News & Opinion

A (sarcastic) salute to America's health-care system

The Columbus Dispatch Op Ed, Wednesday August 8, 2012

 By Kevin Horrigan, The St. Louis Post-Dispatch


 “Perhaps not surprisingly in a country where health-care reform is so controversial, it was the high-profile presence of the NHS that stunned many American writers. … Certainly the U.S. equivalent, which would be dancing health insurance corporate executives, was hard to imagine.”

— Paul Harris, in The Guardian , July 28

?Hah, hah, hah. Very funny. It’s not hard at all to imagine what the “U.S. equivalent” to your Olympic Opening Ceremony’s salute to Britain’s National Health Service would look like. I’m already working on it.

Sure, “dancing health-insurance corporate executives” will be part of it. If you’d made that much money last year, you’d want to dance, too.

Picture this: It’s night in Florida. We’re in a darkened Raymond James Stadium in Tampa, jammed with 66,000 delegates to the Republican National Convention and their guests. A spotlight illuminates the stage. The seven top health-care CEOs, carrying canes and dressed in white top hats and tails, prance on stage as the Mormon Tabernacle Choir sings Puttin’ on the Ritz.

Pretty nice, huh?

The spotlight widens to show 94 primary-care doctors, in multi-colored scrub suits, forming a ring around David Cordani, the CEO of Cigna Health Care, bowing and scraping to honor the fact that at $19.1 million, Cordani made more in 2011 than all 94 of them combined.

The orchestra breaks into Gershwin’s It Ain’t Necessarily So as the stadium floor is lighted, revealing 400 actual health-insurance bureaucrats wearing telephone headsets and sitting at small desks. They shake their heads back and forth in our “Salute to Rescission.”

The crowd erupts, because fans know that if Republicans repeal the Affordable Care Act, God will be in his heaven, all will be right with the world and insurance companies once again will be allowed to retroactively cancel coverage when someone needs it.

Lights around the stadium’s upper tier are forming a large donut, signifying the “Medicare donut hole” that will return once “Obamacare” is eliminated, thus ensuring that drugs for anything between basic coverage and catastrophe are not covered. The orchestra swings into Live and Let Die.

Cannons in the end zones fire clouds of pills into the sky. As they fall to the floor, out of the stadium tunnels limp thousands of senior citizens who are allowed to scrounge for the pills. Then, it’s time for our….

Tribute to the ER! Giant video boards flash the image of former President George W. Bush uttering these immortal words in 2007: “I mean, people have access to health care in America. After all, you just go to an emergency room.”

The theme from the TV show ER comes up as sirens wail, ambulances tear around the stadium floor, disgorging patients into the busy “emergency department” on center stage, already jammed with insured adults and children who have no primary-care doctors.

Our ER “treats” them and sends them on their way with big weights (symbolizing hospital bills) strapped to their backs, which they then pass to the people in the crowd — who are delighted to get them!

On wires stretched across the top of the stadium a huge number “17.6” sparkles in lights. It represents the percentage of the gross domestic product devoted to health care — 8 percent higher than the Brits. The music swells into Creed’s Can You Take Me Higher?

The crowd sings along, waving 66,000 foam “We’re No. 1” fingers, signaling America’s status as the nation with the most expensive health care in the world — 2.4 times more expensive than the silly Brits.

KA-BOOM! go the fireworks. We crane our heads skyward to see a giant figure “37,” symbolizing the World Health Organization’s ranking of the American health-care system.

The big finale: With the crowd’s attention diverted skyward, volunteers from health-insurance companies have erected cardboard cutouts of men, women, children and babies around the floor of the stadium. There are so many of them — 45,000 — that they loop around the field in a squiggly line almost a mile long.

They represent the 45,000 Americans whose lack of health insurance contributes to their premature death each year, according to a 2009 study by the Harvard Medical School. Now riding into the stadium atop Rafalca, his wife’s Olympic dressage horse, is Mitt Romney, who will be nominated for president on the following night.

He guides the mare’s nose to the first cardboard figure. A simple nudge and, like dominoes, they topple over in spectacular sequence. The crowd goes wild.

Kevin Horrigan writes for the St. Louis Post-Dispatch.

khorrigan@post-dispatch.com

Time to Fix Healthcare

[Editorial from the March 26, 2007 issue of The Nation]

 

The need to expand access to affordable healthcare is rapidly emerging as the top domestic policy issue in the 2008 presidential race. And no wonder: With the number of uninsured now up to nearly 47 million, and more than one-third of that total consisting of households with family incomes of $40,000 or more, lack of health insurance has become a concern not just of the poor but also of the middle class. Moreover, soaring medical costs--increasing in large part because at least one of every five healthcare dollars goes to administrative costs and insurance company profits--are a worry even to those who have some form of insurance. More than half of personal bankruptcies today are caused by illness or medical debts.

 

There's no mystery about the fix Americans want: Nearly two-thirds of those surveyed in a recent New York Times/CBS poll say the government should guarantee health coverage for all Americans. Half said they'd willingly pay as much as $500 a year more in taxes to pay for universal coverage. To do that, this country needs to establish a single-payer system--one inspired by Canada and other developed countries but distinctly American in approach. There's already legislation, with seventy-eight co-sponsors--the United States National Health Insurance Act (HR 676)--that would accomplish this by expanding and improving the existing Medicare system. The popularity of such an approach, endorsed March 6 by the AFL-CIO executive council, is illustrated by the ease with which California legislators passed a single-payer plan last year--only to have Governor Schwarzenegger veto it. In late February, the plan was introduced again, as part of a reform-from-below push that is seeing states tackle the healthcare crisis.

 

Ultimately, however, America needs a national fix.

 

Americans have lost hope that the Bush Administration will do anything to address the national healthcare crisis. Only 24 percent of those in the New York Times/CBS poll said they were satisfied with Bush's handling of the issue. And that number will surely shrink with recent revelations about the deplorable conditions at the Army's Walter Reed Hospital--another reminder of this Administration's incompetence. But so far most of the major presidential candidates have failed to take advantage of Bush's low standing to advance bold proposals.

 

Among the candidates, Congressman Dennis Kucinich has a long record of embracing single-payer proposals. Unfortunately, he is a lonely leader. The front-running Democratic contenders remain vague and cautious. Senator Barack Obama says, "I am absolutely determined that by the end of the first term of the next President, we should have universal healthcare in this country." Senator Hillary Clinton says she would enact "health insurance for every child and universal healthcare for every American"--with specifics "yet to come." Former Senator John Edwards moves beyond rhetoric to a plan: He would require everyone to have insurance and require employers either to provide coverage or pay into a fund to provide it. But although he reaches out to labor on other issues, Edwards is unwilling to embrace HR 676, which has earned support from nine international unions, seventeen state federations and sixty-three central labor councils.

