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Paul Jay speaks to Leo Gerard, President of the United Steelworkers’ union about his fight for single-payer health care reform and the unionization legislation. Gerard says that, “the unions are first and foremost going to be very active in the fight to pass the Employee Free Choice Act (EFCA) and the fight for health care reform.” Speaking on the proposals of the Chairman of the Finance Committee, Gerard says, “I think Senator [Max] Baucus (D-MT) is off the mark,” because the Senator’s proposal to tax employer provided health care will, “drive more people out of the health care system.”

Story Transcript

GERALDINE CAHILL, TRNN: Hi. I’m Geraldine Cahill with The Real News Network. This health-care story is part of a series we are doing to help Americans make better-informed decisions about health-care reform. But we can only do this work with your financial support. The economic crisis has hit us hard. Please become a member today so that we can continue bringing you stories like this.


PAUL JAY, SENIOR EDITOR, TRNN: Welcome to The Real News Network. I’m Paul Jay, coming to you today from Pittsburgh. I’m with Leo Gerard, president of the United Steelworkers. Thanks for joining us, Leo.


JAY: So when President Obama was elected, the American union movement had two—maybe more, but two critical objectives. One was real health-care reform, and the Employee Free Choice Act. So let’s start with health-care reform. Senator Baucus in the Finance Committee has been saying, well, we’re going to please the insurance company and we’re going to have some kind of public component, but everyone’s going to wind up happy here. But the more we get into this, the more not everyone can be happy here, ’cause the insurance companies have made it very clear, with the Republican Party: they don’t want any public component at all. So where are we at, and what are the unions going to do about all this?

GERARD: Well, obviously, the unions are first and foremost going to be very active in the fight to pass the Employee Free Choice Act and the fight for health-care reform. The health-care system in America is broken, absolutely completely broken. It’s the most expensive health-care system in the world, and close to 50 million people have no health care, and almost another 50 [million] have what would be termed inadequate health care. So we’re going to be fighting for that. I think Senator Baucus is off the mark. He’s talking about things like taxing employer-provided health care. Well, all that will do is drive more people out of the health-care system. And clearly the insurance industry isn’t in the business of providing health care; the insurance industry is in the business of making profits.

JAY: So president Obama has come out to some extent saying there has to be a public component. But many of the people all around him—his chief adviser, [David] Axelrod, was on Stephanopoulos’s show on Sunday—a little bit of hedging on the issue of public component coming from the White House. And you guys, there wouldn’t be a President Obama right now if there wasn’t for the trade unions.

GERARD: Look it, it’s clear, and I take a lot of pride: it wouldn’t only be for the trade union movement; he wouldn’t have won Pennsylvania and Ohio if it wasn’t for the steelworkers and other unions, and so that without winning Pennsylvania and Ohio, he probably wouldn’t have become president. Having said that, we need to have health-care reform in this country. I guess I could quote Winston Churchill. Winston Churchill said you can always count on America doing the right thing after they’ve done everything else. That’s what we’ve been trying to do with health care, right? They went to HMOs and they went to different kinds of models. Now they’re saying, “Well, we can’t go to a single-payer,” yet we all know that a huge part of the expenditures in health care are administrative expenditures. Huge amount of money gets spent. We know that there’s way more fragmentation. We know that there’s way more testing being done so that doctors are trying to do what they think will generate revenue. And so we need a system that generates health care, not one that generates profits.

JAY: So are you in support of the single-payer system?

GERARD: Personally, the Steelworkers Union and myself have been in support of single-payer. This accent’s from Canada.

JAY: So that’s—I was going to ask you that next. There’s always all this vilification of the Canadian health-care system here, and it seems to go in the media virtually unquestioned, as if it’s a given there’s something wrong with the Canadian health-care system. Yet when you ask Canadians, by far the majority of Canadians would never choose an American system. But what do you make of the way this plays down here?

GERARD: I want to correct you as a Canadian. It’s not the overwhelming majority; it’s almost unanimous that Canadians wouldn’t give up their health-care system for the American system. And the fact of the matter is that the Canadian system has a lower infant mortality rate and a higher life expectancy rate. Rich folks don’t like it in Canada ’cause they don’t get to jump to the front of the queue—everyone’s treated the same. Now, having said that, I can also say that the Canadian health-care system has been under attack since the day we got it. Every time there’s an election, one of the right-wing governments, whether it’s in the province or nationally, cuts expenditures, tries to delist some of the stuff, and they want to try to weaken it. And every election we fight to protect it. And no one would ever dare in Canada run on a campaign that they’ll eliminate the Canadian health-care system.

JAY: It would be suicide.

GERARD: It would be political suicide. Now, having said that, America spends, depending which economist you’re talking to, between 16 and 16.5 percent of its gross domestic product on health care. Driving in this morning to work, I listened to NPR, and there was a person there saying that by 2025, unless we do something, America could be spending 25 percent of its gross domestic product on health care. That is unheard of. No other civilized society in the world could ever think like that.

JAY: Now, what about within the trade union movement? There’s quite a difference of opinion about, quote-unquote, what’s “politically possible”. And there’s a whole section of trade unions—in fact, I think majority of the leadership of most of the unions and the AFL-CIO—who have said: we’re going to support the Obama public plan in competition with private insurance companies because, quote-unquote, single-payer’s not “politically possible”. What do you make of the argument?

