We at Wisdom Voices have always trumpeted the efforts of those in the labor movement who advance the betterment of all. Our book, Wisdom of Progressive Voices, featured the lives and quotes of Eugene V. Debs and Caesar Chavez. And Stewart Acuff, Utility Workers Union of America, AFL-CIO, proudly told us during the interview: "Ultimately, we have a responsibility to stand up for human values and justice in every part of our lives."
The thing about union activists and organizers is -- they really do that; they just don't talk about it. That's the case with Cindy Young, who is the Special Projects Coordinator for the California Nurses Association. She also serves as the campaign coordinator for Campaign for A Healthy California (see sidebar below). This role is just the next step in a more than 30-year journey in her quest to bring justice and fairness into the workplace.
"What gets me up and motivated?" Young pondered. "Because we can't give up. This fight for single payer is a worthy fight -- and it's the right thing to do. It (single payer) may be obvious to many of us, but it's not to the average person who for so long has been filled with this notion that we should be on our own or that health care should be tied to employment.
"People think "I'm going to work and I get health insurance. If you'd just go to work, you'd have health insurance.' Well there's no way anyone's health care can be tied to a job. Everybody deserves a decent level of health care, whether they're working or not. We have a silly health care delivery system here. We need a better way to deliver something that we all need -- that when we're sick we need medical care or when we're hurt we need medical care whether that's at work, in an auto accident or we're out boating with our family and you cut your finger and need stitches. All of us need health care; even if you're healthy today, you step out the door and in an instant the world can be very different.
"The right wing in our country has created a frame that keeps lowering our standards. We need to change the public's thinking from "I don't have health insurance when I retire, why should you?' Or worse yet, "why should I pay taxes for yours?' Until we get everyone insured under one health insurance plan (single payer), we need to continue to provide examples of things that we pay for that most believe are for a public good. For example, there is no question that every neighborhood should have a fire station because the fire fighters protect us all from the danger of a fire. There is a strong fiscal argument for single payer, and this should attract a more conservative audience.
"The right wants people to think that if everyone has it, there won't be enough of it. They tell people that it's socialized medicine, when in fact we already have socialized medicine in this country. It's called the Veterans Administration and their costs are cheaper than the private market. It's really the one-on-one conversations that you have with people that bring them to a different place. And that's what we all have to do -- is have more one-on-one conversations to help educate people about single payer."
2013 may seem like odd timing to continue to push for single payer as most everyone has turned their attention to implementation of the Affordable Health Care Act (ACA). Yet Young says now, more than ever, is the time to push the conversation on single payer. She's quick to point out the elements of the ACA that benefit people, especially those who will be on MediCal in her own state. She believes it's when the full implementation of the ACA is accomplished that people will see just how the ACA falls short of the health care currently enjoyed by every other modern/industrialized nation on earth -- universal health care for its citizens.
Vermont became the first state to pass legislation for implementation of single payer. Hopes are that a state with the size and strength of California will be next. And Midwestern states such as Minnesota also have legislation introduced to put single payer in place. Many other states have organized single payer efforts as well.
"There are advances in the ACA that are worthy of supporting. Anything that builds the infrastructure of our public health system, especially here in California, is certainly worth supporting," Young said. "The problem is that there are going to be millions who will still be uninsured, even when the ACA is fully implemented. In California, the estimate is still 4 million by 2019.
"The other component is that all the health care delivery system hopes that are part of the ACA have been tried before and failed. You can't really reform the delivery system as long as the insurance companies control the market and then refuse to release information about it because they claim it's proprietary. Insurance companies tell us that their provider networks offer superior cost containment. The fact is insurance companies can't control the cost of health insurance -- or they would have done it.
"For years they came up with some kind of scheme that they sell to us -- PPOs, HMOs, AC0, etc.," Young said. "The threat of health care reform has been the only time rates went down. Every study that's ever been done on single payer has told us the same thing: It insures everyone; it improves quality and it saves lives. And it saves money. You could do a bazillion more studies and another study would tell you the same 4 things.
"So that's where my hope is - that once all of the ACA is fully implemented that people will see that there is still a need for a universal health care plan. And as was shown in Massachusetts, their individual mandate does not prevent medical bankruptcies or really solve all the other financial needs that aren't even patient care issues. I am hopeful because when something like this (the ACA) happens, there's a shift. And, I think the shift will be that more folks will realize that we tried with the ACA and we got only so far and that we have more work to do.
"My epiphany came in 1980. I was the first woman to be hired in a French Service dining room in San Francisco," the native Californian remembered. "I didn't really have much of a union consciousness, but my union voted to go out on strike and that's what catapulted me into activism. I became active in the union and got on the Industry Wide bargaining committee in 1983. I became good friends with Ramon Castelblanch who did the health care negotiations for our union. He took me under his wing and helped me understand how a health insurance renewal is developed. The large San Francisco hotels didn't want to pay for retiree health and welfare benefits. Ramon and I sat in the back room and he taught me how to tear apart the numbers that the insurance companies had proposed, and that there are mistakes, and holes in their arguments for increases. After Ramon and I were done with them, there was enough money to keep the retirees covered for the term of the collective bargaining agreement.
"I was only 25, but I realized that what these employers were saying is that after working for 20 years they were going to cut you off from health care coverage. And I thought, "why should health insurance be tied to job?' That was my epiphany. Can you imagine a banquet server, carrying those trays for 20 years and then you're going to tell them they can't have health insurance."
Young knows the advantages of single payer from every side of the argument -- be it financial or from a social justice viewpoint that health care is a basic human right. "Every union in every community is different in terms of how the push for single payer gets promoted," Young said. "For some, cost is more of an issue, but other unions are completely sold on everyone deserves healthcare and it's not about the money. I've come to a place where it doesn't matter what it costs, everyone needs to be treated with the care they need. Single payer addresses cost, quality, outcomes and everyone is insured. It's a simple argument whether we're talking financial outcomes or a human right.