Big Labor’s Big Prize in Health Care “Reform”

In his Wall Street Journal column today, Holman Jenkins highlights one of the prizes at stake for organized labor in the current health care debate.

Union members not only like the tax-free, open-ended health -care benefits they’re used to getting. More important and often overlooked, organized labor itself is increasingly made up of health-care workers who benefit from an incentive system that artificially force-feeds great gobs of GDP into the industry’s maw.

Their long retreat elsewhere in the economy may continue unabated, but unions are steadily growing their clout in government and health care, two sectors that increasingly overlap and would become even more overlapped under the bills in Congress. Consider a scheme being test-driven in Missouri, where Democratic Gov. Jay Nixon, AFSCME and SEIU last year backed a ballot proposition to create a “Missouri Quality Homecare Council.”

As the A.P. matter-of-factly reported: “The ballot summary shown to voters said nothing about making it easier for in-home care providers to unionize.” But that was precisely the function. Now some 13,000 home health workers hired by patients but paid for by Medicaid are on the verge of being recognized as a union.

But won’t collective bargaining inevitably mean higher Medicaid costs for Missouri taxpayer? Gov. Nixon, whose campaign reportedly received $650,000 from SEIU and AFCSME, obviously has other priorities.

In Canada, where health care is largely government controlled, 61% of health-care workers are unionized. In the U.S., it’s only 11%. Democrats are bent on changing that and the bills floating around Capitol Hill are rife with provisions to replicate the Missouri scheme nationally.

As my co-authors and I point out in a new Cato Policy Analysis (“Vallejo con Dios: Why Public Sector Unionism Is a Bad Deal for Taxpayers and Limited Government”), organized labor has been pursuing this strategy for some time now.

Now some unions are trying to expand the definition of “public” by trying to organize government contractors. Washington state provides a good example of this. There, the trend began in 2001, when voters approved a ballot measure, Initiative 775, to allow independent long-term health care providers to unionize and bargain collectively over hours, compensation, and working conditions.39 Then in 2007, Washington state authorized collective bargaining for adult-home-care providers who receive Medicaid and other state aid.40 Stretching the definition of “public employee” to any home-care provider who may contract with the state can give a public employee union a foothold in the private sector. Further, under such an arrangement, union fees can be deducted from state compensation checks before the recipients ever see them, so the care providers never miss money they never see.

For more on labor, see here.

For more on SEIU, see here.

For more on health care, see here.