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January 18, 2022
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Single Payer Healthcare
Updated On: Jan 21, 2020

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Everybody In Nobody Out

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The American Healthcare System is Broken

Health care expert and former labor negotiator Mark Dudzic explains the state of health insurance in the United States (hint: it’s lousy). In this video, Brother Dudzic quickly summarizes the problems with our current system. American health insurance costs twice as more than the rest of the industrialized world, covers fewer, and is far more tenuous for the working class. If you lose your job, you lose your coverage. If you get sick and can’t work, you oftentimes lose your coverage. That’s not to mention, the current health insurance you receive through your employer is expensive, and those costs are swiftly being passed on to you.

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Source Materials Provided by:

Runaway Inequality and the Crisis of Healthcare in America

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The Single Payer System Solution

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In this video, Brother Dudzic discusses the plan to treat healthcare like a public good: otherwise known as the Medicare For All solution. Its base point is that a person’s health should be a right of life in a democratized society. “Whether you live in Trump Tower of the dumpster underneath Trump Tower, you should be treated the same at the hospital.” Brother Dudzic further delves into the costs of Med4All and how moving to a just and equitable system is something that is long overdue.

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Taking Healthcare Off the Bargaining Table

The cost of bargaining over health insurance has become unsustainable. In this video, Brother Dudzic outlines how having health insurance linked to your employment is an antiquated and unfair system that was only instituted when President Franklin D. Roosevelt’s plan for universal coverage went unfulfilled. Costs of health care have risen twice as fast as wages in this country, which has stagnated wage growth and spending power. No other country in the world treats healthcare as a “benefit” to employment. It is time we take this chip off the bargaining table and, in turn, the leverage that dangling health insurance over our head provides the railroad companies.

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Graph: Healthcare Costs Rise Much Faster than Wages

Graph: Real BMWED Average Rate, Real Rate Adjusted for Health Insurance Contributions and Real Class I RR Net Income

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What the Opposition Will Tell You

In this video, Brother Dudzic dissects some of the most commonly recited speaking points against a Medicare For All system. The health insurance companies are desperate to protect their racket and there is no shortage of fear-mongering they will float for public consumption. From scary price tags, to death panels, to government criticism, to “free loaders,” the crooks at the top of the health insurance pyramid scheme will stop at nothing to protect their sacred cash cow. Brother Dudzic does a fine job of discrediting all their bluster.

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Graph: 38,882 Deaths During in the United States in 2019 Due to Being Uninsured 

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Canadian Healthcare Poll

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How Organized Labor Can Support Single Payer

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So, how can Organized Labor and Union workers help in the fight for affordable and universal healthcare for all Americans? In this video, Brother Dudzic lays out the game plan. It involves putting pressure on our elected representatives through a litany of ways. Resolutions at the local lodge level. Educating our membership. Using every tool in our mobilizing box, from door-to-door canvassing to public demonstrations. Monthly calls to our lawmakers. We need the “people power.” It is our strongest asset and our most-assured way of achieving healthcare as a public right.

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BMWED Resolution In SUPPORT of Rail Labor for Single Payer Healthcare

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How We Will Pay for Single Payer Healthcare

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The $3 trillion-dollar question:  How do we pay for Medicare For All? It’s a fair and important question and one that BMWED Internal Organizing Coordinator Carey Dall succinctly deduces in this video. Using the revenue flows that are included in the House bill currently on the floor of Congress, Brother Dall walks us through what it would look like for the average BMWED railroader and explains how, at the end of the day, the everyday worker comes out ahead. 

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More and more the people understand how access to healthcare is basic to human dignity. HealthCare.NOW published a flier showing a timeline of healthcare legislation reform and the development of a movement for single-payer healthcare in our country. It’s true that Healthcare reform has been under attack for decades. But why?

The United States is the only country in the developed world that does not guarantee access to basic health care for residents. Countries that guarantee health care as a human right do so through a “single-payer” system, which replaces the thousands of for-profit health insurance companies with a public, universal plan.

