Tag Archives: UHW

The Lessons UHW’s Rosselli Seems to Have Lost Sight Of

Note: Background information about this diary can be found at the new website www.seiufactchecker.org. Mary Kay Henry is International Executive Vice President for SEIU

I would like to thank Calitics for hosting this debate about the future of workers in this country.  

I have worked along side Sal Rosselli, the president of SEIU United Healthcare Workers West (UHW-W) for 25 years, starting when both of us worked on staff for SEIU Local 250 (which is now called UHW-W).  I was the organizing director and he worked in the East Bay as a union representative.

I also worked closely with him when I was in charge of SEIU’s hospital organizing campaign in Southern California from 1999 to 2004 that ultimately resulted in 26,000 workers becoming members of UHW and gaining major improvements in pay and benefits.

So I am surprised by his recent actions. He has been attacking the democratic decisions made jointly by the huge majority of SEIU local unions across the country. In fact, he recently resigned from the SEIU Executive Committee, saying he could no longer abide by decisions made by “simple majorities” of elected SEIU leaders.  

Sabotage in Ohio

For the past three years, SEIU has been working with hospital workers in Ohio to help them organize to win improvements for themselves and the patients they serve.

Like most workers in this country, they didn’t stand much of a chance as long as management was using its power to intimidate them and discourage support for a union. For three years, they waged a campaign with support from the community to persuade their employer to accept a fair vote where workers could freely choose without management interference.

But this month, just as the workers were about to vote to unite with SEIU, Rosselli went to San Diego and met with Rose Ann DeMoro, president of the California Nurses Association (CNA) at the executive council meeting of the AFL-CIO.

Two days later, CNA organizers showed up at the Ohio hospitals with flyers telling workers how bad SEIU is, parroting many of the arguments being put forth by Rosselli.

CNA’s materials referred workers to a website co-sponsored by leaders of UHW that has anti-SEIU propaganda.

It’s hard to imagine a more unconscionable act of sabotage against workers who were courageously standing up for their patients and themselves. Because of the confusion caused by a union putting out anti-union propaganda, the vote had to be called off and more than 8,000 Ohio healthcare workers were denied a chance to improve their lives.

Some California Organizing History

The idea that Rosselli could be connected in any way to the situation in Ohio is puzzling given the history of his local union. That history provides several lessons that Rosselli seems to have forgotten.

1. The road to winning better pay and benefits for workers and better communities depends on uniting many more workers with us.

2. With so many employers now regional, national, or global, it takes the combined strength of workers and their local unions from across the country to get management to respect workers’ rights.

3. With labor law so heavily stacked against workers, the first step in winning the right to form a union usually is to wage a community campaign to get management to agree not to intimidate workers in the process.

In the early 1990s, the only national chain where Southern California hospital workers had a union was Kaiser. Those members had good pay and benefits and thought they could never lose them. But Kaiser looked around, saw it was the only union company in the South, and started pushing wage cuts.

It was then that SEIU local unions and the national union made an historic decision to pool our resources and unite our strength to help workers organize the other big hospital chains in California – because we realized that uniting tens of thousands of other workers to win better lives was the only way to protect the pay and benefits of our existing members.

In this profound strategic shift, SEIU local unions from Ohio Florida, Michigan, Illinois, New York, Maryland, Washington, and Pennsylvania made the decision to send tens of millions of dollars, and top staff and members came from all over the country to help Local 250 (Rosselli’s local union at the time) and Local 399 in southern California to unite nonunion workers at major hospital chains in the state – Catholic Healthcare West (CHW), Tenet, and HCA.

The national union – which pooled the resources of our local unions — could bring resources to bear that no one local union could. At one point the national union had 150 organizers on the ground in Los Angeles.

Through our united action, we won agreements that limited the interference by these big chains in their employees’ right to organize a union. As a result, 26,000 hospital workers gained a union and became members of what is now UHW-W, added to California members’ strength, and helped all SEIU hospital workers to achieve and maintain better standards for pay, benefits, and working conditions.

These organizing wins led directly to dramatic changes in workers lives. In the first contract with CHW hospitals, healthcare workers won raises of 14-28% and full, employer-paid family healthcare. Better yet, the new union benefits became the industry standard: Within months after the CHW contract was ratified, the other large hospital chains began providing family healthcare as well, improving the lives of an additional tens of thousands of families.

