Leonard Woodcock, United Auto Workers president, speaking before the closing session of the Minnesota Social Service Association's 82nd Annual Welfare Conference in Minneapolis. Woodcock’s address was on the topic "Economic Realities and Human Needs."
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(00:00:00) Ladies and gentlemen, I feel a certain kinship and being in Minnesota the home of the democratic-farmer-labor party of Floyd Olson. Who the young Dal your present Governor Wendell Anderson as well as of course as the home of senators Humphrey and Mondale. We have the labor movement have identified with the forces for social progress, which have distinguished your estate your children's code dating back to World War 1 became a model for other states your enlightened attitude toward treatment of the Blind exemplified by the vocational training for the blind Act of 1923 became a guidepost to others. You are W with some 9,000 members in Minnesota has had a special interest in your community mental health Act of 1957. This predated the national Community Mental Health Center movement of the 1960s when he negotiated the first Nationwide non-governmental out of Hospital mental health benefits for UIW families in 1963. Your program was among the first we were able to employ in the delivery of those benefits. Time and again the union movement in the field of social welfare have joined forces to develop and promote programs to protect those in our society who are at Hazard as far back as 1903 a commission was appointed by the National Conference on social welfare to investigate the best practicable method of ensuring working people against need in case of accident and sickness during the period of embolism and helpless old age. Today is our nation faces some of the most vexing problems of the last 30 years. We have new obligations and opportunities to work together for social (00:01:46) progress. (00:01:48) I want to talk today about the need for planning immediate steps to deal with the economic crisis the social security system and the Health Care system. Most Americans are dissatisfied with the way in which the economy is. Now operating unemployment is at abnormally high levels in the construction and automobile Industries. It is it is at full scale depression levels prices rise inflation in the US has become a source of instability in the World At Large no reliable mechanism in the modern economy relates needs to available Manpower planted materials and consequence. We have shortages of housing Medical Care Municipal Services Transportation energy and numerous other requirements of pressing importance. We have not made it our business to foresee these critical problems and to take steps to for Stalin but in a modern economy planning is not a matter a matter of preference or ideology. It is one of immediate needs. And its absence we will all suffer as was stated in a new proposal of the initiative committee for National Economic planning headed by Vasily leontief of Harvard University the Nobel Laureate and myself only 10 days ago. We believe that economic leadership must be exercised in a new way through an office of National Economic planning. This agency must be in a position to perceive our country's economic and social needs now and for many years to come and to provide the public Congress and the executive branch with alternative plans of action not only to enable us to avert hardship and disaster but to guide the economy in a direction consistent with our national values and (00:03:30) goals (00:03:32) similarly a passes comprehension that a nation's spending some 104 billion dollars. Annually for health care has no National policy. No goals. No directions. We have a proliferation of private and public programs at the federal state and local law. Many inadequate often overlapping with tens of millions entirely left out of the system. It makes no sense to continue the waste of this system when access to decent Health Services is an essential to the continuation of life and of work accordingly. It is my conviction that we need a national health insurance program with the top ballast policy board capable of setting goals and priorities following this it is possible to develop rational planning for programs. We need it once to provide major stimulus to get us back to a decent level of employment and output among the proposals to be included in a comprehensive program. We would suggest substantial personal tax cuts directed to the low and middle income families to be followed by meaningful tax reform. I might say in this regard that I am pleased with the speed at which the Congress is moving a realistic public employment program designed to provide a bare minimum of one and a quarter million public jobs a stopgap program of health insurance coverage for unemployed workers extended and improved unemployment compensation benefits rejection of drastic short-term cuts and oil imports, which would further damage the nation's economy coupled with a strong long run program designed to develop energy resources and reduce consumption reallocation of resources away from unnecessary inflationary defense spending. Toward programs and energy Transportation housing Healthcare Education Human Services and the environment. During the Depression of the 1930s, we develop structures and mechanisms for protection of families of workers, which have kept things today from being a lot worse than they otherwise would have been I'm talking about programs such as Social Security and unemployment insurance as well as job creating programs, which set the precedent for similar government action today likewise, we should now seize the opportunity to develop new programs and to improve existing ones in order to reduce the ill effects of future economic dislocations. I am concerned with recent attacks on our country Social Security System the voices of those who in the 30s trumpeted that it was the opening wage to socialism and communism and America and that would this be the end of the free enterprise system have been silent for many years many of their imitators are making similar noises concerning national health insurance proposals and in January of this year Royal ask them the budget director in an interview with the Associated Press indicated that the Ford Administration fears a national drift towards socialism and is mounting a campaign to restrain the growth and Social Security benefits food stamp programs and the development of national health insurance. It is this philosophy that is behind the administration's proposal to reduce cost of living increases to Social Security beneficiaries to cut food stamp benefits oppose national health insurance and other measures which would bring a level of social justice to the elderly the ill the disabled and the needy in America. I suggest you that in social welfare, and we on the labor movement must understand the problem for what it is and deal with it in terms of philosophy and practical programs. American wage earners and Social Security beneficiaries should be reassured by the recent Judgment of the Social Security advisory