GERARD: Look it, I think that that’s the political reality that we’re living in at the moment. And I think one of the things we need to be able to do is talk about public plans. In America, the most successful health-care program in the country is Medicare. The other successful government programs in America are Medicaid and the medical care given for vets, vets care. In every one of those three circumstances, if you ask those people if they’re happy within that system, it’s almost as popular as it is in Canada, so that government-provided, government-sponsored health care in America is already very popular. In most states, the state provides health care for state employees. That’s government health care. The fact of the matter is the people that are most unhappy are the people that aren’t in the system or the people that are getting exorbitant, exorbitant costs from their insurance companies. And so the fact of the matter is that we’re dealing with the political reality, and I think we need to have not a very complicated system. Let us opt into the Medicare-Medicaid system. Let us opt into the the VA system. If you were a vet and you work in a plant, opt into the VA system. And then let’s have real competition. We live in the myth in this country that insurance companies provide health care. They don’t provide health care. They provide a vehicle to make profits for insurance companies. And one of the ways they do that is by either overcharging or excluding people.

JAY: So in this battle that’s coming, do you agree that in the current conditions, single-payer isn’t politically possible? And—.

GERARD: I think we need to fight for single-payer. I think we ought to be fighting for a principled position that lays out that this is the most efficient health care in the world, and single-payer is a euphemism for government-sponsored health care. Every other major OECD country has health care that is sponsored and managed by the government.

JAY: And what about this euphemism? Why not just say it’s a government insurance plan? Isn’t it just confusing people?

GERARD: Look it, I think the problem is that in America there’s been, for the last 35 years, the vilification of government by Wall Streeters, by globalists, I guess since the Nixon days. I mean, it was Richard Nixon that gave us EPA [Environmental Protection Agency], you know? Those days have moved on. I think what we need to do is compare. And you never hear any real comparisons between the system in the US at 16.5 percent of GDP and, say, the system in Switzerland or the system in France or the system in Germany or the system in Great Britain or the system in Canada. In real terms, what are the costs and what’s provided? What they’ll say in America is it’s going to drive up your tax. But I’m paying for it now already. I’m paying it in my wage.

JAY: So let me ask you—.

GERARD: Let me make this one point about the tax. If you’re having health care in a decent health-care plan in America today, the average plan, it’s costing $12,000 a year for a family. If you translate that into an hourly rate, that’s six dollars an hour. If you gave me to the Canadian health-care plan, it’s at roughly $4,000. That’s $2 an hour.

JAY: Except the Canadian plan’s already built into your taxes, and you’re paying the same amount of taxes in both countries.

GERARD: And we’re paying the same amount of taxes in both countries. Exactly. So one of the failings of our debate is failing to make comparisons of apple to apple, oranges to oranges. We’re letting them compare a grape to a banana.

JAY: Okay, one final question. If the White House starts to vacillate on this public program—it looks now like Obama’s committed to some kind of public program, but it might be so watered down as it isn’t that meaningful. What kind of clout does the union movement have with the White House now?

GERARD: Look it, I think that there’s two elements to the health-care debate that the labor movement is pretty unified on. One is it’s irrational to tax employer-provided health-care benefits, because that will drive people out of the health-care system and drive them into the uninsured category, and that will drive up costs. They start by saying, well, we’ll only tax above a certain level. Well, if you tax about $250,000 a year of income, there’s not enough money to pay for the changes. So that’s the silly part of that debate. But the only way that you can bring meaningful competition is to have a viable public option that people can opt into. I’m not uncomfortable having a debate about opening up Medicare and let us, let me as a negotiator decide if the members of our unit—ABC Electric, I guess, whatever you put out of the air—would rather be with their insurance company or whether they’d rather be in Medicare. Let them make their choice, because in Medicare you get to choose your doctor, you get the doctor to prescribe you. You don’t get that choice with the insurance company. The insurance company tells you which doctors are in the HMO, which doctors are in network, out of network. When I came to the US, had to learn all kinds of forms like PPO, preferred provider, or, I mean, HMO. I mean, I learned all these forms, these concepts.

JAY: Which is one of the myths in America about Canada, that in Canada you also choose your doctor [sic].

GERARD: Yeah. You know, I carry my health card when I go back to see my kids. And what I tell people: if I get hit by a truck on the side of the border, it’s going to cost my union tens of thousands of dollars to fix my broken leg. Once I cross the border in Buffalo, if I get hit by a truck, my kids don’t have to pay.

JAY: Well, let’s hope you don’t break your leg.

GERARD: Me too.

JAY: Thanks for joining us.

GERARD: My pleasure. Good to be with you.

JAY: Thank you for joining us on The Real News Network.


Please note that TRNN transcripts are typed from a recording of the program; The Real News Network cannot guarantee their complete accuracy.

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Leo W. Gerard is a steelworker and president of the United Steelworkers (USW). He was involved in the formation of the Industrial Union Council of the AFL-CIO, and in February 2003, was appointed to serve on the AFL-CIO's Executive Committee, as well as serving on its Executive Council. He was named Chair of the AFL-CIO's Public Policy Committee in March 2005.