| Number 103 | January 26, 2000 |
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This Week:
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Greetings, I apologize to those of you who receive the paper version of Nygaard Notes through the U.S. Postal Service. I noticed after I dropped them in the mailbox that the "Quote" Of The Week was the same as the previous week's. Those of you who receive both the paper version and the electronic one may have noticed that the e-version was different. It's not discrimination! It's just that I didn't catch the bonehead error until moments before sending out to the cyber-subscribers. Sorry! I received quite a bit of mail from readers this week, which I really appreciate. And several new subscribers have come on board, so I welcome you with open arms. I hope you enjoy the ride! Short on space this week, so I'm done. See you next week, Nygaard |
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I received a letter from my HMO this week which began by saying "UCare Minnesota has made a change to make it easier for you to see a dentist by changing our dental network to Doral Dental." My dentist is not a member of Doral Dental. The letter concluded, "If you have any questions, please call UCare customer service at ..." So I did, and I asked them how this "change" was supposed to "make it easier" for me, which yielded this week's "Quote" of the Week. The very friendly and honest customer service person laughed loudly at my question and, without hesitating, told me:
That's what I thought. |
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On occasion I bemoan the lack of a "labor section" in the newspapers. Fifty years ago it was quite common for a daily paper to have a section devoted to labor news, or at least to have a reporter or two who worked a labor beat. Now it's almost unheard of in this country. As I was perusing a recent copy of the excellent local bi-weekly The Union Advocate (UA), published by the St. Paul Trades and Labor Assembly phone 651-291-8302 it once again occurred to me that there is a lot of important labor news out there that never gets into the mainstream, or corporate, press. The January 10th issue of UA in particular was full of things that I think are important for Minnesotans to know. One of the UA stories gave a nuts-and-bolts list of what workers can expect from the new ergonomics rules put out by the Occupational Safety and Health Administration (if Bush doesn't reverse them). This seemed like important news to me, but neither of the local newspapers bothered to have a reporter write anything on it. In fact, the Star Tribune (Newspaper of the Twin Cities!) only listed a total of four articles during the past year that even mentioned "ergonomics," and they were all about how George W. wanted to overturn the recently-implemented standards! There were, however, several articles about ergonomic furniture in the home. I reported in Nygaard Notes #80 that, in a victory for unions in general and immigrant workers in particular, the largely-immigrant workforce at a local meatpacking plant called Dakota Premium Foods carried out a "breathtakingly quick" organizing drive and voted overwhelmingly to unionize the plant last July. An important follow-up article appeared in the UA this month, reporting that the company has been "devoting a tremendous amount of resources" since July aimed at "thwarting the valid results of the election," in the words of the attorney for United Food and Commercial Workers Local 789, Brendan Cummins. As I reported at the time, "In the United States, winning a union election is just the first step. Actually getting a fair contract (or any contract!) can be a long, and often unsuccessful, battle." That certainly appears to be the case at Dakota Premium. Despite the important implications for the area's meatpacking workers and immigrant workers, to this day the Star Trib has not published a word about either the election or the subsequent shameful behavior on the part of the company. In November there was a representation election at a generator plant in Fridley, a Twin Cities suburb, owned by the Onan Corp. In this case it is the United Auto Workers union which is appealing the results of the election, which they lost, alleging that the company engaged in all sorts of dirty tricks to intimidate workers and turn them against the union. One of the now-standard tricks is to threaten to close the factory if the workers vote in a union. This the company did, as well as engaging in a variety of other tactics of questionable legality. Whether or not the union's charges are true, these are serious charges, and the outcome of the case will affect all union organizing drives in the area in the future. Not a word in the local corporate newspapers. My expectations are pretty low, but by now even I was surprised at the almost total lack of any labor reporting in either of our two daily papers. I thought I would just do a quick search for some other terms that have meaning to labor and that I think should be in the news these days. I looked for "permatemps," which is the term for the permanent workers that Microsoft used to call "temporary" so they could avoid paying benefits to them. Few are aware, perhaps, since it was completely absent from the local corporate press, that Microsoft agreed in December to pay $97 million to settle a class-action suit filed by their "permatemps" that's been going on for the past eight years. In addition, Mr. Gates has now hired 3,000 of these people as regular workers. All of this was reported in the Union Advocate. I then went in search of the phrase "steel tariffs," since the European Union recently filed a suit in the World Trade Organization to overturn U.S. tariffs on steel wire rod and welded line pipe, with Japan fighting a similar fight against our government. Big news, right, what with all the hubbub about the WTO in all the papers lately? The labor press thinks so. Yet my search of the local dailies again yielded not a single word. I couldn't even get a hit on the word "tariff." How about the phrase "National Labor Relations Board," or "NLRB?" Nothing. This was getting weird. Finally, I searched for "AFL-CIO" not an uncommon term, I thought and still I found only one article in all of the year 2000. And it wasn't just any article. The single Associated Press article, from last July 6th, was headlined "Clean Air Pact Job Threat, Study Says," and I will quote the entire lead paragraph: "Hispanic and black Americans will suffer disproportionately if the United States adopts a U.N. treaty to reduce greenhouse gases, says a report commissioned by six minority groups (sic) and paid for by the coal industry." The "minority groups" mentioned include the Latin American Management Association and the National Black Chamber of Commerce. This isn't exactly "labor" reporting. As the economy passes out of the "longest economic expansion in U.S. history" workers will be asked to absorb much of the pain that comes with a shrinking economy, and non-union workers stand to suffer the most. In this context, some news of the struggles of organized workers and the forces arrayed against them might be not only interesting, but of practical use to the majority of us who are workers. The fact that this news will never be found in the daily papers says volumes about who runs the show in the nation's newsrooms. |
