A labor leader’s take on universal healthcare

washington -- Labor leader Andrew Stern, president of the Service Employees International Union, has become one of the most outspoken and unconventional proponents of healthcare changes to guarantee coverage for all while reining in costs.

His pursuit of that goal has led him into unusual alliances with corporate and political leaders, including Wal-Mart Chief Executive H. Lee Scott Jr. and Gov. Arnold Schwarzenegger, although Stern’s union opposed the governor’s reelection. Stern was interviewed in his Washington office.

You’ve said the employer-based health insurance system is dead. But it still covers 60% of Americans, so what do you mean by that?

“There’s a big context. Our country and the world are living through the most transformative economic revolution in history. As we move from a national to a global economy, and from manufacturing to finance and services, [it’s] not a one-job-in-a-lifetime economy anymore. Twenty-five percent of the American workforce will be contingent by 2012 -- they’ll have no full-time employer.

“It seems impossible to imagine how you can have an employer-based healthcare system with the incredible creative destruction and change in the nature of work in our economy. It’s not an ideological issue; it’s really just a practical, real-life, 21st-century issue.”

The last attempt at national healthcare reform was in the 1990s, and it fell apart. What’s different this time around that makes you optimistic?

“In 1993, it was seen more as a moral issue in our country: Is healthcare a right or a privilege? I think now it’s become an economic issue: Can America be the only industrialized nation to put the price of healthcare on the cost of our products, when our competitors don’t? And I think the answer is: That’s a crazy economic plan.

“American business leaders -- they’re global business leaders -- run companies that exist in multiple countries. Many of those countries have a universal healthcare system. And [American companies] don’t seem to find that the world is going to cave in [in those countries]. They can compete just fine. In fact, it’s a lower cost and more predictable in the other countries.”

So is the United States going to wind up with a government-run system like Canada’s, a single-payer system?

“That’s unlikely. I don’t think Americans have a great trust of government in general. I think things like Katrina and Walter Reed don’t make people feel comfortable that government’s going to solve their problems. I think single-payer would be the most efficient system, but I think Americans want to have an American solution, not a Canadian solution.”

If the employer-based system of health insurance is not sustainable, what’s going to replace it?

“I don’t think ... it’s going to happen all at one time. It’s going to be a series of phases.

“We are seeing some plans that are talking about some of the possibilities. You have Sen. Ron Wyden [R-Ore.] taking the federal employee health plan, and his premise is: Why shouldn’t every American have the same health plan as his member of Congress? We have states showing that given more flexibility and some more federal resources, that they can assemble a healthcare plan.”

Is there a future for the health insurance industry?

“I think there will be, but it’s got to play a different role, and it’s got to add more value to the system. There’s too much administrative cost, too much advertising, too much money that’s not spent at the bedside. Insurance companies are going to have to find new ways to deal with prevention and chronic disease management, not just processing claims.”

California, Illinois and other states are debating healthcare reform, and Massachusetts is trying to put a plan into place. Why isn’t there more action in Washington?

“The natural course of events in Washington is not to find common ground, but to position yourself.

“I think the pieces are in front of us; the question is where the leadership is right now.

“The federal government is like a locomotive. They start really slow because it takes a lot to get the first wheels turning. Then it builds up momentum. I feel like at the federal level, they are starting to think that maybe the wheels should turn.”

ricardo.alonso-zaldivar@latimes.com