 

Voters have to demand more if they want more. Obama at least recognizes the frustration of Americans for whom meaningful healthcare reform has been a dream deferred at least since the collapse of the Clinton Administration's bureaucratic proposals of the mid-1990s. The Clinton plan rejected single-payer and embraced a complicated hybrid that relied too heavily on the same insurance companies that had failed to make healthcare affordable and accessible. "We can't afford another disappointing charade in 2008, 2009 and 2010," says Obama. He's right. But he and his fellow front-runners should recognize that as long as they avoid talking about single-payer and continue to tinker around the edges of the current system, they are players in the charade.

`Single-Payer' Idea Stays Afloat

Legislative Committee Clears Two Differing Approaches To Health Care Reform

By DIANE LEVICK
Courant Staff Writer

March 14 2007

A bill to create a single health insurer in Connecticut - an anathema to the industry - won half-hearted approval Tuesday from a legislative panel, which also passed a reform bill the industry favors.

The Insurance and Real Estate Committee, in a 12-7 vote, approved a bill aimed at creating a "single-payer" system to ensure coverage for all Connecticut residents not on Medicare.

Several Democrats on the committee, including committee Co-chairman Brian J. O'Connor, said they were voting for the Connecticut Saves Health Care bill simply to keep reform debate going despite misgivings about potential job loss in the insurance industry.

State Rep. Christopher R. Stone, D-East Hartford, who voted yes Tuesday, said he wouldn't support the bill on the House floor.

The bill's proponents, though, scored the vote a victory because it showed a major shift in the climate for universal health care and keeps the single-payer idea afloat.

The Connecticut Saves Health Care program would replace the current system of employer-based and individually purchased policies, taking away much of the role of private health insurers. However, they wouldn't be prevented from selling supplemental coverage.

The insurance committee is known for preserving the role of insurance companies in health care, but "what they've said today with their vote is the system is broken and we need to change it," said Phil Sherwood, legislative director of the Connecticut Citizen Action Group. "I think that rang loud and clear."

Legislators of both parties, however, voiced worries about insurance industry jobs in Connecticut, should there be a switch to a single-payer system.

State Sen. Louis C. Deluca, R-Woodbury, the committee's ranking member, said Iowa has become as big or bigger a mecca for insurers than Connecticut because of legislators' actions here over the years.

"We continually give them reasons not to be here," he said. "I believe this would be another one."

Keith Stover, a lobbyist for the Connecticut Association of Health Plans, warned that "If Connecticut wants to maintain its pre-eminence as an insurance state, I would think that passage of single-payer would be about the worst possible message you could send to the industry.

"It's a lot of families that are supported by the insurance industry, a lot of mouths are fed, a lot of children put through college, and the idea that people are willing to just chuck that is extremely disturbing."

But state Rep. John C. Geragosian, D-New Britain, praised the single-payer concept, saying, "Insurance companies don't add any value in this [current] system" and that "it's time to take some bold action" to solve the health care crisis.

Stover blanched at that, saying after the meeting that "essentially every innovation in health insurance, from chronic disease management to consumer-driven health plans, etc., all come from the minds here in Hartford, in Connecticut."

Tuesday's vote was a "victorious first step toward comprehensive change," said Juan A. Figueroa, president of the Universal Health Care Foundation of Connecticut, which had pushed the single-payer bill.

The vote, he said, "acknowledges that incremental steps are not the way to fix our state's broken health care system."

The vote for a single-payer system also drew praise from Council 4 of the American Federation of State, County and Municipal Employees, the largest AFL-CIO union in the state, and from Citizens for Economic Opportunity, a labor-community coalition.

But a single-payer system is "potentially unsustainable" from a funding standpoint, said Eric George, associate counsel at the Connecticut Business and Industry Association, which has "grave concerns" about the idea.

The state already under-funds Medicaid payments to hospitals, driving hospitals to make up a part of the shortfall through reimbursements from private insurers, George said. In a single-payer system, health care providers wouldn't have private insurers to fall back on, he said.

The insurance committee removed funding provisions from the bill because there was no consensus, measures that would have levied a 50 percent surcharge on the state income tax and an 8 percent payroll tax on employers of a certain size. The bill now goes to the Senate.

The committee also passed a revised version of the Healthy Steps bill, which Stover said "provides the most rational framework for ongoing discussion" and relies on a market-based system.

The bill, which now heads to the House, would create a new Health Care Reform Commission to develop a more affordable health plan for small employers of 50 or fewer employees.

The state would contract with a private nonprofit organization that would serve as an insurance purchasing pool for previously uninsured individuals and small employers to buy coverage.

The Connecticut Connector program would offer three kinds of health plans, including a high-deductible plan linked with a health savings account.

Legislators removed from the bill a proposed 3 percent tax on revenue of health care providers in Connecticut that would have helped to fund some of the provisions. Doctors protested the tax at a committee hearing last week.

The bill would provide tax credits at varying levels to small employers that provide health insurance that meets or exceeds the standards set for the affordable plan to be developed.

The measure also calls for expansion of the state's Husky insurance program, and increased reimbursement to doctors, dentists and hospitals from insurers serving Medicaid members.

Contact Diane Levick at dlevick@courant.com.
Copyright 2007, Hartford Courant

Healthcare is a Human Right

Health Care is a HUMAN RIGHT

"Everyone has the right to a standard of living adequate to the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services....." Universal Declaration of Human Rights, Article 25, adopted by the United Nations General Assembly on December 10, 1948, signed and ratified by the United States of America.

The right to health is universally recognized as fundamental to human dignity, freedom and well-being. There are many factors that influence our state of health and well-being including housing, workplace safety, environmental conditions, access to a safe and sustainable food supply and our own genetics. However, access to comprehensive medical care is fundamental to our health and well-being. Without that, it is impossible for a person to realize their full potential and dignity as a human being

In order to meet human rights standards, a health care system must be:

  • Universal,
  • Accessible to all and available to all,
  • High quality standards of care for all,
  • Comprehensive and appropriate to all health needs,
  • Financed and delivered in a non-discriminatory way that enables the participation of all individuals and communities,
  • Provides access to information,
  • Ensures transparency and
  • Has effective mechanisms to hold both the public and private sector accountable to the citizens.

SPAN Ohio is dedicated to achieving a health care system that fulfills the human right to health care and that ensures every person will receive the care they need in a manner that affords them the dignity they deserve.

For further information on the human right to health care, read the following articles:

 

 

About Us

WHO WE ARE – The Single-Payer Action Network Ohio (SPAN Ohio) is a statewide coalition of organizations and individuals in Ohio seeking fundamental health care reform in our state and country so that every resident is guaranteed full and comprehensive coverage. This includes the full range of medical services, hospitalization, prescriptions, vision care, dental care, mental health care, home care, long-term care, and care for all injuries and illnesses. 

