Originally appeared in Jacobin on Oct. 21, 2019.
James Hoffa (Wikimedia)
Last week, the International Brotherhood of Teamsters announced the beginning of a new endorsement process for the 2020 presidential election. In contrast to their last-minute 2016 endorsement of Hillary Clinton, this process began with an issue survey sent out to every one of its 1.4 million members — over 20,000 responded — with more than a year to go before the general election.
Out of roughly ten issues that members were asked to rank, the top three were chosen to constitute a “Teamster Pledge”: pension and retirement security, fair trade deals, and strengthening the right to organize. Though the data are not publicly available, it is likely these are the three issues that unite both Republican and Democrat members of a typically more conservative union.
While health care was not among these top issues shaping the three-point pledge, Teamsters president James P. Hoffa decided to address it anyway — not by declaring the right of all people to quality health care, but by flatly dismissing Medicare For All:
The Teamsters have health care for all. And I just think we have to educate [the candidates] on that issue. I can’t believe they would say that we’re going to give up our insurance. That’s something we would be very, very strong on. That’s just not something that we would concede.
It is true that the overwhelming majority of Teamsters are covered by a union-negotiated health insurance plan. As a truck driver for a unionized carrier, I happen to be one of them. Relative to the insurance plans of my working-class peers, it is a decent plan with low co-pays, a small yearly deductible, and no out-of-pocket premium. But anyone knowledgeable about Medicare For All would trade in even a great private plan for the publicly funded approach — including Teamsters like myself.
The Medicare For All plan advanced by Bernie Sanders (and we should accept no substitutes) would mean every person has the right to quality health care, including dental and vision, delivered by a doctor of their choosing. It would render most private insurance redundant, and with it an array of financial terms that no working-class person would ever miss hearing: premiums, co-pays, coinsurance, deductibles, and so on.
Opposing a sensible plan that would provide life-changing benefits to tens of millions of Americans on the grounds that “we’ve got ours already,” as Hoffa appears to be saying, is bad enough. But this tacit defense of the private insurance system is also a political dead-end for the labor movement. Medicare For All could dramatically improve our ability to negotiate higher pay, organize more workers, and establish unions as the most powerful defenders of health care for the entire working class — not just our own dwindling memberships.
While I don’t see expensive premiums come out of my paycheck like many workers do, union-negotiated health care is by no means cheap. As a participant in TeamCare, a Teamster health care plan that administers the coverage of about 220,000 workers, my employer pays about $400 a week into the fund. That amounts to roughly $20,000 a year, which is currently the average cost of health insurance for a family.
What if, instead of paying that huge chunk of change into the health care fund, my employer was mandated to shift a portion of it into wages instead? That’s exactly what the Bernie Sanders plan calls for:
If Medicare for All is signed into law, companies with union negotiated health care plans would be required to enter into new contract negotiations overseen by the National Labor Relations Board. Under this plan, all company savings that result from reduced health care contributions from Medicare for All will accrue equitably to workers in the form of increased wages or other benefits.
As Ben Beckett explains, “any union member who doesn’t endorse [this plan] is leaving a huge pile of money on the table.” Teamsters, and millions of other union members, would not only get better health care with lower costs, but also a pay raise, according to Sanders’s implementation of Medicare For All.
Under the current system, too many union members have to make a depressing decision every time contracts are renegotiated: do we want a good raise with cuts to health care, or do we want to preserve our current health care and keep wages flat? This has led to a problem in the trucking industry where union carriers actually offer lower take-home pay than nonunion carriers, since the latter shift health care costs onto workers. As a result, Teamster organizers have the unenviable task of convincing a young truck driver — who may not be insured at all — that he or she would be better off with a lighter paycheck.
Until Medicare For All takes health care costs off the bargaining table and ensures all employers contribute equally, it will be impossible to rebuild our union in what used to be a core industry. When organizers can focus on how unions give workers better pay and a voice on the job, without having to get into more complicated questions about health care plans, they will be more successful convincing a new generation of workers to say “union yes.”
De-linking health care from employment altogether will give unions another edge in new organizing and contract negotiation. Workers everywhere will have more freedom to stand up to their boss, and even to go on strike, once they aren’t afraid of losing access to life-sustaining health care for themselves and their family members. In this way, Medicare For All takes a huge weapon out of the boss’s arsenal.
Of course, winning Medicare For All will be far from easy and corporate interests will always be looking to chip away at whatever we do manage to win. The working class, which stands to benefit most from Medicare For All, will need powerful organizations to drive the effort, to safeguard every victory, and to continually strive for improvement. The union movement is best positioned to take up that historic responsibility and to establish organized labor as the rallying point for all workers, union and nonunion, who seek a better life.
Shortsighted union leaders like Hoffa may never see the massive potential of labor-led advocacy for Medicare For All or other democratic-socialist demands, like universal rent control or the Green New Deal. This is one reason it will be up to rank-and-file union members who do have a vision to take the lead on educating both union leaders and our fellow workers. The conservative stranglehold on union politics that began with the expulsion of left-wing activists in the 1940s is finally losing its grip, but it will take continued effort to pry away the last few fingers. The fight for Medicare For All is perfectly suited to make the case that democratic-socialist demands are not only positive but necessary for rebuilding a fighting labor movement.
Ryan Haney is a rank-and-file union member in Texas.