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Supreme Court Upholds Health Care Reform—and We Have Much Work Ahead

John August, executive director of the Coalition of Kaiser Permanente Unions, sends us this update on the U.S. Supreme Court's decision to uphold the Affordable Care Act today. The coalition is an alliance of 29 local unions representing 90,000 health care workers.

Important and good news: The pathway to provide health care for all of our people has survived. Since the Civil War, many attempts to extend health care for all have failed. As of today, June 28, 2012, the path has finally been cleared.

Of course, the law is not an extension of Medicare for all, nor does it guarantee health care for all tomorrow. It certainly does not guarantee health care for all that is equitable, affordable and of the highest quality. Those struggles are still before us.

But, advocates for high-quality health care for all have been given a huge boost to build on the platform of the Affordable Care Act, which survived the political gridlock in Washington, D.C. Chief Justice John Roberts was the “swing vote” in the 5-4 decision that upheld the law. That Roberts turned out to be the swing vote is historically significant in my view. His vote says to me that our government can rise above politics when the demand for social change is loud and clear.

To me, that is the real victory.

For many, many years, on the fundamental question of whether or not the American people believe that everyone should have access to health care, the answer has always been “yes”—and people have also agreed overwhelmingly they would pay more taxes to see to it that health care is available to all.

For us, the health care workers of the Coalition of Kaiser Permanente Unions, we have been working very hard, getting ready for this moment.

Now that the path for tens of millions of uninsured people to be insured has survived, profound transformation in the way in which health care is delivered and paid for now must become the focus of the nation. We know that U.S. health care:

  • Costs too much.
  • Is not equitable.
  • Is not consistently delivered as the right care at the right time.

For health care to truly become a right, rather than a privilege, we must reform the delivery system. Our commitment as unionized health care workers to performance improvement and improvement of our own health and the health of our communities will provide leadership in the nation to make the law work.

We work in the largest accountable care organization in the nation. We have the best wages, benefits and working conditions in the industry. We have said for years that we are in partnership to transform Kaiser Permanente so that we can transform health care in the nation.

For health care to work well for everyone in this country, we must continue to struggle for access for all people, including our vast immigrant populations. Much additional reform is necessary.

The “industry” cannot achieve success as it is. The “industry” must transform as required in the act. This will happen not without front-line workers leading the transformation. Here at Kaiser Permanente, we have the right model of care, the systems in place and the people to succeed.

We in our coalition have the additional opportunity and obligation to show the nation the relevance and necessity of unions in leading social change for the betterment of everyone.

Put this all together and what does it mean? It means June 28, 2012, is the day the path for health care for all has been affirmed once and for all. Expectations are high, the barriers are enormous and the economy is in tatters.

To truly build a health care system that provides affordable, high-quality health care for all, we must lead on the path to achieve it. The key to the next victory is a fully engaged, unionized workforce committed to improvement in every aspect of quality and affordability. We have the tools, we are working hard—and with today’s victory, we must redouble our efforts. We can do it!

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