Does that sound impossible to win in the United States? It already exists - for seniors! Medicare is a public, universal plan that provides health coverage to those age 65 and older. Medicare costs less than private health insurance, provides better financial security, and is preferred by patients. Single-payer health care is often referred to as “Expanded & Improved Medicare for All.”

Under the single-payer legislation in Congress (H.R. 676):

  • Everyone would receive comprehensive healthcare coverage under single-payer;
  • Care would be based on need, not on ability to pay;
  • Employers would no longer be responsible for health care costs and coverage decisions;
  • Single-payer would reduce costs by 24%, saving $829 billion in the first year by cutting administrative waste and allowing negotiation of prescription drugs; and
  • Single-payer would create savings for 95% of the population. Only the top 5% would pay slightly more.


Profits over People: Healthcare Petition Action


Supported and Endorsed by the Pennsylvania Federation BMWED-IBT

Our nation’s healthcare crisis is ruining the lives and livelihoods of millions of Americans.  The huge number of uninsured and underinsured families is growing dramatically and, increasingly, members of our unions are joining their numbers.

This crisis intensifies the difficulties of all workers struggling to survive in today’s predatory economic environment.  Shifting the cost of healthcare to workers under the current profit-driven system is a painful feature of virtually every set of contract negotiations these days.  For the vast majority of workers without a union, the situation is even more desperate.  A publicly financed, single-payer national health care system like those in virtually all other industrialized countries is the only solution that will control costs, increase access and improve the quality of care.

The primary purpose of the Labor Campaign for Single-Payer Health Care is to increase grassroots labor support for H.R. 676 as an essential element in winning the support of Congress to enact the National Health Care Act “Medicare for All” as the public policy of this country because we believe that health care is a human right.

The Labor Campaign for Single-Payer Health Care is being launched at this critical time as an extension of already existing single payer support among many labor organizations and is intended to increase and help coordinate grassroots labor support for universal, comprehensive, single-payer healthcare as embodied in HR 676, the legislation introduced by Congressman John Conyers, and co-sponsored by 92 members in the last Congressional session.

Read More... about the Labor Campaign for Single Payer Healthcare

Resolution 21 - "... Be It Resolved, that the delegates assembled at this Twenty Second Regular Quadrennial Convention of the Pennsylvania Federation Brotherhood of Maintenance of Way Employees Division of the International Brotherhood of Teamsters renew our support for a national single-payer healthcare system and for all legitimate legislative proposals that move us towards such a system and are in accordance with the principles of this Resolution and that we endorse and support the work of the Labor Campaign for Single Payer and will urge the union to do the same." adopted August 5, 2015

As Cadillac Tax Threat Looms, How Can Unions Respond?
November 2, 2015 | Dan DiMaggio

Your employer has already brought it up in bargaining, or else is about to: the health care headache known as the “Cadillac tax.” How hard are unions getting hit—and what can we do about it? Labor Notes interviewed Mark Dudzic, coordinator of the Labor Campaign for Single Payer, which just issued a new report on the tax. Download it here.

Turning Chevys Into Cadillacs: The ACA Excise Tax and the Future of Healthcare Bargaining A LCSP Briefing Paper

The term “Cadillac” denotes special privileges and unnecessary luxury. It implies that certain workers receive benefits which are unearned and at the expense of everyone else and that the elimination of these benefits won’t really hurt anyone. Ever since the “welfare Cadillac” slanders of the Reagan era, the term also has unfortunate racial connotations. The implication is that this tax will only affect a bunch of spoiled parasites that had it coming to them.

In reality, the tax will fall heaviest on decent, bread and butter benefits that provide basic security for working class families. It should more aptly be called a “Chevy Tax” because everyone should have one.

It is true that unions have bargained healthcare benefits as part of a total compensation package and have often sacrificed wage gains in order to preserve healthcare benefits for themselves and their families. However, in an era of massive inequality and unrestricted corporate power, it is highly unlikely that most unions will be able to recover these deferred wages. Non-union workers will fare even worse. The more likely outcome is that workers’ pre-tax benefits will be cut while they pay more of their healthcare costs out of their post-tax wages. The tax undermines the 75-year tax deductibility for employer-paid healthcare benefits and reflects the principle that tax policy should be used to provide incentives for desirable social goals. Taxation of health benefits treats healthcare as if it were a privilege and a luxury rather than a necessary right in a civilized society. Read More...