Council that the social security system is and should remain the nation's primary means of providing economic security and the event of retirement death or disability. Similarly. The panel's allegiance to the program's fundamental principles, including Universal compulsory coverage earnings related benefits paid without a test of need and contributions toward the cost of the program from cupboard workers and employers is equally constructive. However hard look must be taken at the short and long range Revenue needs of Social Security and undoubtedly, some adjustments will have to be made we must take care not to succumb to the recent panicky stream of media propaganda variously portraying the system as being on the edge of bankruptcy in danger of imminent collapse. Facing staggering deficits or Worse such charges only serve to create and security among persons whose present or future income is greatly dependent upon Social Security benefits. There has never been any cause for alarm that the federal government either now or in the foreseeable future would renege on promised benefits or that Social Security faces an immediate or short-range crisis in funding it is correct that out go will probably exceed income in this and succeeding years, but the framers of the program recognized this would occur from time to time that is why I reserve fund was established. It contains sufficient reserves to assure payments in the next few years while necessary adjustments are made in the program. (00:09:04) The present (00:09:05) Congress is going to be reviewing the social security system and is expected to produce some significant legislation. This presents us with the opportunity to develop a solution. That would not only retain established Social Security principles, but it would also introduced far greater Equity among participants. There are four major aspects of such an approach number 1 the maximum wages and salaries subject to Social Security taxes and counted for benefits should be raised in several Steps From the present $14,100 to $28,000. The latter figure would represent the full wages of about 96% of all people covered by the system and would be comparable to the percentage covered when the system was inaugurated in 1935 such an approach would represent a major degree direction of the burden of Social Security Financing to those with greater ability to (00:10:02) pay. (00:10:04) Number two General Revenue should be introduced into the system on a gradually increasing basis. The framers of the Social Security program anticipated. This would be necessary the inclusion of an urgently needed minimum benefit, which is not related to wage earner contributions is but one of several aspects of the program, which Justified General Revenue support number 3, although tax reform goes beyond the issue of Social Security taxes, the latter are clearly a significant component of the issue any effort at achieving Equity among persons at differing income levels should consider the combined burden of both income and payroll taxes and number four and further study of the program consideration should be given to raising the level of benefits Beyond those presently in the law too many elderly Americans primarily dependent on social security income are being forced to live. in poverty There are other problems which must be dealt with over the longer range there is time and knowledge to provide effective Solutions in the short-run. However, we need to understand that one of the most important things which we can do to protect the social security system is to strengthen our economy. Your field has shown its usual sensitivity and getting major attention to the nation's Healthcare problems. I'm told that the theme this year for the national conference on social welfare is Healthcare as a right human and political Dimensions. Social workers have been among the first to recognize the relationship between health status and social conditions. They have known for decades what the commissioner of Labor Statistics and President Johnson's Administration pointed out next to inadequate education poor health is the second leading cause of poverty in America seven years ago the UIW along with other unions and Progressive forces in the Health Professions industry Farm organizations Youth and civil rights groups launched a major New National effort to bring about the adoption of a sound national health insurance program for this country. Over the last several years. Any number of public opinion polls have indicated the country is ready for this the people want it. They are fed up with runaway health care costs which consistently exceed the increases in the cost of living with maldistribution of services inadequate care a private insurance system whose coverage is more characteristic of Swiss cheese than a blanket and an orientation to the protection of providers rather than those who receive the service we are a nation that has made Splendid advances in the medical Sciences. We have superbly trained Physicians. We spend almost eight percent of our gross national product for health care as much as any nation in the world and yet the advances of this system do not get to millions of Americans who need them. The latest evidence of the ill effects of this system is the issue with which Congress currently is grappling provision for the continuation of health benefits for unemployed workers and their families because we have no Universal national health insurance some eight William 8 million American workers face the prospect not only of loss of income because they have no work but of loss of their health care coverage, I have appeared this month three times in one week before congressional committees to support a stopgap measure to take care and part of this problem. It is an expensive and short-term solution, but it must be dealt with because past congresses have been dilatory in addressing the basic issue. One of the expensive lessons which the nation is learning this year is that national health insurance proposals, which relate coverage to employment as in the Nixon administration's chip program of 1974 the proposals of the health insurance industry. And those of the AMA would not have met the current crisis. Another lesson we have learned is that merely pouring more dollars into this same inefficient system under national health insurance would merely excessive 8, the problem of costs for example among the principal unintended effects of Medicare and Medicaid have been the great inflation in medical care prices and huge increases in the incomes of doctors and hospitals is just basic economics that if you increase the demand for a service and do nothing to increase the availability of that service by either augmenting the number of providers or reorganizing the system to make it more efficient. The result is going to be rising prices still another major health system problem is the lack of access to needed Services by significant portions of our population. Usually those already economically disadvantaged by way of illustration a group of researchers from Mahari Medical College recently conducted