Few liberals speak about health care with the credibility of Andy Stern, president of the Service Employees International Union. His organization represents more than two million unionized workers, from janitors to nurses, who care about better health care because it’s an issue that affects them personally. Under Stern’s leadership, they’ve done as much to advance the cause as any single group in America--in part because Stern was obsessed with the issue long before the rest of the country was.
And, like a lot of liberals, Stern has grave concerns the Senate’s health care reform bill. He wishes it still had a public option. He doesn’t like the tax on relatively expensive benefits. And he thinks it doesn’t provide enough financial assistance, or protection, to lower- and middle-class Americans.
But Stern doesn’t want to kill the Senate bill. He wants to improve it--and then, when that’s done, to start fixing the dysfunctional political system that produced it.
A lightly edited transcript of our interview follows:
JC: What’s the basic message SEIU is trying to send today?
AS: Our message is that it’s time for the Senate to finish its job. We probably have the best we are going to do, and trying to improve the Senate bill doesn’t seem realistic right now. The real final chapter in this story is going to be written in the conference committee. That’s where all of us have to push together--to try to improve the affordability issues that, we think, the Senate did not handle as appropriately as the House.
We had this woman on our conference call today, Athena, who is a home care worker. She goes to work every day, taking care of people, and the cheapest health care she can find is impossible to pay for on the 9.20 an hour she makes. We would say the Senate bill doesn’t do enough to help her.
We had another worker, a clerk from Connecticut, she has good health benefits. But she would certainly not say they are “Cadillac” benefits. And she would be taxed in the next few years, because she’s in a relatively small group with a higher than average age.
There are some real life issues here. ... And if we’re not going to have a public option, we’d better have some stronger insurance reforms.
JC: But what makes you think you can fix these things in conference committee? The final bill still has to get through the Senate, which means getting it past the same small group of skeptical senators.
AS: I think there are certain issues here that are far less ideological or principled--and we can make progress there. Whether subsidies are, for the sake of argument, at 300 or 400 of the poverty level is a money issue, not a principle issue. I’m not saying that you don’t have to come up with the money somehow. But if it’s deficit neutral, so we pay for the extra subsidies, then I don’t think there’s a serious ideological or principled argument against that. It’s not like there are senators taking a stand against better affordability.
There are, on the other hand, certain areas where it’s harder to see changes, like the Medicare buy-in and the public option. I’m not saying people won’t try, but we’ve all watched the same play in the halls of the Senate. It’s hard to imagine how you get a different ending.
JC: Lately we’ve heard a lot of objections to the individual mandate, from the left as well as the right. And, for the left, it’s closely tied to the death of the public option. They don’t like the idea of forcing people to buy private insurance. What’s your position on that?
AS: The whole purpose of this is to cover people, not figure out how we don’t cover people. Our goal is to solve, in the conference committee, some of the affordability issues that we think are not adequately addressed. It’s not a question of whether you’re buying coverage from private insurance or not. It’s a question of whether people can afford it, whether they can afford the co-pays and deductibles.
Look, I’m covered by private insurance and most of our members are covered by private insurance, whether or not I like it. So I don’t think that’s a reason to oppose the mandate. We want to improve the affordability. But I don’t think letting people out of being covered is the right way to do that.
JC: So where should progressives be putting their energies? There’s a lot of frustration out there, and for good reason.
AS: The Senate is distorting democracy. They’ve set up a system that does not represent what the American people want--and not just on health care. It sets the stage for America to be unable to meet the challenges on everything from jobs to energy to trade to foreign policy.
We have an organizational culture that allows individual senators to stop a vote from happening or stop a debate from taking place. I think that is morally wrong. It hurts America, diminishes its ability to solve problems. No single senator is so important, their ideas so important, that they should be able to stop us from having a debate over critical issues.
JC: Who do you hold responsible for that? Is it individual senators? The leadership? The administration and the president?
AS: I think, from the moment they had sixty votes, there should have been an expectation. When it comes to your position on any issue, we would encourage you to be part of the majority but respect that every senator has different views and different states to represent. But when it comes time to discuss these things, none of us will stand in the way of having the debate. This is not about what Harry Reid or Andy Stern does. It’s about the leadership and the members making decisions as a group--decisions that everybody is going to be accountable for this.
Democratic senators have to make a decision: What is the expectation of being a member of the caucus, having the privilege of serving as chair of a committee, having opportunities to make nominations, and other courtesies we afford members of the majority. So far, the expectation--set by the fat that we haven’t consciously set a standard--is that anyone who has a problem can overrule everybody else. The Senate is not “Let’s Make a Deal.” It’s a deliberative body that the people expect to solve problems.
I think they have a decision to make, bigger than any single issue. Are we going to use procedural games and rules to keep frustrating th ewill of the majority. We expect opposition from the Republicans, they’re doing it quite clearly. But there is no such thing as a Republican filibuster right now. It’s only a Democratic filibuster.