John August, executive director of the Coalition of Kaiser Permanente Unions, sends us this update on the Affordable Care Act and health care reform. The coalition is an alliance of 29 local unions representing 90,000 health care workers.
The Supreme Court decision upholding the Patient Protection and Affordable Care Act was great. No question! And while we are pleased with the direction of the law, there are still many obstacles that stand in the way of ultimate success.
It is essential that we in the Coalition of Kaiser Permanente Unions look at the road we must travel to meet our goal: that every person in the United States has the right to affordable, equitable, high quality care--and that the front line of health care will continue to be the driving force to attain our goal.
Deep-seated problems to overcome
- The cost of health care in our nation is simply too high. The free market system has made it possible for too much profit, administrative costs and other unproductive costs to take too much of our precious resources away from care.
- Achieving widespread access to high quality services, especially preventive services, will take tremendous reorganization and commitment.
- Our federal government, states and counties are all running gigantic deficits. The ability to find the revenue and reprioritize government spending is another monumental mountain to climb if everyone in the nation is to have health care as a right.
These problems and barriers seem intractable at this moment in our history.
I believe in at least one way in which workers and their unions can help: we remind ourselves that democracy begins at home, within each person’s ability to participate and contribute.
By any standard, most people in health care are frontline caregivers. Here at Kaiser Permanente, our skill and our voices are mobilized around our Value Compass. This mobilization is and must continue to successfully unleash the power of our pre-paid, preventive model of care.
By showing the nation that a health care system can provide consistent, high quality and safe outcomes, we can get voters, policy makers, and political leaders to take initiative on the next steps. No, we cannot single-handedly solve the nation’s health care crisis, but we can create the model that will show that solutions are indeed possible.
Once solutions are seen, various forces will be motivated to go further, asking the harder questions necessary to address the barriers I identified above.
Beyond health care
We wonder all the time: what will it take to create an economy that can truly benefit all? With health care absorbing nearly 20 percent of all economic output, it is quite clear that a major overhaul in the way health care is delivered and paid for is necessary. And we cannot wait much longer.
Beyond health care, every region of the country faces high and chronic unemployment, public sector deficits with cuts in basic services, and a realization that there is no path to the creation of high paying secure jobs.
I like to think of our work in the Labor Management Partnership as a great experiment in how unionized workers can relate their work to the broader questions of social development.
The dialogue in the workplace that leads to innovation and improvement should be held in the community more broadly. Problems are there to be solved, but they will not be solved by waiting for one party or another to provide solutions. Dialogue designed for problem solving gets real results.
That is what we need going forward on a larger scale. Our work can lead to new thinking about improvement in our communities, beyond health care.
Another reason to succeed at our work at the front lines at Kaiser Permanente!