Work and Health
Expanding Access to Health Care by Controlling Costs
 or low-wage workers and their families in California who are represented by labor unions, health insurance coverage is arranged through collective bargaining between their employers and the union. Because the cost of health care has escalated in recent years, this issue now dominates many contract negotiations, making it difficult to address other issues such as higher wages, pensions and job training programs.
In March 2004, to help raise awareness of the problem among union members, contract negotiators and employers, the California Works Foundation received a TCWF grant of $135,000 over two years to develop a statewide health education, training and alliance-building program to increase workers’ access to affordable, high-quality health care. As a first step, they formed the California Health Care Coalition (CHCC), whose members now represent more than 750,000 California workers and their families, including low-wage workers in the grocery and janitorial industries.
“We were not convinced by the conventional wisdom that says increases in medical costs are driven by the patient utilization or the demand side of the equation,” said Sally Covington, CHCC’s director, referring to factors such as the aging of the population, increased use of high-tech diagnostic tools and patient-focused health indicators such as smoking or obesity rates.
“Our analysis shows that hospital costs, driven by the supply side, account for more than 50 percent of the annual increase,” she said. “Excessive pricing as a result of consolidation of ownership is one factor, as is the uneven quality of care.”
CHCC has worked with several communities in California to collect data that will allow for comparison between providers within markets on measurements such as price, health outcomes, transparency of data and the amount of charity care provided. Based on these findings, CHCC hopes its members and employers will require providers to meet high standards in order to be included in benefit plans.
CHCC hopes that pressure to maintain market share position will force higher-cost and lower- quality providers to improve both service and affordability so as to compete for business with those that meet the CHCC standards.
“Because the cost of health care has escalated in recent years, this issue now dominates many contract negotiations, making it difficult to address other issues such as higher wages, pensions and job training programs.”
Building on successful efforts in Sacramento and the Inner East Bay area, CHCC is now looking to mobilize employer and employee organizations in Modesto.
When organizations join CHCC, they commit to educating their health plan participants about health care cost issues and to learn what questions about costs to ask during negotiations. Through organization newsletters, fax updates, web outreach, presentations at union locals, meetings of shop stewards and other efforts, CHCC is spreading its message that health care purchasers and consumers need to join together to preserve affordable health benefits.
“An important strength of CHCC’s approach to health policy advocacy is its focus on action,” said Fatima Angeles, TCWF program director. “Their research and information provides a road map or action plan for members to follow while working to expand access to affordable health care for low-wage workers in their own communities.”
For more information, please visit www.cahealthcarecoalition.org.
|