a study. Over 1,200 households and the inner city of Nashville in which 65 percent of families reported annual incomes of less than $5,000. They found for that for those problems diagnosed by the physicians in the survey in only 13 percent was appropriate care being received 90 percent of diagnosed Dental conditions were not being treated nursing Services weren't widely needed because of lack of understanding of a health condition or because of poor health practices and Social Services were seldom receive for emotional and interpersonal problems other Studies have corroborated such findings elsewhere and have demonstrated that such shortcomings are widespread. The next two months I expect there will be a renewal of the debate in the Congress. And what kind of health program is required to solve the ills of the healthcare system and to meet the health needs of the American people. I'm reasonably confident that before this Congress completes, its work in 1976. They will pass national health insurance. The principal danger we face is that we will get the wrong kind of national health insurance one. Will that will not meet the problems, but may in fact exacerbate them an adequate system of national Healthcare must embody certain basic features coverage must be Universal with equal benefits of assured for every American the must be no categories classifications or other gimmicks to exclude or discriminate against members of society coverage should include all services necessary for the prevention of illness treatment of disease or injury and Tatian of the disabled reflecting on costs again. We are told by by economists that a broad range of benefits will result result in the most efficient and least costly use of Health Services. There should be no coinsurance or deductibles to serve as barriers to care or to attempt that to hide the total cost of the program several proposals. Now before Congress includes such features under the rationale that they are needed to reduce unnecessary and frivolous use of Health Resources by consumers. Get the governmental health insurance program of the Canadian province of Saskatchewan found that coinsurance failed to reduce costs overall, but did tend to cut into utilization of Physician Services by the poor. Even though the national government was paying their coinsurance Saskatchewan dropped its coinsurance charges in 1971, a national health insurance program must deal with the disorganization of the health services delivery system. Not just pour more inflationary dollars into that system special funds should be earmarked to increase resources for services and to distend to stimulate the development of new organized programs of service you and the Human Services will understand the desirability of the team approach to meeting complex human needs. Strong cusk controls must be existent including an annual ceiling on health costs. So the percent of GNP devoted to health will not expand workable positive mechanisms of cost control must be built into the system with annual budgets for all Health Services negotiated fee schedules for providers and prospective reimbursement for hospitals. The budgetary process should be used to strengthen local and state planning to stimulate more efficient institutional Administration to reverse the current undesirable emphasis on inpatient Hospital Services wasteful duplication of services and Facilities should be gradually gradually eliminated by withdrawal of funding. In order to get the maximum payoff and health for the money spent imaginative and effective mechanisms to ensure quality of care must be included national standards must be established for participation by both individual and institutional providers continuing educational requirements for professionals are necessary institutions must be required to establish working relationships with other providers of care to ensure a Patient continued treatment of any condition utilization controls must eliminate unnecessary surgery and hospital treatment, which only drive up costs at the expense of our health. An adequate amount an appropriate distribution of Manpower and Facilities should be achieved over time through control of the budgetary process while minimizing coercive action in the end. However, the needs of the people for Health Care must take precedence over the prerogatives of special interests consumer participation must be instituted at every level of administration of the program. The system should encourage organizations of consumers to sponsor and develop Community Healthcare. Organizations Health Care is too important to matter to leave even to the most enlightened professionals. Let alone the special interests financing of national health insurance should be accorded according to the proven Social Security method payroll contributions from workers and employers should be matched by contributions from federal General revenues. This method is most Equitable and will establish health insurance as an integral part of our society. System of social insurance following the experience of every major Western Country including Canada public accountability for the system must be guaranteed by public administration through the Social Security Administration several proposals. Now before Congress allow for various degrees of involvement by private insurance carriers, it is again valuable to look at the recent tested experience of our neighbors in Canada from the beginning of their Hospital insurance plan in 1958. The Canadians determined that public administration of national health insurance was essential to achieving effective accountability and controls. Most of the province has agreed one or two, including Ontario where many UAW members work in lived and not when physician coverage was added to the Canadian national health insurance plan some five years ago. Ontario opted to use the private insurance carriers as fiscal agents, it did not work after a year or so. The private insurers were dropped today. The Canadian program is publicly administered in every Province must we in the United States go through the same wasteful trial and error process before we conclude that public financing requires public accountability and control we should not disregard the Canadian lessons. The principles. I have enunciated are Incorporated and the health security bills S3 and HR 21 the Kennedy Coleman bills, which have close to 100 sponsors in both houses of Congress. We can see these programs passed by this Congress. If forces like yours actively join in the coalition to put into place the sound companion measure to the cash benefits of the social security system. I've talked about the need for National planning immediate steps to deal with the economic crisis Social Security and health care. I am well aware that I am proposing programs of breadth and the scope they are I believe of the dimensions required to meet National needs of comparable size. We in the labor movement dedicated to a value system that puts people first are fighting for these programs. I invite and I urge you who have some of the similar values to join in the good fight.