Unions Can Lead the Struggle for Single-Payer Health Care
August 18, 2014 | Kay Tillow  

Despite passage of the 2010 health care reform bill, employers continue to push for cuts in benefits and to shift costs to workers in higher monthly payments, co-pays, and deductibles.

Wage increases are always trumped by this costly health care monster. Some employers, in anticipation of the $2,000 annual fine for not offering health insurance, are threatening to drop coverage and instead pay the cheaper fine.

Many companies are dropping benefits for spouses, retirees, and part-timers. Current law does not stop them. Multiemployer plans are disadvantaged by the preferable treatment available to the plans of non-union employers. The 2018 excise tax will cap the ability to bargain better health benefits. Insurance companies continue to decide what doctors and hospitals workers can use.

Unions are playing in a ball park where the odds are stacked against them, a field dominated by private health insurance companies. Unions need a new arena where they can win the battle, improve coverage, and secure it once and for all.

Read More... and understand how with single payer in effect, unions, including those with multi-employer plans, can use their health care bargaining power to improve pensions, sick pay, and other benefits as well as wages.

Beyond Obamacare:  Why Labor Deserves Better” with Dr. Andrew Coates

Bernie Sanders Introduces Single-Payer Bill in U.S. Senate
December 11, 2013 | By Labor for Single-Payer

On December 9th Senator Bernie Sanders (I., VT) introduced legislation in the U.S. Senate to provide healthcare to everyone in America through a single-payer, Medicare-for-All system.
“The United States is the only major nation in the industrialized world that does not guarantee healthcare as a right to its people,” Sanders said. “It is time that we bring about a fundamental transformation of the American health care system. It is time for us to end private, for-profit participation in delivering basic coverage.” Read More...

Congressman John Conyers Reintroduces Single-Payer Health Care Bill
February 14, 2013 - endorsed by 26 Internation Unions

"Many Americans are frustrated with high out-of-pocket costs, skyrocketing premiums, and many other serious problems that are part and parcel of a health care system dependent on private health insurance plans. H.R. 676 would reform this broken system." Read More...

Healthcare is a Right - Not a Privilege
Sustaining the Movement for the 99%, Statement by Labor Campaign for Single-Payer

This autumn has been witness to an extraordinary moment in American history as the Occupy Wall Street movement swept the nation and gave voice to a widespread anger at corporate greed and raging inequality.   With winter approaching, and more and more cities sending police to physically assault and clear out their outdoor entime to take stock of the achievements and prospects of this movement. Read More...

House Votes to Repeal Obama Healthcare Law
All 242 Republicians Voted to Repeal Healthcare

The House on Wednesday (1/19/2011) voted to repeal the Democrats' landmark healthcare overhaul, in a largely symbolic step that the new Republican majority said marked the beginning of an all-out effort to dismantle President Obama's signature domestic policy achievement. Read More...

No union can bargain without facing a demand or hard choices on health care coverage in our contracts. The absence of a national health care system significantly depresses our members' wages despite the productivity gains their work produces.

March 9, 2010 - Members of the Pennsylvania Federation joined thousands of union members, community activists, religious leaders and others performing a citizens' arrest of the insurance companies as they were meeting in Washington, DC to plot to kill health reform. The boisterous, energetic, diverse crowd marched from the AFL-CIO and AFSCME buildings and DuPont Circle to the sound of beating drums and shouted slogans like, “Blocking health care is a crime” and “Health care can’t wait.” The crowd was so large, it completely encircled the block-long Ritz-Carlton hotel in Washington, D.C., where the front group for the nation’s biggest insurance companies, the America’s Health Insurance Plans (AHIP) is meeting. Health Care for America NOW (HCAN) sponsored the rally and march.