We advocate the establishment of a public fund that would pay all health care bills without co-payments or deductibles. Funding would come from the savings realized by eliminating the administrative waste and profits of the 1,500 private insurance companies and HMOs, savings from greater utilization of preventive medicine, and from additional mechanisms deemed necessary to ensure that the public fund has the necessary financial resources, with adequate reserves. The plan we call for is known as a single-payer health care system.

SPAN Ohio is a non-profit, non-partisan 501(c)4 organization.

Contributions to SPAN are not tax deductible.

WHAT WE DO – We carry out a variety of programs designed to educate and inform on the need for single-payer. A focus of our activities is to win enactment of the Ohio Health Care Plan, either through direct legislative action or by an initiative petition sponsored by SPAN Ohio.

SPAN Ohio functions democratically and those who attend its meetings decide what the group's activities shall be. We distribute educational materials, organize public meetings featuring physicians and others with expertise on health care issues, circulate petitions, and introduce single-payer resolutions to organizations and legislative bodies. While campaigning to win single-payer health care in Ohio, we see this as a stepping stone toward achieving a national single-payer health care system, which is our ultimate goal.

HOW TO REACH US — Voice mail: 216-736-4766 — Email: span@spanohio.org — Web site: www.spanohio.org

WHEN WE MEET – SPAN Ohio meets quarterly. Check the SPAN Ohio website calendar for dates, times and locations. Join us!

Origins and Development of SPAN Ohio

When the Clinton health care plan collapsed in 1994, many people active in the movement to reform the system concluded that national health care was way off in the remote future and that the emphasis should be on attempting to win "small victories" and incremental reforms.

Actually, the Clinton plan never called for true universal health care. It specifically rejected eliminating the private health care insurance companies from the system. It was basically a plan for managed care or, more accurately, managed costs.

A broad coalition of forces actively fighting for a single-payer system in the early 1990s disappeared after the 1994 debacle. By the year 2000, increasing numbers of people had come to understand that an incremental approach could not solve the country's health care crisis and that only a fundamental reform of the system would. Indeed, when Clinton left office, there were eight million more people without health care insurance than on the day he was inaugurated. The single-payer movement began to experience a revival.

In February, 2001, six people met at a union office in Cleveland and constituted themselves the Single-Payer Universal Health Care Organizing Committee (SPUHCOC). Their goal was to educate the public about the advantages of a single-payer plan and to build a movement at the grass roots calling upon the Ohio General Assembly to establish such a system.

The founding group was diverse in composition and included unionists, a physician, community activists and retirees. SPUHCOC decided as its initial function to organize a public meeting to be addressed by Claudia Fegan, a Chicago physician who was a past president of Physicians for a National Health Program (PNHP) and co-author of Universal Health Care: What the United States Can Learn From the Canadian Experience. The meeting was held April 10 and drew an audience of 130 at Case Western Reserve University.

In subsequent months, SPUHCOC concentrated on drafting a model single-payer resolution and getting political bodies, other health care groups, health care providers, unions, community organizations and faith groups to endorse it. In relatively short order, the Cleveland City Council approved the model resolution with only minor modifications and other cities and town councils followed suit. Many physicians, nurses, local unions, and a variety of others endorsed a statement which simply said, "We endorse the campaign to get the Ohio General Assembly to act without delay to pass publicly funded health care guaranteeing coverage for all Ohioans." This statement was unanimously approved by the Cuyahoga County Commissioners, three members of Congress — Sherrod Brown, Dennis Kucinich and Stephanie Tubbs-Jones — and a number of state legislators.

In November, 2001, at the insistence of growing numbers of activists, SPUHCOC changed its name to Single-Payer Action Network Ohio (SPAN Ohio). Meanwhile, single-payer groups in Toledo and Cincinnati had begun to form and they affiliated with SPAN.

In early 2002, thousands of steelworker retirees from LTV in the Greater Cleveland area lost health care benefits they thought had been guaranteed for life. They were among 600,000 steel retirees confronted with the same drastic loss. The anguish of this situation and the constantly growing numbers of the uninsured from all walks of life created further disillusionment with the market-driven, for-profit system and much greater openness to the single-payer alternative.

By mid-2002, SPAN had become the established organizing center for the single-payer movement in Ohio. By then, SPAN had established a web site at www.spanohio.org, which in its first six months received over 10,000 hits.

It became clear that SPAN needed to branch out and become a genuine statewide coalition. In the summer of 2002, SPAN activists began discussing the possibility of organizing a statewide conference which could be the springboard for forming an Ohio coalition that could mount an effective campaign for single-payer. In September, 2002, the Ohio AFL-CIO, representing 850,000 workers and meeting in convention in Cleveland, voted unanimously to endorse SPAN's campaign for a single-payer health care system in Ohio. The UAW, on a statewide basis, had also endorsed. These developments helped propel momentum for the state conference, which was held in Columbus on January 18, 2003.

This conference was a great success with keynote speeches by Dr. Claudia Fegan and Dan Martin, representing Steelworkers District 1, a panel discussion and workshops for constituency groups. The upshot of the conference was a call for a March 1 meeting to formally launch a statewide single-payer coalition.

The March 1 meeting brought together organizations representing a million Ohioans and a number of dedicated individuals. It was agreed that "Single-Payer Action Network Ohio (SPAN Ohio)" would be the name of the coalition formed at the meeting. An Interim Steering Committee of 29 was elected, pending the adoption of bylaws.

While SPAN continued to gather endorsements for its campaign, the March 1 meeting exhibited increasing interest in the idea of an initiative petition ballot campaign to put the single-payer issue on the ballot. Bob Smiddie, of Pomeroy, had long been urging an initiative and, now that SPAN Ohio had the affiliation of major forces, the idea seemed eminently reasonable, despite Ohio's highly restrictive constitutional provisions on initiatives.

In the months following that meeting, SPAN fleshed out its structure, approved bylaws, changed the name of its governing body to State Council (retaining as members on that body those previously elected to the Interim Steering Committee while adding others), convened periodic meetings of the State Council and moved forward in the drafting of the initiative petition. After months of meetings, discussions and plain hard work, a petition upon which all could agree was finalized and approved by a statewide meeting of SPAN supporters. The petition summary and 201 signatures were filed with the Attorney General's office on July 14, 2004. (The state requires that 100 or more qualified electors sign to begin the process of proposing a law to the Legislature.) On August 5, 2004, the Attorney General certified the petition, and by August 20, five thousand copies, each accommodating 65 signatures, had been printed for distribution. Within five days, nearly 2500 had been picked up by chapters, unions, and individual supporters, all volunteering to help SPAN reach its goal of 140,000 valid signatures. (To be valid, a signature must be that of a registered voter, and must be personally witnessed by the petition circulator.)