By 2004, more than 50% of Southern California hospitals were union. Rosselli was strongly supportive of those efforts and provided resources because he knew that a stronger union presence in southern California would help his members at Local 250 in northern California improve and maintain their pay and benefits.

Rosselli’s local also benefited from another key strategy decision made jointly by SEIU local unions at our national convention in 2000. We all decided that workers could win more for their families and communities if members in the same industry and geographical area were united in the same local instead of being divided into multiple organizations.

Under that strategy, the hospital worker members of Local 399 in southern California voted to merge with their counterparts in Local 250 in the North to form UHW-W.

Between that merger and the California organizing led by the national union and supported by local unions from across the U.S., Rosselli’s local nearly tripled in size between 2000 and 2006– growing from about 50,000 to 140,000 members.

When the newly merged local was formed, it was SEIU President Andy Stern’s responsibility to appoint the local leader until elections were held. Stern appointed Rosselli in 2005 to be the leader of UHW-W, believing that his understanding of how California hospital workers had made gains would lead him to use his local’s strength to unite more workers in nonunion states where his local’s national employers operated.

Withdrawing from Democratic Decisionmaking

But over the last few years, I’ve watched Rosselli slowly withdraw from the democratic decisionmaking process of our union.

He has chosen not to attend a series of meetings of national healthcare leadership bodies when debates were taking place and recommendations were being made by local leaders about how to allocate union resources and unite workers’ strength. He chose to sit out key sessions at the January 2008 International Executive Board meeting, depriving his members of a voice in decisions that directly affect them. And most recently, Rosselli resigned from the SEIU Executive Committee – the committee of elected SEIU leaders that makes national decisions about union strategy. In resigning this post, a move that deprives 140,000 UHW members of representation at the highest levels of SEIU, Rosselli said he could no longer accept decisions made by “simple majorities” of the union’s elected leaders.

Rosselli’s actions reflect a decision on his part to put his own priorities above the lives of his own members and the lives of healthcare workers everywhere.

What Is at Risk

Rosselli through his efforts, is risking the pay and benefits of his own members: The massive resources and time he is putting into his divisive attacks is distracting his local union from focusing on the upcoming contract negotiations of more than 70,000 members – about half his membership.

His efforts risk the ability of nurses and hospital workers in the 33 states where there is no union to unite without interference from their employers. By criticizing the same employer neutrality agreements he once fought for alongside his members, he is giving employers ammunition to use against workers who dream of having what UHW members have.

Through his unwillingness to participate in the democratic process within SEIU, he is forgetting how his local union itself was built and is relegating nonunion workers in California and across the country to permanent second-tier status.

Last year UHW-W helped only 888 California healthcare workers organize, but the number of people working in the healthcare industry overall grew by a much greater number. As a result, healthcare workers in California have less strength this year than last.

As the industry grows and the number of workers who have a union does not, workers’ strength diminishes. The labor movement already has too many union leaders who have adopted the business model of unionism – focusing exclusively on their own members – only to see their failure to grow turn back on them and ultimately decimate the pay and benefits of those members in a constantly changing, globalizing economy.

I urge readers to go to the new SEIU website, SEIUFactChecker.org to learn the truth about SEIU’s record of uniting workers to raise their standards of living and our exciting plans for the coming years to build workers’ power and achieve the goals we all share in the progressive movement.

There is a legitimate, healthy debate to be had in the labor movement about our strategies and our shortcomings, but the lives of workers should always come first. I am afraid Sal Rosselli has lost sight of that.

Union growth and standards must go hand-in-hand

(This has been an interesting discussion (when people are not flaming each other), so let’s keep it civil. – promoted by Julia Rosen)

Thanks to Brian for his post on the blogger discussion with SEIU's Andy Stern and for opening this discussion. I'm new to the Calitics community and the new UHW Online Communications Specialist.

As a first contribution to this discussion, I thought it would be helpful to share the broad background of our dispute with SEIU, and the outlines of a few of the lessons we've learned in the course of many campaigns to build our union. Through focused efforts to improve the lives of healthcare workers and the people we serve, UHW has developed a model of growth through strength that at the same time achieves the goal of growth for strength.

