The cost of health care will not be brought under control until three things happen.
- First, the overall cost of providing health protection must be brought under control by imposing economic discipline -- controlling the costs associated with the delivery of health care. That can only be accomplished by adopting statewide a reasonably uniform and consistent approach to the purchase of health care service. In the absence of such a system, we have insufficient leverage with which to control health care delivery costs; we are at the mercy of a market that cannot possibly control itself.
- Second, health care must be extended to everyone under one system, so that the insured and their employers are no longer carrying the burden of paying for the uninsured. Only when all are contributing -- at least as equitably as individual circumstances allow -- can the costs of insurance be fairly distributed.
- Third, as a society we must be willing to say that access to health care should be at least as basic a right as access to education.
Nothing short of comprehensive cost controls, that puts a cap on growth in health care expenditures and establishes uniform provider reimbursement schedules to be used by all payers, will be sufficient to bring the budget under control. As a state, we can no longer afford to spend over $10 billion a year without a single plan to contain costs.
The labor movement is united in its determination to achieve significant cost containment, quality care, progressive financing and universal access. We are calling upon consumers, businesses and providers to join with us in an all-out lobbying effort to win national reform and ensure a healthier future for all Americans.
AFL-CIO Response: Our Platform for Reform
Since 1990, the AFL-CIO has stepped up its efforts for health care reform. Through a grassroots campaign -- and by working with lawmakers to seek passage of reform legislation -- the labor federation has sought to open the doors to care for everyone. Our call for reform encompasses four major areas: The escalating cost of care, the diminishing access to care, the uneven quality of care being delivered, and eliminate the cost shift to those with coverage, in order to cover those without coverage.
We continue to believe, as we have advocated for many years, that a unified health care system with a single payer should be the ultimate goal. We also believe that the urgency of the current crisis demands action now. The AFL-CIO Convention, in a unanimous action, declared in 1991: "The urgency of the health care crisis for the consumers and purchasers of care and for those who have fallen through the cracks in the current system requires us to seek relief now, without compromising our principles, and to support measurers that can be enacted."
As for the specifics, we are urging the General Assembly to:
Put a cap on the annual rate of increase in health care spending by establishing maximum fee schedules, capitation rate, and global budgeting for all providers.
- Establish a core benefit package to which all Hoosiers are entitled.
- Require all employers to contribute equally to the cost of care.
- Develop an equitable and progressive financing plan.
- Establish a state commission of consumers, labor, management, government and providers to administer the Health Care Program.
- Develop a program to cover long-term care services.
Call to Action
We believe that the time is right for the General Assembly to take advantage of this growing consensus and to take the lead in fashioning an approach that will control health care cost, expand access and improve the efficiency of the system.
The General Assembly should pass a law which would be comprehensive, contain costs, provide universal access, and improve quality of care. As a labor movement, we are committed to see that these proposed ideas are not undermined by piecemeal, short-term fixes designed to quell the nerves of those invested in the status quo.
The basic point, however, is that we can resolve these issues only after making an unequivocal commitment to resolve them. Under the present fragmented system, our problem-solving opportunities are limited. No matter how worthwhile they may be, no collection of piecemeal approaches - from tax credit to malpractice reform will do much to control the overall cost of health care or to address the inequities of access and quality of care.
We can have universal health security - if we commit ourselves to get on with the job. To advocate anything less, is to accept the inevitability of continued chaos, in which the state's resources continue to be misapplied and sucked into a black hole of uncontrollable costs. |
