Feeding Two Birds With One Hand

It’s not often that one major policy initiative could solve two huge problems. But a single-payer national healthcare plan could do just that.

Health care will continue to receive considerable attention during the coming months of the presidential campaign. All the talk about “change” and grassroots “involvement” might set the stage for convincing a critical mass of people to demand that the candidates and Congress adopt a single-payer healthcare plan. It would not only solve much of our nation’s healthcare crisis but the school funding crisis as well.

If this is to happen, however, educators and our unions need to speak out boldly and provide leadership. Let me explain.

As a teacher of inner-city children, I see unmet health needs on a daily basis. Some of my students are among the 9 million children in the United States who lack health insurance. In its 2006 report, Campaign for Children’s Health Care reported that uninsured children are nearly five times more likely than insured children to have at least one delayed or unmet health care need and five times more likely to have unmet dental and vision care needs. These children are also four times more likely to have an unmet need for prescription medication, and more than three times as likely as insured children to have an unmet need for mental health services.

The resulting excessive absences, chronic illnesses, and classroom inattentiveness significantly compromise my students’ — and millions of other students’ — learning. Often my 5th-grade students come to school sick. If they receive health care at all, it’s not unusual for it to be from an emergency room. Apparently their parents take President Bush’s words to heart when he said last June: “I mean, people have access to health care in America. After all, you just go to an emergency room.”

In our school, we have many children who have vision and dental needs that are not met unless teachers and the school social worker actively search for providers. I am not arguing that we should not help children and families find adequate health care, but since when were schools anointed to be the key providers of children’s health care? It’s a sad commentary on the state of health care in the world’s richest nation.

Children suffer greatly from our broken healthcare system. But another education-related consequence of this system is rarely talked about: the immense amount of time and money that goes into preserving health insurance for teachers — a benefit won in hard-fought union battles in past decades.

As an active member of my local teacher union, I am amazed at the amount of time spent defending our health benefits to the media and the right wing, who accuse teachers of having “Cadillac” or “Rolls Royce” health insurance plans. By implication they argue that instead of everyone receiving basic health coverage like teachers, teachers should “come down” to the level of those who receive spotty health coverage, or maybe even worse — like the one in five people in Milwaukee who have no health insurance at all.

I am reminded of the absurdity of this situation every time I speak with teacher union colleagues from Canada, England, or Australia. They are dumbfounded to learn that one of the most contentious issues in contract bargaining among U.S. teachers and school boards is health care. I don’t need to ask these colleagues why they don’t waste their time on healthcare matters — each of their countries (and all other industrialized countries of the world) have some form of universal health care.

I can’t imagine any teacher union leader or local school board member who wouldn’t welcome a new federal program that would make the issue of healthcare benefits a moot point in bargaining. Not only would that save countless hours of bitter negotiations, but even more importantly it would save a significant amount of money for local school districts. Billions of dollars are literally being taken from school budgets to pay for health insurance plans — money that could be spent on children’s education if this country adopted a national healthcare plan.

For example, in the 2006-07 school year Milwaukee Public Schools spent over $182 million in healthcare expenses. If those needs were covered through a national healthcare program, it would mean that per-pupil spending in Milwaukee would increase by about $2,000. For an elementary school of 400 students this would mean $800,000 more dollars for hiring teachers, paraprofessionals, social workers, parent organizers, and so on. For a high school of 1,500 students it would mean $3 million.

The same is true for other cities. For example, according to the New York City Independent Budget Office, the New York City Department of Education spent $702 million for the fiscal year 2003-04 on health benefits for teachers and classified employees — approximately 5 percent of the budget.

Contrary to arguments that national healthcare systems are fiscal boondoggles, studies show that costs in countries that have universal health care are substantially lower than health expenses here. A 2004 study by researchers at Harvard Medical School and Public Citizen, for example, estimated that national health insurance could save at least $286 billion annually on paperwork alone. Moreover, because it would be a federal program, the funding mechanisms would be something other than regressive property taxes that many school districts currently rely on. Who knows, with enlightened national leadership in Washington, and a lot of pressure from the grassroots, some of the hundreds of billions of dollars that are being misspent in the war in Iraq could be redirected to programs such as health care for all. Or the $500 billion military budget as whole could be trimmed. According to the New York Times, U.S. military spending has risen 62 percent during the Bush administration — more than all the other countries of the world combined.

Of course, national health plans are not without their problems. Issues of bureaucracy would have to be handled, and more importantly the adequacy of any plan would have to addressed, lest people currently covered by employer health plans (both public and private) experience a decrease in their level of service. Moreover, there is the serious matter of how any government-based program might affect the over 11 million undocumented people in this country.

The problems, however, pale compared to the largest obstacle to universal national health care: weak or nonexistent leadership by politicians. Initially, Barack Obama and Hillary Clinton have pushed “national health care” as a campaign issue, but both have stopped short of proposing a universal plan that is “like Medicare,” “run by the government,” and “financed by taxpayers” — something favored by 65 percent of likely voters according to a December 2007 Associated Press poll.

Proposals like those made by Obama and Clinton would increase coverage of the uninsured, but for the most part keep intact the profit-driven, cost-accelerating haphazard collection of employer-based or individually purchased private insurance programs. The uninsured would be “mandated” to “buy” health insurance for themselves or their children, sometimes with government assistance. But according to Robert Kuttner, co-founder and editor of the American Prospect magazine, speaking on the television/radio show Democracy Now!: “[The] difference between universal social insurance and a mandate is that universal social insurance, like Medicare, says that as an American or a permanent resident of the country, you get health insurance, the same way you get Social Security. A mandate takes a social problem and makes it the individual’s problem.”

Kuttner also noted that with a universal health insurance program we would get cost efficiencies.

If the Democratic presidential nominee were to have the courage to make single-payer universal health care a major campaign issue, a likely effect would be to encourage increased grassroots organizing on this issue. If on the other hand, the nominee says “we can’t get universal health care” and we have to settle for something less — as Clinton did in January — the millions of Americans who want to see a real change in health care in this country are less likely to mobilize.

The bottom line is that children, their families, educators, and the entire community would benefit from a national healthcare system. Health care would improve. Funding could increase dramatically for schools. And the health and learning for all students would likely increase.