SPAN State Council meetings are often characterized by robust debate, reflecting the internal democracy and diversity of views within the coalition. Throughout, it has maintained unity and continues to attract more and more organizations and individuals fed up with the current system and wanting a new one guaranteeing quality and comprehensive health care coverage for all Ohioans. If you are interested in recruiting SPAN supporters in your area, please call 216-736-4766 or email span@spanohio.org.

 

 

Origins and Development of SPAN Ohio

When the Clinton health care plan collapsed in 1994, many people active in the movement to reform the system concluded that national health care was way off in the remote future and that the emphasis should be on attempting to win "small victories" and incremental reforms.

 

Actually, the Clinton plan never called for true universal health care. It specifically rejected eliminating the private health care insurance companies from the system. It was basically a plan for managed care or, more accurately, managed costs.

A broad coalition of forces actively fighting for a single-payer system in the early 1990s disappeared after the 1994 debacle. By the year 2000, increasing numbers of people had come to understand that an incremental approach could not solve the country's health care crisis and that only a fundamental reform of the system would. Indeed, when Clinton left office, there were eight million more people without health care insurance than on the day he was inaugurated. The single-payer movement began to experience a revival.

In February, 2001, six people met at a union office in Cleveland and constituted themselves the Single-Payer Universal Health Care Organizing Committee (SPUHCOC). Their goal was to educate the public about the advantages of a single-payer plan and to build a movement at the grass roots calling upon the Ohio General Assembly to establish such a system.

The founding group was diverse in composition and included unionists, a physician, community activists and retirees. SPUHCOC decided as its initial function to organize a public meeting to be addressed by Claudia Fegan, a Chicago physician who was a past president of Physicians for a National Health Program (PNHP) and co-author of Universal Health Care: What the United States Can Learn From the Canadian Experience. The meeting was held April 10 and drew an audience of 130 at Case Western Reserve University.

In subsequent months, SPUHCOC concentrated on drafting a model single-payer resolution and getting political bodies, other health care groups, health care providers, unions, community organizations and faith groups to endorse it. In relatively short order, the Cleveland City Council approved the model resolution with only minor modifications and other cities and town councils followed suit. Many physicians, nurses, local unions, and a variety of others endorsed a statement which simply said, "We endorse the campaign to get the Ohio General Assembly to act without delay to pass publicly funded universal health care guaranteeing coverage for all Ohioans." This statement was unanimously approved by the Cuyahoga County Commissioners, three members of Congress — Sherrod Brown, Dennis Kucinich and Stephanie Tubbs-Jones — and a number of state legislators.

In November, 2001, at the insistence of growing numbers of activists, SPUHCOC changed its name to Single-Payer Action Network Ohio (SPAN Ohio). Meanwhile, single-payer groups in Toledo and Cincinnati had begun to form and they affiliated with SPAN.

In early 2002, thousands of steelworker retirees from LTV in the Greater Cleveland area lost health care benefits they thought had been guaranteed for life. They were among 600,000 steel retirees confronted with the same drastic loss. The anguish of this situation and the constantly growing numbers of the uninsured from all walks of life created further disillusionment with the market-driven, for-profit system and much greater openness to the single-payer alternative.

By mid-2002, SPAN had become the established organizing center for the single-payer movement in Ohio. By then, SPAN had established a web site at www.spanohio.org, which to date has received over 10,000 hits.

It became clear that SPAN needed to branch out and become a genuine statewide coalition. In the summer of 2002, SPAN activists began discussing the possibility of organizing a statewide conference which could be the springboard for forming an Ohio coalition that could mount an effective campaign for single-payer. In September, 2002, the Ohio AFL-CIO, representing 850,000 workers and meeting in convention in Cleveland, voted unanimously to endorse SPAN's campaign for a single-payer health care system in Ohio. The UAW, on a statewide basis, had also endorsed. These developments helped propel momentum for the state conference, which was held in Columbus on January 18, 2003.

This conference was a great success with keynote speeches by Dr. Claudia Fegan and Dan Martin, representing Steelworkers District 1, a panel discussion and workshops for constituency groups. The upshot of the conference was a call for a March 1 meeting to formally launch a statewide single-payer coalition.

The March 1 meeting brought together organizations representing a million Ohioans and a number of dedicated individuals. It was agreed that "Single-Payer Action Network Ohio (SPAN Ohio)" would be the name of the coalition formed at the meeting. An Interim Steering Committee of 29 was elected, pending the adoption of bylaws.

While SPAN continued to gather endorsements for its campaign, the March 1 meeting exhibited increasing interest in the idea of an initiative petition ballot campaign to put the single-payer issue on the ballot. Bob Smiddie, of Pomeroy, had long been urging an initiative and, now that SPAN Ohio had the affiliation of major forces, the idea seemed eminently reasonable, despite Ohio's highly restrictive constitutional provisions on initiatives.

In the months following that meeting, SPAN fleshed out its structure, approved bylaws, changed the name of its governing body to State Council (retaining as members on that body those previously elected to the Interim Steering Committee while adding others), convened periodic meetings of the State Council and moved forward in the drafting of the initiative petition. After months of meetings, discussions and plain hard work, a petition upon which all could agree was finalized and approved by a statewide meeting of SPAN supporters. The petition summary and 201 signatures were filed with the Attorney General's office on July 14, 2004. (The state requires that 100 or more qualified electors sign to begin the process of proposing a law to the Legislature.) On August 5, 2004, the Attorney General certified the petition, and by August 20, five thousand copies, each accommodating 65 signatures, had been printed for distribution. Within five days, nearly 2500 had been picked up by chapters, unions, and individual supporters, all volunteering to help SPAN reach its goal of 140,000 signatures.

SPAN State Council meetings are often characterized by robust debate, reflecting the internal democracy and diversity of views within the coalition. Throughout, it has maintained unity and continues to attract more and more organizations and individuals fed up with the current system and wanting a new one guaranteeing quality and comprehensive health care coverage for all Ohioans. The formation of a Columbus Chapter of SPAN on July 26, 2003 and a Southeast Ohio Chapter on July 24, 2004 were important steps forward. The goal of establishing additional chapters around the state remains a key SPAN priority.

If you are interested in organizing a SPAN chapter in your area, please call 216-736-4766 or email spanhealthcare@aol.com. Also take a look at "Forming Chapters of the Single-Payer Action Network Ohio (SPAN Ohio)" which is also posted on this website.

SPAN Ohio Bylaws

Article 1: Name

The name of the coalition shall be Single-Payer Action Network Ohio (SPAN Ohio), hereafter referred to as SPAN Ohio.

