Unions Shouldn't Have to Fight for Healthcare

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From the beginning of last night’s Democratic debate, the many no-name moderates on stage went after Sens. Bernie Sanders and Elizabeth Warren over their support for Medicare for All. This was predictable, but one particular line of attack was more disingenuous than the rest.

Rep. Tim Ryan and former Rep. John Delaney attempted to attack the idea of single-payer from, uh, the left, kind of. “My dad the union electrician loved the healthcare he got from the I.B.E.W. He would never want someone to take that away,” Delaney said in between getting owned by Warren and Sanders.

“This plan that’s being offered by Senator Warren and Senator Sanders will tell those union members who gave away wages in order to get good healthcare that they’re going to lose their healthcare because Washington’s going to come in and tell them they got a better plan,” Ryan added, which eventually led to Sanders’ viral “I wrote the damn bill!” line. (Ryan, funnily enough, is a co-sponsor on the House Medicare for All bill, which should be an indicator of how seriously some of these people are taking their constituents’ pleas to support single-payer.)


The “pro-worker” argument made by Delaney—whose status as the son of a union electrician is apparently much more pertinent to the conversation than the fact that he made his millions running a healthcare business, and continues to make more millions by investing in healthcare businesses—is a tad more cynical than Ryan’s. But no matter the intent, the basic reasoning behind the argument itself is completely bankrupt.

It’s true that organized labor has spent an ungodly amount of time bargaining for good health insurance. The argument made here is that they should keep forcing themselves to do that, for reasons that are unclear besides that it’s what they’ve always done. It’s a little like arguing that because unions have fought tooth and nail for paid family leave, we shouldn’t have paid family leave at the federal level. It makes no goddamn sense.


To start, unions—generally speaking—do not want to give management leverage in collective bargaining if it’s not something that’s absolutely necessary. Healthcare is a more useful bargaining chip for employers than workers, as it serves as another tool to keep wages down. This is not a controversial idea; it’s actually how employer-sponsored health insurance got started in the first place.

In addition to unions being forced to give away a ton in the way of non-healthcare priorities, healthcare has also been at the center of labor disputes. “Healthcare has become the biggest cause of strikes, lockouts and concession bargaining,” Washington Labor Council president Larry Brown said in an op-ed earlier this year calling for Medicare for All. “Healthcare costs drive wage stagnation as unions routinely trade off wage increases and other benefits in order to maintain basic health care for their members and retirees.”


Ryan even mentioned Kaiser Permanente, the multi-state managed care company, in his tirade against Medicare for All. This week, Kaiser workers started voting on a strike authorization over a whole range of issues, including wages, adequate staffing and—you guessed it—health insurance benefits.

If unions did not have to fight for health insurance benefits (or paid leave), that would be one less thing on the docket, and one more opportunity to fight for things like higher wages, good severance packages, career development, just cause, non-discrimination clauses and inclusivity initiatives, and a host of workplace-specific issues that workers have to currently cede ground on to get better healthcare, or just to keep the healthcare they currently have.


If some unions want to tie one hand behind their back in bargaining just to keep fighting for healthcare for the hell of it, that’s certainly a choice. It is not one I would make.