AFL-CIO President Richard Trumka laid it on the line, telling the crowd: "The insurance companies won’t stop unless we stop them—and we do that by passing health care reform legislation. So today we’re here to put the insurance companies on notice: We will not allow you and your lobbyists to bully Congress into not acting. Not on health care or any of the issues important to America’s working families."

The crowd placed a crime scene tape around the hotel and several leaders and victims of health insurance abuse delivered a “warrant” to the front of the hotel calling for the arrest of the insurance company executives.

We need reform, we need it now, and we won't let their lobbyists or their money stop Congress from passing it. We will fight, and we will win.

January 14, 2010Despite the so-called agreement announced today by various labor organizations, the International Association of Machinists and Aerospace Workers (IAM) reiterated its opposition to any health care reform legislation that is funded by taxing the value of workers’ existing health care benefits. Read More...

January 14, 2010 - Senator Sherrod Brown (D-Ohio) initiated a letter to the Senate Majority Leader and Speaker of the House concerning the proposed Senate healthcare excise tax. The good Senator's request for co-signers was met by several reasonable thinking Senate leaders, including both Maryland Senators, New Jersey's senior Senator, Senators from Illinois, New York, Vermont, and others. Make sure you thank your Senator for supporting this important issue. Or share your disappointment in your Senator's failure to support the middle class and workers. Read Senator Sherrod Brown's letter here

January 11, 2010 BMWED President Simpson writes House Speaker Pelosi about the potential defection of BMWED members from the Democratic party if our so-called "Cadillac" health plans are taxed. Read President Simpson's letter here.

October 28, 2009 Teamster President Hoffa's letter to the Senate regarding excise tax on insurance companies who offer comprehensive plans to workers. This notion of taxing health benefits will impact workers, resulting in insurance providers passing on the cost to our members. Read President Hoffa's leter here.

June 16, 2009 BMWED President Simpson writes President Obama in connection with a proposed tax on employer provided healthcare benefits, asking for a veto of any legislation that taxes our benefits. Read President Simpson's letter here.

BMWED correspondence which clearly address the dangers of taxing our healthcare benefits. View a printable version here.

President Obama has created a unique opportunity to transform the health system.  Health care consumers, women and public health advocates know we need an Equitable, Quality, Universal, Affordable health system.  But special interests in D.C. have other ideas.  Sign up to let the President and Congress know we need a publicly financed, publicly administered plan like Medicare.  We'll send the message to them by April 6, when the White House health care forum convenes in Los Angeles.

Support this message by linking to the Center for Policy Analysis site and signing the on-line petition. Ask your friends and colleagues to sign too!

Labor Campaign for Single-Payer Healthcare

Healthcare Is A Right -- Not A Privilege

January 16, 2009 St. Louis – More than 150 union leaders from 31 states gathered in St. Louis last weekend to step up a grassroots campaign to enact comprehensive national healthcare reform.  The group is promoting a single-payer plan, which would work like an improved and expanded Medicare program to cover everyone. The national kick-off meeting was convened by Labor for Single-Payer Healthcare, a campaign spearheaded by scores of trade union organizations.  

The national single-payer bill, HR 676 – expected to be reintroduced in Congress later this month – has been endorsed by 39 state AFL-CIO federations, 100 Central Labor Councils, and more than 400 local unions. The bill has 92 co-sponsors in Congress, more than any other health care reform bill.

For more information visit the Labor For Single Payer web site

Labor's "Medicare for All" Advocates Test Strength
Mischa Gaus, Labor Notes - Yet some major unions that have endorsed single payer, including AFSCME and the Service Employees, in practice are backing plans that would preserve private insurers. Both union federations, the AFL-CIO and Change to Win, already have lined up behind compromise plans....Read More

First-of-Its Kind Study:

Single-Payer Reform Would Be Major Stimulus for Economy

2.6 Million New Jobs, $317 Billion in Business Revenue, $100 Billion in Wages

Establishing a national single-payer style healthcare reform system would provide a major stimulus for the U.S. economy by creating 2.6 million new jobs, and infusing $317 billion in new business and public revenues, with another $100 billion in wages into the U.S. economy, according to the findings of a groundbreaking study released today.