Article 2: Purpose

SPAN Ohio is a statewide coalition of individuals and organizations in Ohio that seeks fundamental health care reform in our state and country so that every resident is guaranteed full and comprehensive coverage for illness or injury, including work-related illness or injury. Under the plan we advocate, all medically necessary services are covered, including primary care and prevention, inpatient care, outpatient care, emergency care, prescriptions, durable medical equipment, long term care, home care, mental health services, the full scope of dental services (other than cosmetic dentistry), substance abuse treatment services, chiropractic services, and basic vision care and vision correction (other than laser vision correction for cosmetic purposes). We advocate the establishment of a public fund that would pay all health care bills without co-payments or deductibles. The plan we call for is sometimes referred to as a single-payer health care system.

Article 3: Membership

Effective June 1, 2016 and forward, SPAN Ohio shall become a membership organization where membership is defined as timely payment of applicable dues, based on a rolling 12 (twelve) month membership period (from the date of membership initiation or renewal through the end of the same month of the following year) with the following categories of membership – Individual (Regular/Senior/Student) and Organization. Active membership (membership in good standing) entitles a person or an organization representative to vote in SPAN Ohio State Council elections, to nominate and hold SPAN Ohio State Council office and to receive any other benefits offered to members.

Article 4: Structure

a. State Council: The State Council shall meet at least quarterly and shall guide the work of the coalition. The State Council shall be composed of the following: (1) the SPAN Ohio Executive Committee; (2) seven regional coordinators; (3) representatives from each of the following constituencies: labor, health care community, community organizations, faith groups, business community, and other organizations and individuals not fitting into the preceding five constituencies. An equal number of seats shall be set aside for each constituency and in the event a constituency does not fill its allotted number, seats shall remain open for that constituency until that number is filled by vote of State Council members who represent that constituency. Members of the State Council elected to serve on the Council in more than one capacity (for example, as regional coordinator and constituency representative) shall have only one vote. Members of the State Council shall be elected for a one-year term at the annual meeting of single-payer supporters referred to in Article 5, at which time the seven regions shall caucus for the purpose of electing regional coordinators, after which the constituencies shall caucus for the purpose of electing their representatives, with no more than one representative coming from any one organization. The State Council shall be empowered to establish additional constituencies, if necessary, preserving parity among all constituencies. Members of the State Council may be represented by alternates of their choosing, who are members of SPAN Ohio, at State Council meetings and such alternates shall be accorded full voice and vote. State Council meetings shall be open to all supporters of SPAN.

b. Quorum: A quorum of 34% of State Council members shall be required to conduct business, and decisions shall be by simple majority of those present and voting. In the absence of a quorum, any decisions made must be ratified by the State Council either by e-mail or at the next State Council meeting.

c. Executive Committee: At the annual General Meeting referred to in Article 5, the State Council shall elect an Executive Committee which shall be composed of the SPAN Ohio State Director, SPAN Ohio Secretary, the SPAN Ohio Treasurer, and five at-large members, four of whom shall be elected and, by virtue of their election, be members of the SPAN Ohio State Council.  The fifth at-large member shall be appointed as set forth in Article 4(h). The Executive Committee shall serve as the governing authority between State Council meetings. The business of the Executive Committee shall be conducted by simple majority of those present and voting, where a majority of the Executive Committee will constitute a quorum. In addition, the Executive Committee shall be responsible for monitoring and supervising the work of any consultants or professionals employed by the State Council. A member of the Executive Committee shall chair any meeting of the State Council in the absence of the State Director.

d. State Director: The State Director shall be elected by the State Council and shall chair all meetings of the State Council. The State Director shall work with SPAN Ohio supporters and Constituency groups to develop and expand education and worksite programs, work with the State Council and the Constituency groups to develop strategies for outreach and growth, work with the State Council to develop and implement legislative strategies and/or initiatives geared to promote the single payer solution and health care for all Ohioans, work with the State Council to develop and implement a fund raising strategy, work with other key coalition partners in Ohio (and nationally) promoting single payer legislation and function as the key media spokesperson for the organization. Commensurate with these responsibilities, the State Council may approve reasonable financial compensation (including expenses) to the State Director which could be adjusted relative to achievement of fund raising targets.

 e. Secretary: The Secretary shall be elected by the State Council. The Secretary shall maintain records, take minutes of State Council meetings, conduct correspondence, and keep the State Council informed of SPAN Ohio activities and developments in coordination with the Executive Committee.

f. Treasurer: The Treasurer shall be elected by the State Council. The Treasurer shall receive all contributions, pay all expenses, maintain records of all financial activity, and give financial reports to State Council meetings. Payment of ordinary administrative expenses shall not require prior approval by the State Council, but payment shall not be issued to anyone absent written documentation supporting the expenditure, such as an invoice or paid receipt bearing the date of the purchase, a description of the item or service purchased, and the reason for the purchase.

g. Regional Coordinators: One Coordinator for each of the seven geographical regions corresponding to the seven Ohio Department of Health regions shall be elected at a caucus of the attendees from each respective geographical region at the annual General Meeting. The Regional Coordinators are responsible for the recruitment of SPAN Ohio supporters, maintenance of supporters lists and development of contacts among the various constituency groups within each respective region of the state. In addition, the Regional Coordinators are to work in coordination with the SPAN Ohio State Director in the development and implementation of education, outreach, petitioning and legislative action programs in their respective regions. Also, the Regional Coordinators are expected to regularly submit reports of their activities at State Council meetings.

h. Membership Committee: A Membership Committee shall be composed of three (3) members appointed by the Executive Committee for one (1) year terms and the Chairperson of the Membership Committee shall be an at-large member of the Executive Committee. The Membership Committee, in cooperation with the Treasurer, shall be responsible for recruiting new members, developing membership materials and notifying members when their dues are up for renewal.

i. Audit Committee: An Audit Committee of three members in good standing shall be appointed by the Executive Committee, excluding Executive Committee members. The Audit Committee members shall audit the Treasurer’s books and records at year’s end and report their findings to the State Council at its first meeting of the year. However, nothing shall preclude the Audit Committee from conducting more frequent audits should it deem it prudent to do so.

j. Special Committees: The State Council or the Executive Committee may establish special committees as needed.

k. Removal from Office: Any person elected or appointed to serve in any position within SPAN may be removed from office for misfeasance, malfeasance or nonfeasance in office. No representative may willfully misrepresent the mission and policies of SPAN, or use the SPAN Ohio name/logo to promote other activities not approved by SPAN. "Willfully" means that the person has received written notice of the violation and continues the unapproved activities or has refused to desist. The issue will be presented at the next scheduled meeting of State Council and submitted for a vote in case of elected positions. A 2/3 majority vote is required for dismissal.

l. Termination of Membership: The membership of a member shall terminate upon the occurrence of any of the following events:
1. Upon the member’s notice to the Secretary that he or she wishes to terminate membership.
2. Upon the member’s failure to renew his or her membership by paying dues on or before their due date.
3. Upon a determination by the State Council, after providing the member with reasonable written notice and an opportunity to be heard either orally or in writing, that the member has engaged in conduct materially and seriously prejudicial to the interests or purposes of SPAN Ohio.
All rights of a member in SPAN Ohio shall cease on termination of membership as herein provided.

