SEIU 503  Universal Healthcare Special Committee

Working Paper for Board of Directors (Revised)

Recommendation:

We recommend that the SEIU 503 Board of Directors support the efforts to make Oregon the first state to have a universal healthcare system, and support health care as a fundamental human right.

Background:

Many of our union members have healthcare coverage, and the Affordable Care Act of 2010, along with further state legislation, has brought healthcare coverage to over 90 percent of adults and nearly all children in Oregon. Yet Oregon, much like the nation as a whole, still suffers from a dysfunctional, inequitable, unaffordable, and unsustainable healthcare system. Many of us have examples in our own lives, or the lives of our families and friends, where there was unnecessary suffering due to a healthcare system that was inaccessible or unaffordable.  We see health care workers who have dedicated their professional lives being underinsured; underpaid; overworked; understaffed, with record numbers leaving due to burnout; and experiencing a rise in health care union worker contract negotiations leading to the brink of strike time and time again.

If our union jobs have healthcare insurance, all too often we bargain away gains to wages and other benefits in order to maintain the coverage we have. And as the COVID-19 pandemic has made clear, many of us will lose what little healthcare access we have if we lose our jobs.  Additionally, the pandemic has exacerbated health disparities experienced by tribal communities and communities of color – including American Indian/Alaska Native, Black/African/African American, Asian American, Native Hawaiian, Pacific Islander, Latino/a/x, and the intersection of these identities with those who also identify as LGBTQIA+, and/or people with disabilities. These communities continue to suffer disproportionately from the pandemic, whether by experiencing higher rates of job loss, houselessness, food scarcity, infection, hospitalization, death, and/or by being scapegoated as the cause of COVID-19 through bias and hate crimes.

The Case for Universal Health Care:

• A system of universal healthcare, a system that is less fragmented and more comprehensive, is the next step in fulfilling a vision of health care – including physical, mental and behavioral, and dental and oral – as a fundamental human right – regardless of age, race, national origin, religion/spiritual beliefs, language, immigration status, sexual orientation, gender identity, disability, neurotype, veteran’s status, job status, socioeconomic status, social class, and/or geography. While universal healthcare is desirable as an end in and of itself for a just and equitable society, it is also pragmatic, sustainable, and feasible to achieve. As defined by us, principles of a universal healthcare system include: Everyone must have access to the full scope of affordable health care (physical health, mental and behavioral health, dental and oral health) regardless of income, assets, and whether or not a person is employed;
• Adults and children must have access to the full range of patient- and family-centered health care services and treatments — including sexual and reproductive health, naturopathic and alternative medicine, end of life care, and providers of their own choice – including culturally and linguistically competent providers and healers, traditional health workers, qualified and certified health care interpreters, and school and social service-based providers;
• A system of universal healthcare should be designed without private insurance companies, eliminating the costs of private-sector administration and fees, making the delivery of health care much more affordable and at less cost than the current system;
• A system of universal healthcare must be delivered and paid for in a way that promotes health equity. Payment must fairly compensate a diverse, multicultural, and multilingual workforce that reflects the needs of the communities it serves, and those workers should have a path to unionization and a meaningful voice in the care they provide their patients;
• A system of universal healthcare, under public direction, must be patient-and family-centered and emphasize getting the right care, at the right time; and health outcomes which eliminate health and health care disparities for all, including: racial and ethnic minorities, LGBTQIA+ persons, persons with disabilities, persons with limited English proficiency, and persons with these intersecting identities, rather than payment per procedures, for a more results-oriented healthcare system to meet individual needs;
• A system of universal healthcare must financially commit to reducing disparities in health outcomes and can incentivize collaboration across stakeholders, including researchers (quantitative and qualitative), to work together to achieve the Triple Aim: better health, better care, and lower costs;
• A system of universal healthcare must facilitate more inclusive input from tribal communities, communities of color, and other communities who have experienced disparate health outcomes, leading to more culturally- and linguistically competent health care services, which address the root causes of health inequities—such as social determinants of health (g., nutritious food insecurity, unemployment, lack of child care, lack of insurance, lack of high school education, lack of housing or substandard housing, social isolation, limited English proficiency, discrimination, lack of transportation, etc.)

By decoupling healthcare from employment, people would have additional ability to change employment without disruption in care. As union members, universal healthcare would set a base for collective bargaining that would allow workers to have the opportunity to set other priorities to change their economic circumstances, such as wages, retirement, working conditions, etc.

Our Recommendation and Next Steps:

Therefore, we recommend that the SEIU 503 Board of Directors support the efforts to make Oregon the first state to have a universal health care system, and support health care as a fundamental human right.

In making this recommendation, we ask for the Board’s support in taking the next concrete steps:

• Support healthcare systems that put patients and consumers at the center of care over profits.
• Support union health care workers with fair wages and benefits and a meaningful voice in quality affordable health care through action legislatively and at the collective bargaining table.
• Declare health care as a human right;
• Support efforts to educate the membership, both at the 503 level and the Local and Sub-local levels, on the case for universal healthcare, and use examples to show the benefits of taking healthcare off the bargaining table, such as through the creation of the Homecare Workers’ Supplemental and Workers’ Benefits Trusts;
• Draw from the experiences of our members in Local 503 and Local 49, who work directly in the broken healthcare system, and who have real world expertise on solutions to fix it;
• Support future legislative efforts to bring about universal healthcare in Oregon, and channel this work through the Universal Health Care Governance Board created by SB 1089 (2023);
• Support candidates running for office who support universal healthcare;
• Support and champion legislation that strengthens Oregon’s capacity and efforts to close health disparities and inequities affecting tribal communities and communities of color, immigrants and refugees, and people with disabilities;
• As development of a universal healthcare system unfolds, support the work of making long term services and supports more affordable, accessible, and equitable to a growing population that will need them, especially in developing services and supports that are culturally and linguistically competent for the increasing diversity of Oregon’s older adults and younger people with disabilities.

Conclusion:

The Committee thanks the Board of Directors for consideration of this analysis, and of these recommendations and concrete next steps.