Resolution No. 19: Affordable Health Care – A Basic Human Right

WHEREAS, access to universal, quality health care is a basic human right. We are united as a union across our common border in seeking to ensure that our members, their families, our retirees and our citizens are not denied this basic right. However, in both Canada and the United States, our very different health care systems continue to be threatened by the same forces that seek to reap profit for the few at the expense of the many; and

WHEREAS, catastrophic events like pandemics, natural disasters and emergence (or re-emergence) of high-threat pathogenic diseases demonstrate how urgently we need universal quality health care, sound public health policy and cooperation across agencies and nations.  The COVID-19 pandemic was an unprecedented wake-up call, laying bare deep inequalities in access to health care and exposing the failures of our current health care systems.  Health emergencies such as COVID-19 spread human suffering, destabilize the global economy and upend the lives of billions of people around the globe, showing the critical need for health emergency preparedness and investment in critical public health services; and

WHEREAS, in the United States, the health care system is the most expensive (accounting for a 16 percent share of the nation’s GDP in 2023) and least efficient in the industrialized world. An individual’s ability to access health care and medicines is all too often related to how much money they have unless they are among the Americans who have employer-sponsored benefits. As a result, USW members and others covered by their employers have been forced to trade wage increases for compromised employer-sponsored health care benefits; and

WHEREAS, about one in five people taking a prescription drug in the United States report having difficulty paying for their medications, and many forego taking their prescriptions due to cost.  The cost of prescription drugs is the fastest-growing component of health care costs, making vital medications unaffordable for USW families; and

WHEREAS, it is estimated that 8 percent of adults – or roughly 20 million people in the United States owe medical debt, including 14 million who owe more than $1,000.  Nearly 1 in 10 adults nationwide owe at least $250 in medical debt; and

WHEREAS, over the past ten years, the average worker contribution to health insurance premiums has risen by 30 percent and, the average deductible for employer-sponsored insurance has more than doubled; and

WHEREAS, the USW and its members have fought for decades to reform the broken health care system in the United States. After beating back  consistent and ongoing attempts to repeal the Patient Protection and Affordable Care Act of 2010 (ACA), we must guard against attempts to undermine the law’s protections, which provide USW members with improved benefits and support efforts to reduce health care costs, expand Medicare and lower prescription drug costs, including the ability Medicare now has due to the Inflation Reduction Act (signed into law in August 2022) to negotiate with drug companies to help reduce the cost of some of the most expensive drugs; and

WHEREAS, the USW continues to expend a great amount of time and resources at the bargaining table every day negotiating health care benefits for active and retired members and provides valuable resources to our staff and local unions to bargain effectively over employer-sponsored plans. It is important to note that the ongoing battles with employers about the continuation of health care benefits and/or further cost shifting to our members and retirees have not been resolved by the ACA or any other health care-related legislation. The USW will continue to face certain challenges at the bargaining table; and

WHEREAS, the USW has established a number of multiemployer health care funds, including the Steelworkers Health and Welfare Fund in the U.S. and the Steelworkers Benefit Plan in Canada, to allow members more control over their benefits, including providing fair and equitable handling of benefit claims; and

WHEREAS, the public health care system in Canada is under attack, just as Medicare, Medicaid, and Tricare (veterans’ benefits) are in the United States, by those who advocate increased for-profit privatization. This attack, enabled by legislation implemented by right-wing governments, loopholes in current legislation, and court challenges to the Canadian Medicare system, results in more private clinics and privatized services appearing in some Canadian provinces, putting at risk the most important universal social program achieved by Canadians; and

WHEREAS, in Canada today, governments are looking at ways to transfer more public funds to private, for-profit companies, a move which threatens both universal access and sustainability; and

WHEREAS, health expenditures in Canada as a percentage of GDP have been fairly stable since 1990 and account for 12.1 percent (2023) of GDP.  Although right-wing governments and their allies in private industry complain that health care spending constitutes a larger portion of government spending every year, public health care costs are not, in fact, increasing disproportionately. The data actually demonstrates that private health care spending is increasing disproportionately while public health care spending remains relatively stable; and

WHEREAS, Canadians’ spending on prescription drugs nearly tripled between 2001 and 2020 (an increase of 178 percent). Adjusted for inflation, the amount that Canadians spend on drugs is now increasing by five and a half percent per year. The level of expenditures on drugs has increased from $11.9 billion in 2001 to $32.7 billion in 2020, and drugs now rank second after hospitals in terms of their share of total health care spending, having overtaken spending on physicians in 1997. Pharmaceutical companies do not enjoy the same freedom of advertising in Canada as they have in the United States, but they violate the minimal restrictions that do exist by aggressively advertising or bribing doctors, academics and the media in order to drive up consumption of new and more expensive medications. Drug companies spend more on marketing than on research, with an estimated $30,000 per year for every doctor in Canada on drug samples, sales rep contacts, conferences, trips and giveaways; and

WHEREAS, union members in Canada have negotiated insurance coverage for health    care benefits not paid by the public system. Work-based plans cover 84 percent of unionized workers and their families and 49 percent of non-unionized workers. Medications for chronic illnesses and out-of-hospital drugs are a substantial part of the cost of private coverage, and the increasing price of drugs is making work-based plans more and more expensive. This cost pressure is causing employers to seek increases in co-payments and deductibles, making it more difficult to reach settlements at the bargaining table. Further, Canadian governments are exploring the possibility of taxing these benefits; and

WHEREAS, passing the Pharmacare Act in Canada in October 2024 marks a significant labor and NDP victory, thanks to the decades of advocacy of the labor movement, and the legislation is a step toward achieving a universal, single-payer pharmacare program.

THEREFORE, BE IT RESOLVED that:

1. The United Steelworkers will work to ensure that the right to health care is considered a human right in every country where it represents workers.
2. We will continue to fight to ensure affordable access to health care and prescription drugs for USW members, retirees and their families.
3. We are committed to leading the fight for the protection and expansion of the universal public health care system in Canada. We will continue to advance five principles for federal and provincial legislation: universality, portability, comprehensiveness, public administration and accessibility to all, and we will fight to keep publicly financed, publicly delivered health care in every Canadian jurisdiction.
4. We are committed to supporting the implementation of the national pharmacare program in Canada as the necessary and unfinished business of the Canadian national health care system.
5. We will fight any proposal in Canada to tax privately negotiated health care benefits.
6. In the U.S., while we fight to protect our existing benefits, we will also strive for our ultimate goal: publicly funded universal coverage, cost controls and comprehensive benefits.
7. We should continue to demand adequate, affordable, and fair health care coverage, including reproductive health, from our employers, and whenever beneficial for our members, negotiate that medical and related benefit programs be provided through participation in the Steelworkers Health and Welfare Fund in the U.S. and through the Steelworkers Benefit Plan or a similar plan in Canada.
8. We will continue to fight to retain the benefits and protections won by the Affordable Care Act and other meaningful legislation impacting health care in the U.S.
9. We will work to prevent the repeal or capping of the tax exclusion for employer- provided health care and in opposition to additional taxes on our members’ health benefits.
10. In the U.S., our union will continue to fight to preserve and expand Medicare and Medicaid as we know it and will fight against privatization.
11. We will continue to participate in discussions with federal and state agencies as health care policy progresses and provide resources to our staff and members via various mediums.