For the first two terms of Andy Stern's presidency, from 1996 to 2004 and beyond through the initial days of Change to Win, UHW and SEIU shared vision of increasing union membership and improving workers' lives based on building the capacity of strong local unions, maximizing member partcipation in organizing and politics, coordinating our strength across entire industries through democratic structures of accountability to rank and file union members.

However, in recent years, SEIU's priority of growth has lost its qualitative dimension.  It is now an act of blasphemy to question what kind of growth makes sense or what purpose growth should serve or what role the informed consent and active participation of workers should have in growth.  It is expected that local leaders accept the gospel of growth for growth's sake and accept the quickest short cuts possible to achieve it, even when that means putting employers agendas ahead of workers' aspirations, taking decisions out of workers' hands, and limiting workers' rights to advocate for themselves and for the public interest, both now and in the future.

In this climate, UHW's success at winning some of the nation's best contracts that significantly improve standards (wages, benefits, voice on the job to improve patient care, etc.) has actually been derided as “polishing the apple” – i.e. forgoing growth opportunities by using the union's money, staff and political capital to improve contracts that are already “good enough” instead of using those resources for more growth and for that alone.

The misguided notion at play here is that there's a one-to-one correspondence: the more resources spent on improving standards, especially when that involves struggle with employers, the less growth will be achieved.

This caricature does not stand up to scrutiny.

The fact is that UHW was the fastest growing local in SEIU from 2001-06 (excluding growth from mergers) and it's also the fact that most of SEIU's growth in recent years has come through the creation of quasi-public employers for independent homecare and childcare providers rather than from actually winning union recognition from corporate employers based on the kinds of “value added” arrangements that Stern touts in his book, “A Country That Works”.

But even putting aside these facts, we should question the fundamental logic of the Stern regime's premise that pursuing higher standards for organized workers is an impediment to achieving growth, an expenditure of limited resources in a zero-sum game.

Our members' experience is that improving standards and achieving growth generally go hand-in-hand because when workers win higher standards in one place, it inspires workers in other places to join the union.  Indeed, this is why most workers want to join the union.

The hidden and deeply troubling premises of the Stern regime's false choice between growth and standards are these: that no substantial growth can take place in the face of employer opposition and that workers themselves can't be trusted to make wise decisions that defer short-term gains for growth and the long-term power it builds.

The first premise is troubling because starting out, as the Stern regime does, with the PRIMARY purpose of currying favor with employers rather than addressing the issues of union member and consumers cheats workers of their power to achieve real change.

The second premise is troubling because it leads to the kind of autocratic leadership and abuses of power documented at www.seiuvoice.org.  When you believe workers are incapable of making good choices, you take the choices out of their hands and entrust them to a closely held inner circle accountable only to itself and to it own agenda of growth at any cost.

These premises bring extremely big problems.

First, the structural tensions between the goals of workers and the goals of employers require that a good union be able to work constructively with employers when that's possible and to fight their initiatives when that's necessary.  When winning employers' approval is universally understood as a prerequisite for growth and growth is your only concern, you're operating from a position of weakness, as you've given up in advance on winning any objectives that employers might not prefer.  Literally, workers don't even have a fighting chance.

Second, it's wrong and undemocratic and fundamentally disempowering to cut members out of shaping their own destiny. You shouldn't make sacrifices for someone else without their informed consent, and you can't do so without building a hollow organization. Workers can and must take real ownership of their unions and make real choices for themselves to build power.

Moreover, counter to the Stern regime's elitist assumptions, workers have shown time and time again that they are capable of making decisions to postpone short-term gains in favor of long-term growth.  Such trade-offs are an integral part of what unions do, but workers themselves must decide to make them.  It is unacceptable for these decisions to be made Washington insiders who think they know better than the workers themselves what trade-offs are in their best interest.

In a future post, I'll lay out in greater detail some of UHW's concrete experiences of the corrupted culture within SEIU's current top leadership that we are fighting to put right.

