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.


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