverage at work

3. Give massive tax breaks to wealthy corporations and CEOs

4. Take away health care from millions of working people

5. Drastically cut Medicaid, which provides vital services for a large group of Americans

There isn't a lot of time to stop this complete hijacking of our health care. 

Call your senators today and every day to demand they vote "no" on a bill that takes away our health care: 1-888-865-8089. Tell your friends to call too. 

 

Jackie Tortora Fri, 06/23/2017 - 12:41

Why Working People Benefit from Apprenticeship Training

Thu, 22 Jun 2017 16:00:51 +0000

Why Working People Benefit from Apprenticeship Training

Union leaders meet at apprenticeship meeting.
Mike Gillis

There is a distinct difference between a job training program and an apprenticeship, and leaders in the labor movement are spreading this message.

 “Apprenticeships are comprehensive experiences, where individuals not only learn a skill, they practice and develop that skill in conjunction with the needs of the business community, while earning a fair, living wage,” said Pennsylvania AFL-CIO President Rick Bloomingdale. “Any job training program that does not involve businesses and industry, a decent living and solid instruction, fails in comparison. Highly skilled manufacturing jobs are the future, and apprenticeship programs are an essential part of filling those jobs.”

Representatives from industrial labor unions, manufacturing employers, state labor federations, state and federal labor agencies, and education and workforce and development advocacy groups met earlier this week in Oakwood, Pennsylvania, to discuss state and national efforts to bolster apprenticeship programs.

Apprenticeship training programs mean working people who participate in them learn the latest technologies and skills, and also learn how to stay safe on the job. “Embracing and developing these training programs will modernize systems and procedures to improve productivity and safety,” said Ohio AFL-CIO President Tim Burga.  

The event was co-hosted by the Pennsylvania AFL-CIO and the Ohio AFL-CIO.

Jackie Tortora Thu, 06/22/2017 - 12:00

Why Do We Need Medicaid?

Fri, 16 Jun 2017 16:54:58 +0000

Why Do We Need Medicaid?

Like many Americans, you may have parents or other loved ones in nursing homes because they require around-the-clock care.

Nursing-home care is expensive, typically $80,000 per year for a semiprivate room—far more than the income of a typical senior. Medicare generally pays only for short-term nursing-home stays. Yet only about 1 in 10 people 65 and older have private long-term care insurance to cover nursing-home costs. For a great many people, that insurance is too expensive.

Medicaid is the one thing people can count on when their money has run out. Losing that coverage, as could happen to some people if congressional Republicans and President Donald Trump succeed in gutting Medicaid funding to pay for tax cuts for corporate CEOs and the wealthiest 1%, would force working people to make impossible choices about how to care for their parents and other family members when they can no longer care for themselves.

This is just one reason why Medicaid matters to working people and their families. Consider a few other impressive Medicaid facts and think about what would happen to you, your family, your friends and your community without it:

  • Medicaid helps seniors and other people with significant disabilities stay in their homes and communities, instead of being forced to go to nursing homes.
  • Medicaid guarantees more than 30 million children access to medical care.
  • Nearly 5 million children with special care needs, such as Down syndrome, cerebral palsy and autism, are covered by Medicaid and other public insurance.
  • Medicaid pays for half of all childbirths in the United States.

Watch the video above reminding all of us why Medicaid is so important to working people, and why slashing Medicaid’s federal funding by half to pay for huge tax cuts for the wealthiest 1%, CEOs and corporations is so wrong.

 

Jackie Tortora Fri, 06/16/2017 - 12:54

Tell the Labor Department Not to Repeal the Persuader Rule

Thu, 15 Jun 2017 15:22:18 +0000

Tell the Labor Department Not to Repeal the Persuader Rule

NYU Graduate Students
UAW

The Labor Department issued a proposal on Monday that would rescind the union-buster transparency rule, officially known as the persuader rule, designed to increase disclosure requirements for consultants and attorneys hired by companies to try to persuade working people against coming together in a union. The rule was supposed to go into effect last year, but a court issued an injunction last June to prevent implementation. Now the Trump Labor Department wants to eliminate it.

We wrote about this rule last year. Repealing the union-buster transparency rule is little more than the administration doing the bidding of wealthy corporations and eliminating common-sense rules that would give important information to working people who are having roadblocks thrown their way while trying to form a union.

