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31 Lab. Stud. J. 1 (2006-2007)

handle is hein.journals/labstuj31 and id is 1 raw text is: Introduction Adrienne E. Eaton T here is wide recognition that the U. S. healthcare system is in crisis. The clearest manifestations of this crisis are related to costs and health outcomes, although the United States spends more per capita on health care then any other nation in the world. This spending might well be worth it if it yielded the best health outcomes in the world but sadly, it does not. In 2000, the World Health Organization (WHO) ranked the United States thirty- seventh in overall health system performance (WHO 2000). This ranking comprises a number of indicators. For instance, among OECD nations, the United States has one of the lowest life-expectancy rates and one of the high- est infant-mortality rates.' Not surprisingly, we fall even lower on fairness of health financing, which indicates how evenly health resources are distributed across the population. On this measure the WHO ranks us as fifty-fourth to fifty-fifth in the world (WHO 2000). In turn, the disparities in access to health care are reflected in the distribution of health outcomes, particularly across race and class lines. A further dimension to the problem is that healthcare costs continue to rise at a rate well above overall inflation. (See the Nack and Clark and Clark papers in this volume for specific data on the growth in healthcare costs and spending.) While in any context an increase in costs of this nature would constitute a significant social problem, in the United States it becomes a labor problem because employer-provided health insurance has been the foundation of our system. Further, union workers are more likely to have health insurance through their employer. Because those benefits are more costly to the employer on average, this issue has become an important point of conflict in collective bargaining in recent years.2 Thus, one of the two overarching areas mentioned in the call for papers for this volume concerned issues raised for workers and the labor movement by the employer-based system. This included such specific topics as collective bargaining over healthcare, trends in the percentage of the insured population, retiree coverage, and trends in cost-shift- ing or cost-containment. It also included union strategies for reform of the healthcare system including state and federal policy initiatives and incremental versus broad approaches. Finally, papers on the history and evolution of the LABOR STUDIES JOURNAL, Vol. 31, No. 1 (Spring 2006): 1-4. Published for the United Association for Labor Education by the West Virginia University Press, P.O. Box 6295, West Virginia University, Morgantown, WV 26506. 0 2006, West Virginia University Press. 1

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