Article 5: General Meetings:

SPAN Ohio shall convene an annual meeting in Columbus in the month of April or May, open to all Ohio supporters of a single-payer health care system, and in addition the State Council shall be authorized to call special general meetings when in its judgment they are warranted. The purpose of General Meetings shall be to provide Ohio single-payer supporters with an update on SPAN Ohio’s activities, programs, and campaigns, and to encourage their input, suggestions and evaluations with respect to SPAN Ohio’s work. The annual General Meeting shall also serve as the occasion for convening caucuses of the seven regions for the purpose of electing regional coordinators, and caucuses of the respective constituencies for the purpose of electing members from each constituency to the State Council, as described in Article 4(a). An agenda will be made available two weeks in advance of the General Meeting.

Recommendations for agenda items for General Meetings should be made to the Executive Committee within two (2) weeks of the General Meeting. Voting rules at the General Meetings will be governed by Article 4(a) above.

Article 6: Vacancies in Elective Positions

In the event of a vacancy in any elective position the SPAN Ohio Executive Committee may designate a temporary replacement who shall serve until the next SPAN Ohio Annual Conference, at which time a replacement can be elected.

Article 7: Amendments to the Bylaws

These bylaws may be amended by a two-thirds vote of the State Council. Notice of proposed changes to the bylaws must be mailed to State Council members at least two weeks in advance of the State Council meeting at which the amendments are to be voted upon.

Bylaws as adopted 6/21/03 and amended 8/16/03, 10/11/03, 12/4/04, 7/9/05, 6/2/07, 12/15/07, 8/22/09, 7/9/11, 2/8/14, 2/6/16 and 4/6/16.

 

Campaign Endorsers

Endorsers of the campaign sponsored by Single-Payer Action Network Ohio (SPAN Ohio) to achieve an expanded and improved Medicare for All type health care system in Ohio:

HEALTH CARE COMMUNITY
James W. Agna, M.D.
Mary A. Agna, M.D.
American Medical Student Association, Case Western Reserve University
American Medical Student Association, Ohio State University
Gina Angiola, M.D.
Chris Babcock, R.N.
Holly Barrows, M.D.
Barbara T. Baylor, MPH, CHES
Stephen Beck, M.D.
Michael Bissell, M.D., Ph.D, MPH
Renee Bohannon, R.N.
Trudy Bond, Ed.D. (Consulting Psychologist)
Jeanette N. Boraby, R.N., B.S.N.
Michaela Brennan, R.N.
Daniel J. Brustein, M.D.
Brendan T. Carroll, M.D.
Wendy Cicek, M.D.
Pamela K. Cobb, M.D.
Brad Cotton, M.D.
Joseph Daprano, M.D.
Barbara I. Delarwelle, R.N.
Clarence A. DeLima, M.D., D.A.B.P.N., D.P.M.
Teri Dew, R.N.
Cynthia L. Dilauro, M.D.
John Ditraglia, M.D.
Frances Dostal, R.N.
John Egar, M.D., Ph.D.
Gaby El-Khoury, M.D.
Alice Faryna, M.D.
James Foley, L.P.T. (Physical Therapist)
Amasa B. Ford, M.D.
Constance Fox, M.D.
Eric Friess, M.D.
Elizabeth Frost, M.D.
Thomas A. Fuller, M.D.
Edward Goldberger, M.D.
Rakesh Gupta, M.D.
Christopher T. Haas, M.D.
Robert W. Hamilton, M.D., FACP
Eric Hasemeier, D.O.
B. Mark Hess, M.D.
Karl W. Hess, M.D.
Margaret Houlehan, PA-C
Marilyn Huheey, M.D.
Wendy Johnson, M.D.
Erick A. Kauffman, M.D.
Kristopher Keller, DC, DABCO
John H. Kennell, M.D.
Heidi Kreidler, R.D., L.D.
Sophia Kwiatkowski, R.N.
Lorenzo S. Lalli, M.D.
Jerome Liebman, M.D.
Dena Magoulias, M.D.
Jan Maiocco, C.R.N.P., Associate Medical Director
Joy Marshall, M.D.
Charlotte Masserant, R.N.
Catherine Mauser, C.N.M.
Jack Harvey Medalie, M.D., M.P.H.
Edward D. Miller, M.D.
James Misak, M.D.
Susan Louisa Montauk, M.D.
Bill Myers, M.D.
Mary Nichols-Rhodes, L.P.N.
Pamela Oatis, M.D.
Annette Opfermann, R.N.
Mary Ostendorf, R.N.
Clifford Packer, M.D.
Halesh M. Patel, M.D., FACP
Eleni Pelecanos-Matts, M.D.
Brenda Pettus, L.S.W.
Physicians For a National Health Program
Harry W. Pollock, M.D.
Amy Prack, M.D.
Eric Prack, M.D.
Thomas G. Pretlow, M.D.
Patrice Rancour, M.S., R.N., C.S.
George A. Randt, M.D.
M. Edith Rasell, M.D., Ph.D.
Ann B. Reichsman, M.D., Medical Director
Susan Righi, M.D.
Johnie Rose, M.D.
Johnathon Ross, M.D.
Kathleen Ross-Alaolmolki, Ph.D., R.N.
Donald L. Rucknagel, M.D., Ph.D.
Michael Joshua Seidman, M.D.
Gabriel E. Sella, M.D.
Mary Louise Shaw, M.D.
Susan B. Shurin, M.D.
Marcia Silver, M.D.
David E. Smith, M.D.
Gabriel Stanescu, M.D.
Sul Ross Thorward, M.D., F.A.P.A.
Joan E. Trey, M.D.
Laurel A. Twardzik, R.N.
Eugene J. VanLeeuwen, M.D.
Lisa Vantrease, M.D.
Aaron E. Villaba, M.D.
Heather A. Ways, M.D.
Paul Webb, M.D.
Joan B. Webster, M.D.
Cheryl Ermann Weinstein, M.D.
Meredith Weinstein, M.D.
Robert S. Weiss, M.D.
Molly M. White, C.R.N.P.
George L. Wineburgh, M.D.
Anne S. Wise, M.D.
Richard Wyderski, M.D.