A Conversation With Sal Rosselli of UHW on Health Care Reform

Just before the holiday break in December, the Courage Campaign hosted a conference call with several California bloggers and Sal Rosselli, head of United Healthcare Workers-West, and other members of the reform coalition to discuss the health care reform bill, ABX1 1, that is still pending in the legislature. The call spawned a follow-up discussion between some of the participants and Sal Rosselli over e-mail, which the participants (including Sal) wanted to post here.

Specific issues discussed include the relationship of UHW and other union leaders in the health care reform coalition to their rank-and-file, the financing of the ABX1 1 proposal, the political landscape against which this happens, and the relationship of ABX1 1 to single-payer care.

It’s my hope that the conversation Sal was gracious enough to help initiate can be continued here, with input from others on Calitics and in the netroots. Read what we’ve all said, and then weigh in with your own thoughts. These kinds of discussions between progressives are essential to the construction of a better California, even when – especially when – we have disagreements on policies. Thanks to Sal Rosselli for his continued engagement with us, and to the Courage Campaign for initiating this discussion.

Joel Wright, December 20, 2007:

Just wanted to note Sal’s response to my question about surveying UHW membership was quite troubling to me. Nothing personal to him or them, but I’ve seen that dodge by union leadership a lot. My experience on this issue has been consistent: when leadership is tops down, they almost always are not in tune with membership. Particularly on big issues. It’s akin to an elected saying “I know what my district thinks” because of the friends and donors they talk to.

Not to say UHW members don’t support the healthcare plan or the strategy. Maybe, maybe not. The point is leadership doesn’t actually know what membership thinks and they assume members will follow them. When the organization gets into a high profile, pitched battle like this, they sometimes find themselves distracted, having to put out backfires they didn’t expect because they didn’t get their internal ducks in a row first. So it says something politically very important to me that they haven’t gotten lock on with members on this. It’s a real vulnerability in the face of the high difficulty of getting the whole thing done, regardless how individuals in our team and the blogosphere view the plan itself.

Robert, December 20, 2007:

I had the same reaction to the response to that question as you, Joel. Similarly, I didn’t feel they directly addressed jsw’s points about the insurers. He’s right that the public is sour on health insurers and without clear means to “tame” them – means I don’t see in this specific proposal – it’s going to turn off voters from the idea they should be forced to pay into that system. There was an “action diary” at Daily Kos today about Cigna telling a 17-year old girl she can’t get a liver transplant, and it seems like that discussion and the discussion about giving health insurers a guaranteed place in the delivery of care in this state are happening on completely different planes.

There were any number of questions I felt like asking, but I was similarly left unconvinced by the response to my question about the funding sources. The employer contribution is going to decline as an overall number as CA continues to shed jobs. Already our unemployment rate is in the high 5% range, itself likely an understated number, and most economists now expect that number to rise throughout 2008. With a smaller payroll you get not only a smaller amount of money from employers, but you also have a lot more uninsured and jobless people wanting into the public system being proposed here. Massachusetts has already experienced this phenomenon – their public subsidies are currently running a $145 million shortfall. And they don’t have a $14 billion budget hole to worry about. And that doesn’t even begin to discuss the question of whether an ERISA waiver will be granted – the AB 1493 waiver hasn’t exactly turned out well for us has it?!

While I’m pleased that they are insisting that a minimum benefit package be defined in law, and not by a government board, it seems there’s too much acceptance of flawed principles to begin with. As far as I can tell this all comes down to a political assessment, that compromise with Arnold is necessary because we can never get the voters to accept something that is either more ambitious or that isn’t tied to an individual mandate. Single-payer is held out as the end of the Yellow Brick Road but it’s not clear how this actually takes us closer to it – and opponents on the left are portrayed, not surprisingly, as purists unwilling to accept a compromise.

-Robert

Sal’s Response, dated December 27, 2007:

Thanks so much for initiating the dialogue on healthcare reform efforts in California between our union and so many important contributors to the progressive blogosphere, both in-state and nationally.

We were very pleased to take part in Thursday’s phone conference and thank you and Joel and Robert for sharing their response thread with us.

To keep the conversation going, I want to speak to a few of the issues that were raised and fill in a few of the details that may have been missing from the phone conversation.

Joel raises the question of whether we might be out of touch with our members on the direction of our healthcare reform work, prompted by hearing that we haven’t yet polled internally on the legislation in its most recent form.