AFL-CIO spokesman Josh Goldstein said:

The persuader rule means corporate CEOs can no longer hide the shady groups they hire to take away the freedoms of working people. Repealing this common-sense rule is simply another giveaway to wealthy corporations. Corporate CEOs may not like people knowing who they’re paying to script their union-busting, but working people do.

If the rule is repealed, union-busters will be able to operate in the shadows as they work to take away our freedom to join together on the job. Working people deserve to know whether these shady firms are trying to influence them. The administration seems to disagree.

A 60-day public comment period opened Monday. Click on this link to leave a comment and tell the Labor Department that we should be doing more to ensure the freedom of working people to join together in a union, not less. Copy and paste the suggested text below if you need help getting started:

“Working people deserve to know who is trying to block their freedom from joining together and forming a union on the job. Corporations spend big money on shadowy, outside firms that use fear tactics to intimidate and discourage people from coming together to make a better life on the job. I support a strong and robust persuader rule. Do not eliminate the persuader rule.”

Kenneth Quinnell Thu, 06/15/2017 - 11:22

Union Member and Public School Teacher Reflects on Opportunities DACA Has Provided

Thu, 15 Jun 2017 12:35:58 +0000

Union Member and Public School Teacher Reflects on Opportunities DACA Has Provided

Maria E. Dominguez
Maria E. Dominguez

This post originally ran in 2015.

This week marks the five-year anniversary of President Obama’s Deferred Action for Childhood Arrivals (DACA) program, an important time to mark the contributions of DACAmented workers to our communities and our economy. DACA has allowed hundreds of thousands of aspiring Americans and union members to live and work without fear in the United States. The labor movement reiterates unwavering support for the expansion of these much-needed deferred action programs. The following blog from Maria E. Dominguez, a first-grade bilingual teacher from Austin, Texas, demonstrates just how valuable these programs are. 

On the third-year anniversary of President Barack Obama’s DACA program, I can’t help but reflect on how DACA has changed my entire life, both professionally and personally. After being granted DACA, I had the opportunity to pursue my life dream of being a public school teacher. Thanks to DACA I am able to serve my community as a first-grade public school bilingual teacher. In addition, I was able to obtain a driver’s license and travel within the United States. Another one of my dreams came true when I was granted advance parole with DACA and, in July of 2014, I traveled to my hometown in Guanajuato, Mexico, after more than 20 years. I saw my grandmother, cousins and other relatives who I had not seen in decades. It was an incredible experience for my whole family.

Many of my students’ parents would be eligible and should be applying for the new Deferred Action for Parents of Americans (DAPA) program today, if it were not being obstructed in the courts. Even though I work with very young children of immigrants, some of them understand their parents’ situation and are frightened to talk about it due to the very real threat of retaliation or deportation. I hope someday my students and their parents can live without fear and proudly say that they also have benefited from deferred action and gained work authorization. I know it would make an incredible difference in their families’ lives, just as it has for mine.

As a member of Education Austin and the American Federation of Teachers (AFT), I have been granted the opportunity to work with the immigrant community—in particular, undocumented youth. I have volunteered at the citizenship drives offered by Education Austin and at DACA forums and clinics held in partnership with University Leadership Initiative in Austin, Texas. I have helped U.S. residents fill out their citizenship applications and DREAMers fill out their DACA application as part of my commitment to Education Austin and AFT. I also have worked with community leaders to bring essential information to the parents at my school for the first time. In March, I attended the AFL-CIO’s We Rise initiative training for union members in Washington, D.C. It showed members how to begin implementing DACA and DAPA educational forums and clinics at their locals. I also have participated in conferences with AFT that focus on immigration and how we as members can work with our locals to help our community. Finally, I have shared my knowledge and my personal story as a DACAmented teacher during educational forums and teacher conferences because I believe in the power of collective action.

I could not do what I do every single day in the classroom if it were not for President Obama’s executive action on immigration. I only wish that Republicans in Congress would muster the same political courage to address our broken immigration system. DACA works, and I’m a testament of that, but it only covers a small portion of our population. It is a small fight that we won, but we need to keep working in order to see a bigger change that can benefit others who will not qualify for DACA or DAPA. We must keep fighting because there are people trying to push us back, as we see in Texas with the injunction. So we cannot give up. Even though we might only see small steps now, I know that if we keep working, we’re going to see a huge change that will benefit everyone. Immigration should not be used to score cheap political points. We’re talking about people’s lives—people like me, who want nothing more than to contribute to our communities. Join me today and call for a permanent solution to our broken immigration system. Our families and our communities can’t wait. 