LABOR ORGANIZATIONS
American Federation of State, County & Municipal Employees (AFSCME) Ohio Council 8
American Federation of State, County & Municipal Employees (AFSCME)
Local 3360
Asbestos Workers Union Local 3
Ashtabula County AFL-CIO
Ashtabula County AFL-CIO Retirees Council 
Boilermakers Local 900
Building Laborers Local 310
Chicago & Midwest Regional Joint Board affiliated with Workers' United
Cincinnati AFL-CIO Labor Council
Cincinnati Federation of Teachers
Cleveland-Akron Allied Printing Trades Council
Communications Workers of America District 4
Coshocton Firefighters IAFF Local 216
Cuyahoga-Medina UAW CAP Council
Farm Labor Organizing Committee (FLOC)
Franklin County AFL-CIO
Graphic Communications Conference/International Brotherhood of Teamsters Local 128N
Graphic Communications Conference/International Brotherhood of Teamsters Local 508 O-K-I
Graphic Communications Conference/International Brotherhood of Teamsters Local 544C
Graphic Communications Conference/International Brotherhood of Teamsters Local 546M
Greater Columbus-Franklin County UAW CAP Council
International Alliance of Theatrical Stage Employees (IATSE) Local 160
International Brotherhood of Electrical Workers Local 8
International Chemical Workers Union Council/UFCW
National Association of Letter Carriers Branch 385
National Production Workers Union
North Shore Federation of Labor
Ohio AFL-CIO
Ohio Association of Public School Employees, American Federation of State, County and Municipal Employees Local 419
Ohio Civil Service Employees Association, American Federation of State, County and Municipal Employees Local 11
Office & Professional Employees International Union Local 1794
Ohio State Legislative Board, Brotherhood of Locomotive Engineers & Trainmen/Rail Conference IBT
Ohio United Auto Workers Community Action Program (CAP) Council
Ohio Valley Council of Sheet Metal Workers
Operative Plasterers Local 80
Plumbers & Steamfitters Local 50
Portage/Summit United Auto Workers Community Action Program (CAP) Council
Professionals Guild of Ohio American Federation of Teachers Local 1960
Richland County AFL-CIO
Roofers Local 42
Service Employees International Union Local 627
Sheet Metal Workers' Local Union No. 24
Sheet Metal Workers’ Local Union No. 33
Toledo Council of Newspaper Unions
Toledo Newspaper and Printing Graphics Union Local No. 27N
Toledo Port Council
United Auto Workers Local 420
United Auto Workers Local 658
United Auto Workers Local 1050
United Auto Workers Local 1250
United Auto Workers Local 2075
United Auto Workers Region 2-B
United Food and Commercial Workers Local 7A
United Food and Commercial Workers Local 17A
United Food and Commercial Workers Local 880
United Food and Commercial Workers Local 911
United Food and Commercial Workers Local 1059
United Food and Commercial Workers Local 1099
United Food and Commercial Workers Ohio Council
United Food and Commercial Workers Region 4
United Steelworkers of America District 1
United Steelworkers of America Local 1375
United Steelworkers of America Local 5724
United Steelworkers of America Local 5760
United Steelworkers of America Local 14964
Utility Workers Union of America Local 270

POLITICAL ENTITIES & INDIVIDUALS
John Agenbroad, Mayor of Springboro
Brook Park City Council
Sherrod Brown, U.S. Senator
Cleveland City Council
Cleveland Heights City Council
Clinton County Board of Health
Danny Colonna, Brook Park Councilman-at-Large
Columbus City Council
Dayton City Commission
Mike Foley, Ohio State Representative
Green Party of Ohio
Robert F. Hagan, Ohio State Representative
Sandra Stabile Harwood, Ohio State Representative
Mathias H. Heck Jr., Montgomery County Prosecutor
Jefferson Village Council
Dennis Kucinich, U.S. Representative
Lakewood City Council
Debbie Lieberman, Montgomery County Commissioner
Mahoning County Commissioners
Dale Miller, Cuyahoga County Council
Montgomery County Democratic Party
North Olmsted City Council
Ohio Progressive Action Coalition
Ohio State Labor Party
Olmsted Township
Painesville Township Board of Trustees
Portage Democratic Coalition
Progressive Democrats of America, Ohio Chapters
Seven Hills City Council
Michael Skindell, Ohio State Senator
South Euclid City Council
Struthers City Council
Village of Newburgh Heights
Warren City Council
Windham Village Council

FAITH & SOCIAL ACTION AND COMMUNITY ACTIVISTS
Rev. Colin Bossen, Minister, Unitarian Universalist Society of Cleveland
Camus Society
Rev. Melissa Carvill-Ziemer, Minister, Unitarian Universalist Church of Kent
Christ Episcopal Church Vestry, Dayton, OH 
Church of the World, Western Reserve Association
Cincinnati Interfaith Committee for Worker Justice
Cleveland Jobs with Justice
Community Partners for Affordable, Accessible Health Care (CPAAHC) 
Consumer & Family Advocacy Council - Franklin County
Contact Center - Ohio Empowerment Coalition 
CORE: Concerned Ohio Retired Educators
First Unitarian Universalist Church of Marietta
Rev. Dr. Joseph W. Goetz, Retired, Roman Catholic Archdiocese of Cincinnati
Greater Cincinnati Coalition for the Homeless
Hard Hatted Women
Justice and Witness Ministries, The United Church of Christ
Warner Mendenhall, Attorney-At-Law
NAACP Cleveland Branch
Northeast Ohio American Friends Service Committee
Northeast Ohio Poor People's Economic Human Rights Campaign
Northeast Ohio Coalition for the Homeless (NEOCH)
Organize! Ohio
Rev. Dr. John S. Paddock, Rector, Christ Episcopal Church, Dayton
Rev. Gordon S. Price, Rector Emeritus, Christ Episcopal Church, Dayton
RESULTS — Columbus Group
Rev. Richard L. Righter, Pastor Emeritus, Congregation for Reconciliation
Rural Action
Single-Payer Action Network Ohio (SPAN Ohio)
Social Justice Committee, First Unitarian Universalist Church of Columbus
South Park United Methodist Church, Dayton
Rev. Dr. Leslie E. Stansbery, President, Interfaith Association of Central Ohio
Stop Targeting Ohio’s Poor
The Empowerment Center of Greater Cleveland
The National Poor Peoples Economic Human Rights Campaign (PPEHRC)
The Peace With Justice Project
Toledo Area Jobs with Justice Coalition
Toni K. Mcbroom, International Association of Machinists & Aerospace Workers - Ohio State Council of Machinists - Trustee of Local Lodge 956; union delegate to Coalition of Labor Union Women (CLUW)
Tri-County Independent Living Center
Universal Health Care Action Network of Ohio (UHCAN Ohio)
Wake Up Ohio
Rev. Maurine C. Waun, Minister, Ohio Valley Unitarian Universalist Congregation
West Shore Unitarian Universalist Church Social Action Committee
Women for Racial and Economic Equality
Women Speak Out for Peace and Justice
Workmen’s Circle Educational Center

BUSINESS/INDUSTRY
Action Septic Service
Advanced Rehab
Bullock's Framing Ltd.
Cleveland Food Co-Op
Dexter City Auction Gallery
Hock's Vandalia Pharmacy
Hood and Hoover Jewelry
Madison Graphics
Mark's Woodworks
McCutcheon Information Services
McFarland's Barbershop
Mosyjowski & Associates Engineers
Nightsweats & T-Cells Co.
Skyview Auction House
The Honey Barn
Touch of Elegance
Turkish Cuisine
WordSmiths



Sample Letter to City, Township, Village Councils

To: Clerk of Council
From: [Person sending the letter, with title and organization]

Date: [Current date]
Subject: Request for Endorsement of the Health Care For All Ohioans Act


To the Clerk of Council: Please make copies of this communication available to members of your council. It concerns the health care crisis, a matter of great concern to the people of our country, state and community.