No one takes more seriously than we do the need to stay close to our members on this and other issues of importance and polling is one of the many methods we employ to do so.

Over the course of 2006 and 2007, we have polled our members multiple times in the course of developing our approach to healthcare reform, sometimes conducting membership-only surveys and sometimes over-sampling our members in the course of conducting larger public surveys.

Compared to other Californians that are similar geographically and demographically, and by ideology and party identification, our members show greater concern for the crisis of our healthcare system and greater tolerance for the expanded government role and the taxes and spending necessary to address it, but the difference is not as dramatic or durable as we might wish and does not translate reliably into stronger support for specific reform plans.

In the end, our members are subject to the same key dynamics that make it so difficult to maintain a solid public majority for any healthcare reform plan: the many of them who have coverage and who are more likely to vote are afraid that change could make things worse, and as they learn more about any plan, significant numbers of them focus on things that trigger these fears and push them to reject it.

It is this fundamental fear of loss and the resistance to change it produces that make it politically impossible to move to a single-payer system in one leap and place such a premium on giving the supermajority of voters who have health insurance greater security that any reform proposal will allow them to keep what they have.

That’s the hard reality of why our current approach, like that of John Edwards, whom we support, and those of the other leading Democratic Presidential candidates, is focused on taking incremental steps to rationalize our healthcare system by expanding access, containing costs, and improving quality while still leaving many features of the current system in place.

All that said, I want to make clear that we don’t believe polling is the only way or the best way to keep in touch with our membership, and that we use polls less to determine our direction than to learn better how to lead in the direction we think we should, based on our principles and our policy analysis.  We take responsibility to lead and keep ourselves accountable by engaging large numbers of our members not only in discussing, debating, and deciding the formal direction of the union, but in acting on it.

In the current instance, this means not only seeking the informed consent and engagement of our almost 100 rank-and-file Executive Board members and our more than 2,000 stewards who lead the union in workplaces and communities throughout the state – including my speaking personally with hundreds of them at numerous gatherings over recent weeks – but generating nearly 40,000 petitions in favor of our principles for healthcare reform, recruiting more than 7,000 new monthly political action donors since August based on our reform effort, and involving nearly 4,000 members directly in lobbying for healthcare reform at the Capitol and in the districts.

Union officials must be held accountable to serve workers’ interests, just as elected officials must be held accountable to serve the public interest, but I’m not sure either union democracy or U.S. democracy suffers primarily from leaders paying too little attention to polls, rather than leaders putting their fingers in the wind too frequently.

In the context of a coming recession, Robert raises the important question of whether the plan’s funding sources are sufficient to uphold its central promise: to make decent coverage affordable by expanding public programs to cover low-income children and their parents and providing tax credits that will allow middle-income families of four who earn up to $82,600 to purchase a basic HMO plan for no more than 5.5 percent of their income.

We, too, would like for the plan to be better funded and for its finances to be more secure under adverse circumstances and over a longer period of time.  In addition to the minimum employer contributions, the hospital provider fee, and the tobacco tax, we would have liked another broad-based funding source, but voters’ showed no appetite for other methods of raising significant revenue.

Given what’s on the table, we are especially concerned that the minimum employer contributions not be of a level and a kind that encourage employers to dump large numbers of their employees onto publicly subsidized care, shortchanging the system and making it unsustainable.

While the currently proposed minimum employer contributions are a marked improvement over what the Governor would previously support, they would eliminate the separate assessment for low wage and high wage employees meant to deter “crowd out” and secure additional funds for the purchasing pool.

We need to convince the Governor of the dumping risk associated with the current plan and win his agreement to adjust the minimum employer contributions accordingly.

It’s important to note that while the economic downturn and the state budget crisis create significant obstacles to healthcare reform, they also produce a greater urgency to pass the best possible reform now, reaping billions in new federal funds and sparing Californians the severe damage that market forces will cause their healthcare in a recession without reform.

Moreover, no social insurance program of such large scope – and certainly not one with economics, technology, professional practices, and consumer preferences that change as rapidly as those in healthcare – can be funded securely in perpetuity, with a sufficient margin to accommodate every circumstance.  Medicare is a case in point, as planners badly underestimated the increased utilization of services by newly insured people with greater longevity, but the social entitlement that the program established built a political base strong enough to secure its funding and make good on its commitment.

