This paper explores the history of the relationship of labor unions to national health reform over the last half century. It is based on a critical appraisal of Marie Gottschalk's book entitled The Shadow Welfare State. Gottschalk asserts that the "private funding" of benefits negotiated by unions, such as health insurance, pensions, and other social programs is deceptive because of the tremendous tax incentives provided to employers by government. Over $100 billion contributed by employers to fringe benefits, is tax exempt. In addition, an institutional framework that perpetuates the shadow welfare state at the expense of a publicly-funded universal healthcare system has grown up: Taft Hartley Funds, ERISA (Employee Retirement Income Security Act) and experience rated health insurance. These "institutions" have brought the interests of labor unions closely in line with those of large businesses and insurance companies. The implications of these developments for single payer national health reform will be discussed.
Learning Objectives: 1. To critically appraise the Marie Gottshalk's analysis of the role of labor unions in shaping national health reform. 2. To discuss the implications for single payer national health reform of the analysis. 3. To develop alternative scenarios for interaction between health care reform advocates and labor unions.
Keywords: National Health Insurance, Labor
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.