America's health care system is broken. Many municipalities, trying to maintain health care coverage for employees at a time of declining revenues, are confronted with soaring premiums. The problem is acute and growing worse by the day.

A significant campaign has been launched in Ohio to get the General Assembly to act without delay to pass the Health Care For All Ohioans Act (HCFAOA) guaranteeing comprehensive, quality, lifetime coverage for all residents. The list of endorsers of the campaign for publicly funded health care includes the Cuyahoga County Board of Commissioners, Brook Park City Council, Cleveland City Council, Dayton City Commission, Jefferson Village Council, Lakewood City Council, Mahoning County Commissioners, Painesville Township Board of Trustees, Seven Hills City Council, Struthers City Council, Village of Newburgh Heights, Warren City Council, Windham Village Council, three members of Congress, state legislators, dozens of unions, 78 physicians, several RNs, and faith and community groups. We are writing to urge cities, townships and villages that have not yet endorsed to do so now.

Here is what we are confronted with:

·  Medical costs are rising 20% a year.
·  The cost of prescription drugs is spiraling out of control. Many seniors are forced to choose between buying needed medicine and food for the table.
·  30 cents of every premium dollar goes for insurance profits and unnecessary paper work.
·  47 million people have no health insurance and that number is increasing rapidly.
·  Additional tens of millions more have only limited insurance and are one catastrophic illness away from bankruptcy.

We must have a publicly funded health care system that covers all Ohioans. Our health care dollars should go for patient care, not profits for health insurance companies.

Please return the enclosed endorsement form to the indicated address, letting us know that we may add the name of your city, village or township to the list of endorsers of the campaign to get the Ohio General Assembly to pass the HCFAOA (HB 186 and SB 168).

 

If you have questions or need more information I can be reached at [phone number].

 

Sincerely,

[sender's signature]

 

Enclosure

Toyota, Moving Northward


By PAUL KRUGMAN
Modern American politics is dominated by the doctrine that government is the problem, not the solution. In practice, this doctrine translates into policies that make low taxes on the rich the highest priority, even if lack of revenue undermines basic public services. You don't have to be a liberal to realize that this is wrong-headed. Corporate leaders understand quite well that good public services are also good for business. But the political environment is so polarized these days that top executives are often afraid to speak up against conservative dogma.

 

Instead, they vote with their feet. Which brings us to the story of Toyota's choice.

There has been fierce competition among states hoping to attract a new Toyota assembly plant. Several Southern states reportedly offered financial incentives worth hundreds of millions of dollars.

But last month Toyota decided to put the new plant, which will produce RAV4 mini-S.U.V.'s, in Ontario. Explaining why it passed up financial incentives to choose a U.S. location, the company cited the quality of Ontario's work force.

What made Toyota so sensitive to labor quality issues? Maybe we should discount remarks from the president of the Toronto-based Automotive Parts Manufacturers' Association, who claimed that the educational level in the Southern United States was so low that trainers for Japanese plants in Alabama had to use "pictorials" to teach some illiterate workers how to use high-tech equipment.

But there are other reports, some coming from state officials, that confirm his basic point: Japanese auto companies opening plants in the Southern U.S. have been unfavorably surprised by the work force's poor
level of training.

There's some bitter irony here for Alabama's governor. Just two years go voters overwhelmingly rejected his plea for an increase in the state's rock-bottom taxes on the affluent, so that he could afford to improve the state's low-quality education system. Opponents of the tax hike convinced voters that it would cost the state jobs.

But education is only one reason Toyota chose Ontario. Canada's other big selling point is its national health insurance system, which saves auto manufacturers large sums in benefit payments compared with their costs in the United States.

You might be tempted to say that Canadian taxpayers are, in effect, subsidizing Toyota's move by paying for health coverage. But that's not right, even aside from the fact that Canada's health care system has far lower costs per person than the American system, with its huge administrative expenses. In fact, U.S. taxpayers, not Canadians, will be hurt by the northward movement of auto jobs.

To see why, bear in mind that in the long run decisions like Toyota's probably won't affect the overall number of jobs in either the United States or Canada. But the result of international competition will be to give Canada more jobs in industries like autos, which pay health benefits to their U.S. workers, and fewer jobs in industries that don't provide those benefits. In the U.S. the effect will be just the reverse: fewer jobs with benefits, more jobs without.

So what's the impact on taxpayers? In Canada, there's no impact at all: since all Canadians get government-provided health insurance in any case, the additional auto jobs won't increase government spending.

But U.S. taxpayers will suffer, because the general public ends up picking up much of the cost of health care for workers who don't get insurance through their jobs. Some uninsured workers and their families end up on Medicaid. Others end up depending on emergency rooms, which are heavily subsidized by taxpayers.

Funny, isn't it? Pundits tell us that the welfare state is doomed by globalization, that programs like national health insurance have become unsustainable. But Canada's universal health insurance system is handling international competition just fine. It's our own system, which penalizes companies that treat their workers well, that's in trouble.

I'm sure that some readers will respond to everything I've just said by asking why, if the Canadians are so smart, they aren't richer. But I'll have to leave the issue of America's comparative economic performance for another day.

For now, let me just point out that treating people decently is sometimes a competitive advantage. In America, basic health insurance is a privilege; in Canada, it's a right. And in the auto industry, at least, the good jobs are heading north.


•     Copyright 2005 The New York Times Company

 

DONATE HERE

Donations to SPAN Ohio help cover operating and lobbying expenses and are NOT tax deductible. To donate, click the DONATE button below. On the page that appears, type in the amount of your donation. If you want your donation to be recurring, check the box where it says "Make this a monthly donation." If this is a one-time donation, leave that box blank.Then click either "Donate with PayPal" (if you have an account) or."Donate with a Debit or Credit Card." Complete the transaction on the page that follows.

Donations to HCFAO go to our education fund and ARE tax deductible. To donate, click the Donate button below. On the page that appears, type in the amount of your donation. If you want your donation to be recurring, check the box where it says "Make this a monthly donation." If this is a one-time donation, leave that box blank.Then click either "Donate with PayPal" (if you have an account) or."Donate with a Debit or Credit Card." Complete the transaction on the page that follows.

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