This brings us to another of Robert’s concerns, that it is unclear how this plan takes us any closer to single-payer.

The brief answer is that by creating the largest purchasing pool outside the federal government, a pool that would make healthcare more affordable for both low and middle-income Californians, it would unite their interests and build common cause for sustaining and improving our healthcare system through collective action.

By giving a significant cross-section of the public a direct investment in and a positive experience with a social insurance program that helps solve their healthcare problems, and by giving them the choice and the example of a public insurer alongside private insurance options financed through the purchasing pool, we will create the context and the security necessary for people to deal with healthcare reform systemically and to see the advantages of a single-payer approach, rather than react out of vulnerability and fear that make them resistant to change.

Finally, regarding the comments from Joel, Robert and Jeremy about the need to be clearer and more forceful in articulating how the plan “tames” health insurers, we agree completely.  Throughout the development and execution of the reform battle to date, we’ve carefully tracked the public’s anger at insurers and drug companies and kept in mind the value of naming our enemies and the danger of appearing to benefit them at consumers’ expense.

That’s the impetus for our campaign to expose Blue Cross’ fight against reform and for our achievement of good policy measures that include placing a cap on insurance company profits and overhead; ending denials of coverage and higher rates based upon pre-existing conditions; banning “rescission” of health insurance to avoid paying for needed care; and providing for bulk purchasing of prescription drugs.

We need to make these points more strongly, especially to our base and we thank you all for the reminder and your ongoing help in doing so.  However, making this all about the negatives of the insurance companies won’t cut it either, since these hits aren’t strong enough across a broad enough segment of the electorate to carry the day for us.

As negotiations move forward toward a final package, we’ll be doing more opinion research among our members and the general public, as well as trying to fix the things we know are both political and policy problems in the bill as it stands, namely: the lack of a “safety valve” to exempt people over 400% of the federal poverty level from the individual mandate if coverage becomes unaffordable to them; defining an appropriate minimum benefit package in statute; and protecting the purchasing pool and the state budget against the potential for more dumping of employer-sponsored coverage than the bill anticipates.

We’re trying to thread the needle and it won’t be easy, but having worked through the alternatives, we’re confident this is our best chance to make real change that would provide affordable, quality healthcare to nearly 4 million people in the largest expansion of coverage since the enactment of Medicare.  That’s an opportunity we can’t afford to miss, because the human cost in needless suffering is too great, and Californians and the caregivers who serve them can’t afford to wait.

Let’s keep the discussion going over the holidays and into the new year!

In unity,

Sal Rosselli

Robert’s response to Sal, dated January 8, 2008

Sal,

Thanks so much for not just your extended and detailed response, but for your openness with us and your commitment to an open dialogue about health care in California. In a broad sense, I think progressives in California have an opportunity to make some long overdue changes in this state and through conversations such as this we help build the coalitions that will make those changes real.

I should lay all my cards out on the table – as a Californian without access to affordable health care (i.e. “uninsured” but I don’t believe that term is the best one to use any longer), I am very much interested in efforts to provide people like myself with the access to health care that we need. At the same time, I am also concerned that whatever reforms we do undertake will actually work for us, and not leave Californians facing costs they cannot pay or a quality of care that is substandard or not sufficient to meet our needs.

Specifically, the ABX1 1 plan includes individual mandates to purchase health insurance. When mandates are involved, the plan adds a new kind of risk – that Californians will wind up having to buy something they cannot afford. And that in turn means that the subsidies that are going to be used to ease this burden on we who are uninsured and who aren’t able to afford insurance on the open market have to be reliable and sound – that we won’t find that, when it comes time to get the subsidies or public insurance care, that there’s not enough to go around.

That’s a problem Massachusetts is already facing. As reported in a New York Times op-ed last month by two Harvard doctors affiliated with Physicians for a National Health Program, Massachusetts is currently running a $145 million shortfall in its public subsidies. This impacts the ability of those who need subsidy to actually get them, and is one reason why over 200,000 Massachusetts residents remain uninsured even after the implementation of their mandated insurance plan.

