Medicare for All spurs complicated feelings in union heavy Michigan

Detroit — In the state that gave birth to the United Auto Workers, union employees are divided on the idea of giving up health care plans they negotiated for in favor of a government-controlled system that guarantees coverage for everyone.

Ahead of Michigan's presidential primary election on Tuesday, proposals known as Medicare for All are a sharp point of difference between the leading candidates in the Democratic race and their supporters.

The contrast between Vermont U.S. Sen. Bernie Sanders' plan to overhaul the nation's health care system and former Vice President Joe Biden's proposal to build on the current system is especially distinct among union workers, many of whom like their current coverage.

"We can’t be selfish like that," argued Meoshee Edwards, a team leader at General Motors Co.’s Detroit-Hamtramck Assembly Plant. "That’s not right. You can’t say go out and get a job, a lot of people aren’t afforded that opportunity. Cancer doesn’t discriminate."

Edwards said she wants to see action taken to bring coverage to all Americans. She says she is grateful for her private health care from GM, especially after her husband was recently hospitalized for heart disease. Still, she supports Medicare for All.

But others like Jonathon Mason, a production worker at Ford Motor Co.’s Dearborn Truck Assembly Plant, aren’t sold on Medicare for All.

"Don’t mess with my health care," said the 43-year-old Detroit resident, who is recovering from major spinal surgery. "Me, speaking on my situation, my health care is very important. It is one of the best parts of my job. I probably would haven’t been able to get the surgery done without it."

Sanders, a self-described democratic socialist, has championed the idea of the government providing health care for everyone. While called "Medicare for All," it doesn't resemble the health care program for seniors, which allows them to buy supplemental private health insurance for whatever the federal government doesn't cover. 

Sanders calls health care a "human right." His plan would eliminate private insurance and would cost at least more than $30 trillion over 10 years, according to multiple analyses.

Former Vice President Joe Biden has criticized the cost of Sanders' plan and that it would do away with coverage "negotiated" by unions. Biden prefers building on the current health care system and the Affordable Care Act by a providing a public or government option that people could purchase if they needed coverage or didn't like their private insurance.

Conservative critics, including the Heritage Foundation, have called public option proposals "single payer on the installment plan." They argue it would directly or indirectly drive out private employer-based insurance coverage, impose rules favoring the government while reducing personal choices and costing taxpayers mores.

The UAW has not endorsed in the Democratic primary. But Bob King, one of the most left-leaning of former auto worker union presidents, has endorsed Sanders. 

A dividing line

There are union workers and Democratic voters in Michigan on both sides of the debate.

Over the last 10 years, the percentage of uninsured people in Michigan has dropped from 12% of the state's population in 2008 to 5% in 2018, according to Kaiser Family Foundation estimates based on Census Bureau survey data. The foundation estimated there were 526,500 uninsured people in the state in 2018.

But many Democratic voters in Michigan appear to be wary of the idea of the government ensuring coverage for everyone.

About 34% of 600 likely Michigan Democratic primary voters said they "support a national, single payer option known as Medicare for All," according to a poll for The Detroit News/WDIV-TV (Local 4).

Among voters who supported Medicare for All, Sanders led Biden 42% to 18% with other candidates — most of whom have since dropped out — getting lower levels of support, according to the survey conducted by the Glengariff Group.

Among the vast majority of voters who supported other health care options, Biden led Sanders, 36% to 11%.

Biden's health care plan would give people the choice to purchase a public health insurance option such as Medicare, according to his campaign website. Biden's plan would build on the Affordable Care Act, signed into law in 2010 by former President Barack Obama, and would "insure more than an estimated 97% of Americans."

At a December presidential debate, Biden said Sanders would do away with health care plans negotiated by workers.

"You may or may not like it," Biden said of the negotiated coverage. "If you don't like it, you can move into the public option that I proposed in my plan. But if you like it, you shouldn't have Washington dictating to you: You cannot keep the plan you have."

Sanders countered by labeling Biden's proposal as "essentially the status quo." The senator said his own plan would eliminate the "profiteering" of drug companies and insurance companies.

At bargaining table

The UAW, one of Michigan's largest labor unions, has long supported universal health care.

Calls from the UAW for government-sponsored coverage began with President Walter Reuther in the 1940s and '50s. Unsuccessful in recruiting the automakers' clout for support, he pushed aggressively for better health insurance at the negotiations table. A resolution passed at the UAW’s special convention last March ahead of labor negotiations reiterated that health care “should be a right, not a privilege” and that the union will “continue to work towards and support the establishment of a national health care system."

At Ford Motor Co., UAW members pay 3% of total health care costs, according to a fact guide released last year ahead of labor negotiations. Costs at General Motors Co. and Fiat Chrysler Automobiles NV are similar. Non-temporary workers do not have a deductible or a monthly premium.

Without changes in health care coverage in the new contract, Ford anticipates paying more than $1 billion for it this year. The average American household is responsible for 28% of their health care costs, according to the Kaiser Family Foundation.

Mason, the Dearborn Truck worker, says he is looking for a candidate who can unite the country, though none so far have stuck out to him. He voted for Hillary Clinton in 2016.

Mason doesn’t want to see people turned away from hospitals and is not opposed to government-supported insurance for those who can’t afford it. But he does not know if Medicare for All is the right answer.

“It sounds good in theory, but as far as the coverage, I would want to know how the coverage would go,” Mason said, adding he has researched countries like Canada and Switzerland that have single-payer systems but have fewer people.

Reports of patients having to wait for long lengths of time for procedures or treatment in Canada concerns workers like Neal Kesterson, an electrician at GM’s Customer Care and Aftersales Plant in Ypsilanti. And he fears situations like that could open the way for corruption.

But Sanders’ Medicare for All plan has the backing of Ryan Pappas, a worker at GM's Romulus Powertain Plant.

“It’s always been Bernie,” said the 30-year-old Taylor resident. “He is for us, the worker. I believe in universal health care. My fiancé, my kids are both Canadian. They have universal health care, and I think Bernie might be the one to do it here. You’re not having to worry about what it is going to cost for anything. If your kid falls and gets hurt, you don’t have to worry about it.”

Pappas adds that he doesn’t mind paying extra in taxes for it so long as he sees results from it.

When two Michigan locals of the United Food and Clerical Workers union backed Biden on Friday, health care was listed as a deciding factor. Locals 876 and 951 represent 51,000 retail, meatpacking, hospitality and other workers in Michigan, according to the union.

Local 876 "believes the Biden campaign has the fortitude and strength to secure the professionals, experts and leaders needed to protect collective bargaining, affordable health care and fair education opportunities for all Americans,” UFCW 876 President Dan Pedersen said in a statement.

The idea that unions oppose Medicare for All "gets overblown," said State Rep. Brian Elder, a Democrat from Bay City who has endorsed Biden.

When workers sit down at the collective bargaining table, they often give up positives, like salary gains, to win better health care, said Elder, who leads the Michigan Legislative Labor Caucus.

“If we had a good medical system at the federal level," he said, "then theoretically, you should be getting more in terms of wages at the bargaining table."

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