Editor's Note: During the AFL-CIO's We Rise initiative training in Washington, D.C., Dominguez said she benefited from DACA, to which AFL-CIO President Richard Trumka responded, "No, we benefited from you," to a roomful of enthusiastic applause. Read more at NBC News.

Kenneth Quinnell Thu, 06/15/2017 - 08:35

Freelancers Take to Twitter to Say #EbonyOwes Them Back Pay

Wed, 14 Jun 2017 15:49:33 +0000

Freelancers Take to Twitter to Say #EbonyOwes Them Back Pay

Freelancing Ain't Free
AFL-CIO

Stories have surfaced in the past few weeks that Ebony owes numerous writers back pay for work they did for the magazine. A story from The Establishment spurred the #EbonyOwes hashtag into trending territory on Twitter. The article cites numerous freelance writers who say that the magazine owes them.

According to a press release, the National Writers Union/UAW Local 1981 represents 23 Ebony writers who are collectively owed more than $50,000 in unpaid wages. The union estimates that more than $200,000 in back wages are owed to as many as 50 freelancers. The magazine recently made a public commitment to fix the problem, but NWU President Larry Goldbetter said that words aren't good enough:

Some of the invoices we’ve seen are over a year old. We are pleased Ebony Media has been responsive to the grievance, but we are now at a point where we need a payment schedule in writing. For a freelancer to have to struggle to pay rent because Ebony owes is ridiculous.

Here are some of the stories told on #EbonyOwes:

Kenneth Quinnell Wed, 06/14/2017 - 11:49

Call Today to Oppose Secret Negotiations to Strip Millions of Health Care

Wed, 14 Jun 2017 14:16:43 +0000

Call Today to Oppose Secret Negotiations to Strip Millions of Health Care

Dont' let Senators take away health care in backroom deals
AFL-CIO

There are reports that Republican leadership in the U.S. Senate is moving behind the scenes to finalize a bill and hold a floor vote on Trumpcare before members of Congress leave for the July 4 recess. The legislation has been fast-tracked, meaning that it won't get the usual committee review before going to a floor vote. This would greatly shorten the time that the public (and members of Congress) has to read the legislation to determine exactly what it does and how many Americans it harms.

These secret negotiations could strip health care from millions of Americans, just to pay for a tax cut for the wealthiest Americans. Taking away the freedoms of working people in order to serve the wealthiest 1% isn't the path forward that the United States needs.

Call today at 1-888-865-8089 and tell your senator to oppose Trumpcare legislation negotiated in secret that strips health care from working people.

 

Kenneth Quinnell Wed, 06/14/2017 - 10:16

How We Should Rewrite the Rules of NAFTA for Working People

Mon, 12 Jun 2017 14:58:40 +0000

How We Should Rewrite the Rules of NAFTA for Working People

The North American Free Trade Agreement is typically called a "trade deal," but in reality it’s not much about trade. Its hundreds of pages of set rules for how the United States, Mexico and Canada can run their economies. Those rules give global corporations strong rights and privileges but don’t contain a single provision to ensure more jobs, better wages, clean air and water, affordable medicines, or any of the other benefits trade is supposed to bring.

By any measure important to working people, NAFTA was a failure. It didn’t raise wages. It didn’t help protect the environment or ensure that people who wanted to join together and negotiate on the job could do so. NAFTA’s rules are rigged—and they must change.

Trade is not inevitably bad for working people. A new NAFTA, with rules that working people help write, could create good jobs, raise wages, protect our natural resources and raise standards of living across North America.

These rules must ensure working people can join together to negotiate for better wages and working conditions. They must ensure citizens are free to make decisions about our economy, including being free from the threat of unlimited investor-state dispute settlement lawsuits by foreign corporations. They must promote investment in our roads, ports, and schools and promote "Buy American" provisions to create jobs locally.

The AFL-CIO has developed comprehensive recommendations that aim to stop NAFTA’s vicious cycle and replace it with a virtuous one. A better NAFTA is possible. And it starts by bringing working families into the conversation so we can be part of the solution.

Read more about the AFL-CIO’s NAFTA recommendations, and share this post with a friend. To join our trade activist team, text “trade” to 235246.

Kenneth Quinnell Mon, 06/12/2017 - 10:58

   
  

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