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Last week I attempted to debunk (I love that word!) 5 myths about the health care system in Canada, which I creatively labeled "Myths #1-5 About Canadian Health Care." Here, in this final installment on the subject, is a set of five more myths and facts. Myth #6: Doctors Are Fleeing Canada to Practice in the U.S. Doctors are a highly mobile group of professionals, but there is no mass exodus of Canadian doctors. Approximately 569 physicians left the country in 1998, compared to 659 in 1997, a drop of 14%. While the total number of physicians leaving fluctuates from year to year, the proportion of those leaving to the total physician supply has remained stable at approximately one to two per cent since the 1980s. The number of physicians returning to practice in Canada increased by 41% from 227 in 1997 to 321 in 1998. The 321 returning physicians represented 0.6% of the total physician supply for 1998. And doctors aren't exactly hurting in Canada; they're the nation's second-highest-paid group of professionals, second only to Supreme Court justices. Myth #7: The Canadian Health Bureaucracy is Inefficient Despite the overall better health outcomes in Canada, Canadians spend less on health care than is spent in the United States. Per capita, Canada spends about $1,785 per year on health care, compared to $4,178 in the U.S. As a nation, Canada devotes 9.5% of its Gross Domestic Product to health care, while the U.S. spends 13.6%, which is 43% more. Either way you measure, the United States spends more on health care than any other nation in the world. Insurance overhead costs in the U.S. run between 10% and 15% of total system costs; in Canada that number is about 1%. Total administrative costs in Canada including hospital administration and physician's office costs -- is about 14% of total health care spending in Canada, as compared to about 25% in the U.S. Myth #8: The Canadian System is Going Broke As in the United States, budget cutbacks were the norm in Canada in the early 1990s, and health care was no exception. With the return of a balanced budget in 1998, the Canadian government increased funding for national health care by $11.5 billion, the largest single new investment ever made by the government. It's a tried-and-true tactic of the anti-government right wing in many countries to cut program funding and then build on the public resentment that results from the program being underfunded. It's an old trick, but it seems to work. Witness the underfunded and endlessly-attacked U.S. Social Security system. Or the public school system, or public transit, or Medicare, or... Myth #9: Many Canadians Come to the U.S. for Health Care One of the ways that Canada keeps their health care costs down is by running their hospitals at or near capacity. When there are unexpected demands such as during a flu epidemic Canadian patients are sometimes sent across the border to U.S. hospitals. Costs are paid by the Canadian provincial government. Some people undoubtedly come to the U.S. for care and pay for it out of their own pocket, but there is no way to track that care, so no one knows how often it happens. It's also true that some Americans travel to Canada and borrow health care cards so they can take advantage of free Canadian health care. Again, it's impossible to know how many people do this, but Ontario recently went through the expense of making everyone get picture IDs in an attempt to reduce the problem, so it's more than a few. One of the underlying causes for the occasional bed shortage is that "during the recent restructuring of health care, new calculations on the number of beds needed were made using US-based data. It turns out that US for-profit hospitals have cut to the bone the numbers of beds needed, and that same number of beds appears to be too few for Canadians," according to Karen Palmer, a nurse and member of the California Physicians Alliance who practices in both Canada and the U.S. Myth #10: The Health System is a Drag on Canada's Economy A 1999 study by KPMG, the international business advisors, comparing business costs in North America, Europe and Japan, found that Canada has the lowest business costs. A significant advantage was Canada's lower labor costs resulting from lower employee-sponsored benefits, especially medical insurance. The list of myths could be much longer, but I've got to stop somewhere. If you want to know more, there is an interesting 1998 book on the subject called "Universal Health Care: What the United States Can Learn from the Canadian Experience." It's only 150 pages long, an easy read, and it's chock full of good information, including a fascinating section on the history of the struggle for universal health care in Canada. I recommend it. Far From A Perfect System A Nygaard Notes reader last week sent me a warning not to "idealize" the Canadian health care system, and that is surely not my intention. I am very aware, for instance, that Native people in Canada are sometimes particularly poorly served by the system. As our reader tells us, "In Cross Lake the nurses' station which is the only access to health care these folks have closer than maybe one of the larger communities, Winnipeg being a 8 hour drive away is known as the Tylenol Station.' The testimony of the folks we talked to is that people are given band-aids and Tylenol and sent home until they are so ill they have to be evacuated by air to Winnipeg where they don't fare well. It's nothing even approaching medium-level late 20th century medicine." The Canadian health care system has other significant problems, including real doctor shortages in some of the (Native and non-Native) rural areas of the country. There are ongoing fights over fiscal control between the states and the federal government, and the methods of allocating resources, both fiscal and human, are sometimes disorganized. These are some of the reasons that I keep stating my preference for a fully-socialized system, although I don't delude myself into thinking that a different "system" would eliminate problems caused by longstanding patterns of racism and poverty. I think it would be somewhat better. Canadians will be quick to point out that all of the problems that they have with their health-care system also exist in the United States. No doubt that's true. For example, I live next to a large hospital and we daily hear the unpleasant roar of helicopters bringing in the latest patient at thousands of dollars per trip from another rural Minnesota town that has recently lost their community hospital. Again, as I said last week, a Canadian-style system is not my first choice of how to organize a health care system. Still, it beats the heck out of our profit-oriented system. It remains true that the Canadian system provides coverage to every one of its citizens (and, apparently, some of ours), while 45 million Americans including 11 million children are now without any health insurance at all, with unknown numbers more being underinsured. Canadian Medicare is not perfect, but recent surveys show that over 90% of Canadians prefer their health care system to the U.S. model. Now that you know a few facts about how their system really works, can you blame them? |