My questions about funding stemmed from this basis. As California is entering a recessionary period, one that many economists believe will be characterized by higher unemployment than we saw in the 2001-02 recession, it seems reasonable to assume that the employer contribution will decline as an overall amount (due to shrinking payrolls) and more Californians will seek public assistance – either for subsidies to meet the mandate requirements or public health care itself, whether at hospitals or through an expanded Medi-Cal program. Given the higher cost of health care in CA and the much larger number of Californians without health care or insurance than in MA, it seems like a recipe for a big financial hole.

I agree with you that it’s the rare public program that is properly funded, and even nations with single-payer, like Canada and Britain, struggle with this problem, largely because of neoliberal economic beliefs that public programs should be starved to maintain low taxes on business. (Though Social Security is an example of a social insurance program that is properly funded, at least before Congressional raids on its capital.) But if there isn’t enough funding to subsidize people in a mandated insurance environment, it’s going to cause serious harm to the budgets of working Californians. Especially as under the revised ABX1 1, the process to be excused from the mandate requires petitioning a state board – MRMIB, I believe – whereas in earlier versions it was much simpler to be excused from the mandate, and in AB 8, there was no mandate at all.

Even in the absence of a mandate, a funding shortfall in a public health care program brings other risks – political risks. This is where the budget deficit is so key. Arnold is already demanding health care cuts. That will not inspire confidence in voters that the public subsidies and care will actually materialize to meet their needs. Further, if the system does run deficits – as MA’s public subsidies are – then it could sour voters on the use of government to provide and guarantee health care, and erode public support for it right when we need them to increase their support.

I think your comments on “dumping” and about the elimination of the separate assessments are on target, though I would go further. In an op-ed I had published in the LA Times last month (“Why Won’t the Times Talk Tax Hikes,” Dec. 9), I cited an LA Times/Bloomberg poll that showed 60% of voters would support higher taxes for universal health care. While those numbers might fluctuate when you talk specific taxes, it seems that we should work to ensure that the program is fiscally sound. The risk of a public backlash to a program that produces more deficits seems bigger than the risk of public rejection of taxes, especially when the public is demanding some kind of health care reform and willing to pay taxes for it.

Sal also speaks of the underlying politics of reform, that we have to address the “fear of loss and resistance to change it produces” when discussing health care. While I believe that there is more support out there for single-payer than is usually assumed, I see the value of an incremental approach. However, is this the best – or the only – form of incremental change that we can offer? At the federal level, SCHIP was a politically popular expansion of public health care options for children. A similar effort here in CA, such as the expansion of public care options, of eligibility for Medi-Cal – in short, everything in ABX1 1 except the mandate – would seem to be a much more useful and popular method of dealing with this crisis. Obviously we have Arnold to contend with, but that should not force us to accept a flawed plan as the price of getting something done this year.

Ultimately this may be a case where you and I will agree to disagree, though I also hope this is but the beginning of a longer conversation about how to provide universal, affordable, and comprehensive health care for Californians. Thanks again for your response to my questions.

-Robert

UPDATED: WTF is up with SEIU?

Update: So there's another story about this in Harper's Blog:

Yet Stern is currently presiding over what some within the union describe as a power grab, and one that could squelch opposition to some controversial deals he and his allies have supported (like a provision, ultimately shot down by internal opposition, that would have imposed a seven-year ban on strikes by Tenet Healthcare union employees). On Friday morning Stern is seeking to push through a deal that would severely weaken his chief critic inside the SEIU, in the name of “restructuring.”

“Stern is essentially seeking to take a public entity private,” one person familiar with the situation told me.

The chief battleground is California, where SEIU has around 650,000 members, 40 percent of its total membership. Back in 2004 there were 38 SEIU locals in California but that number was subsequently reduced to 20. This has occurred because in 2006 Stern and his allies pushed through a statewide reorganization that merged numerous locals into bigger entities, whose membership, critics say, was gerrymandered. Stern then handpicked the leaders at the newly formed unions, installing close allies as officers.

I guess to some extent, I was sucked into the frame of the LA Times story, that this was some profound change in SEIU's health care policy. And while there might be some long term impact on health policy here, I think it might require a keener eye than my own to see really what this is all about.  This could be about something more basic about what organized labor is, what their goals are, how to build a strong union.  There's most assuredly some personality and ego issues involved, but the timing of this potential putsch seems a bit sketchy. 

Updated: I should also link to this SF Weekly article about some of the differences between the two leaders here, just as background if you care to learn more. Ok, back to your regularly scheduled update.

This has been a crazy "YEAR OF HEALTHCARE REFORM," hasn't it? The Governor's Plan doesn't even get a hearing until the special session.  The best solution, SB 840, Sen. Kuehl's single payer bill, doesn't get very far because everybody's aware of the veto that would rain down upon it like a South Pacific typhoon.  The Assembly Dems and the Senate Dems eventually formed a comprimise plan at the end of the session only to see it get vetoed by the Governor. And now, while the Governor has moved on some important issues, like the lottery as a funding source, and changing his employer fee from 4% to 6%, an actual deal could yet elude us. 

And even when (and if) we actually get a deal, because of the funding provisions, we still have to go to the ballot. And now, there's issues in labor.  Exciting, huh?

 Turn the flip for the old story.

It seems SEIU's resolve on health care is rapidly crumbling. After months of towing the It's OUR Healthcare line, of supporting AB 8, and then tentatively supporting ABx1 1, it seems Sal Rosselli wasn't getting results at the pace that Andy Stern wanted them. 

While enthusiastic about the goal of securing coverage for the 5 million Californians who now are uninsured, Sal Rosselli — the president of an Oakland-based SEIU local as well as the state council — has insisted that any deal fully protect middle-class residents from having to pay premiums they may not be able to afford or forcing them to buy bare-bones policies.

 

But through a labor fight that has been more than a year in the making, Rosselli may be removed as president of the state council as early as this morning, two years before his term is scheduled to expire, according to union officials.

 

Many of the issues involved in the action have more to do with internal union politics about labor's direction than with the healthcare battle, but the leadership change could have substantial consequences. The potential new leaders are more eager than Rosselli and longtime Executive Director Dean Tipps to cut a deal with Schwarzenegger — in part to help advance their campaign to overhaul healthcare nationally.

 

That has been the view of Andy Stern, the president of the international union, who has personally expressed to the governor's office his frustration with the stance of California SEIU leaders, according to people familiar with the discussions. (LA Times 11/30/07)

So, Et Tu, Andy? To Mr. Stern, apparently the more important thing is getting immediate press releases, results are secondary. Look, ABx1 1 isn't perfect, far from it. It's not even as good as AB 8, and as It's OUR Healthcare has been saying there's much work to do. We need greater protections for the middle class and quality assurances. But how much more can we go? Are willing to just give in and require an entire individual mandate? Are we willing to yield on some of the cost controls and quality assurances that assure quality healthcare for Californians? Are we willing to give more money to Blue Cross so that Stern has some additional issues to grill Edwards and Clinton on? How'd that work in Massachusetts. Oh right, healthcare costs are double what the Legislature expected and costs have not been contained at all, so people have to just break the law and not carry coverage or buy shitty coverage. There's a whole lot more to this leadership switch than healthcare though. The rumored new leader of the State Council says this of Rosselli:

"Our experience in SEIU and across the country is you don't have to have the perfect bullet to slay the dragon," said Tyrone Freeman, president of the Los Angeles-based SEIU chapter representing 170,000 home care and nursing home workers.

 
So sure, there are plenty of sides to this story. And it's really not for me to judge the internal workings of SEIU. But is this the thinking of Stern as well? The man that was supposed to be our progressive champion? That we don't compromise enough? Wow. Just Wow.

SEIU-UHW in Oakland

Sal Roselli at SEIU-UHW Bargaining ConventionI’m on my cell, so this will be a short post. And I point you to the Courage Campaign blog for more detailed coverage. But what I want to say right now is that this is clearly an organization that is growing and beginning to understand how important the bridges between labor and bloggers really are. I’ll post more when I get a chance.

UPDATE: I’m back at home now, so I wanted to post this picture of SEIU-UHW president Sal Roselli. Elliott Petty of Courage Campaign and I had a few minutes to sit down with him. He had some really great ideas on how to connect labor with new constituencies and the internet. I’ll get a much broader post on this up on Monday.