The number of jobs created by a single-payer system, expanding and upgrading Medicare to cover everyone, parallels almost exactly the total job loss in 2008.

“These dramatic new findings document for the first time that a single-payer system could not only solve our healthcare crisis, but also substantially contribute to putting America back to work and assisting the economic recovery,” said Geri Jenkins, RN, co-president of the National Nurses Organizing Committee/California Nurses Association, which sponsored the study. read more....


Thirteen years ago Bill Clinton became president partly because he promised to do something about rising health care costs. Although Clinton's chances of reforming the US health care system may have looked good at first, the effort soon ran aground. Since then a combination of factors have kept health care off the top of our nation’s agenda. Like the general distraction of a nation focused first on the gloriousness of getting rich, then on terrorism, now on war and occupation.

Also impeding healthcare for all is the unwillingness of our politicians to confront the insurance lobbies whom so successfully frustrated the Clinton effort. Except for Congressman John Conyers, Jr., of Michigan's 14th District.

Congressman John Conyers has sponsored “The United States National Health Insurance Act, (H.R. 676)”, and on August 8, 2007 the Pennsylvania Federation proudly adopted Resolution Nineteen endorsing a national single payer health care system in general and H.R. 676 in particular, urging the union to fight for its creation.

If passed, H.R.676 would cover every person in the United States for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), visioncare, chiropractic and long term care. H.R.676 ends deductibles and co-payments.  H.R.676 would save billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.


“The union movement must marshal its resources for a renewed all-out assault to end the current health care crisis.... There is no institution in America better suited or better able to take on this task.”

AFL-CIO Executive Council statement, August 2002

It is important for our members to educate themselves on how the passage of this bill will not only enrich the lives of the working class, but also benefit America as a nation. When candidates ask for our vote, intelligently ask them how they are going to address America’s healthcare crisis. And if they don't have a plan, we can tell them ours; H.R.676.

Ask yourself why 15,000 of our nations doctors and medical professionals have formed Physicians for a National Health Program? PNHP is the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program., a project of the California Nurses Association/National Nurses Organizing Committee is a leading national advocate for universal healthcare reform, through a single-payer style system based on an improved and expanded Medicare for all. One of the fastest growing health care organizations in the U.S., presently having 75,000 members in all 50 states, representing nurses at scores of hospitals, clinics, and home health agencies.

Also visit H.R., The Citizens Alliance for National Health Insurance and Unions For Single Payer H.R.676.

Something Stinks with our American HealthCare System

While some Americans have health insurance through their employers, employment is no longer a guarantee of health insurance coverage. As America continues to move from a manufacturing based economy to a service economy, and employee-working patterns continue to evolve, health insurance coverage in the United States has become less stable. The service sector offers less access to health insurance than its manufacturing counterparts. Further, an increasing reliance on part-time and contract workers who are not eligible for coverage means fewer workers have access to employer-sponsored health insurance.

Due to rising health insurance premiums, many small American employers cannot afford to offer health benefits. Companies that do offer health insurance often require employees to contribute a larger share toward their coverage. As a result, an increasing number of Americans have opted not to take advantage of job-based health insurance because they cannot afford it, effectively denying them coverage. The number of these working poor combined with the over 50 million Americans who have absolutely no healthcare coverage at all creates a healthcare crisis in America.

The United States has by far the most expensive health care system in the world, both on a per-capita basis and as a percentage of Gross Domestic Product. This high price tag is attributed to the rising costs of medical technology and prescription drugs and the enormous administrative costs resulting from the complex multiple payer system. The huge gap in administrative costs between the U.S. and other nation’s single-payer systems arise from their differing mechanisms of paying for health care.  While other nations, such as Canada and Germany, have a single insurance plan, or “single-payer”, where each province pays the bills for everyone, the U.S. has a complex and fragmented payment structure built around thousands of different insurance plans, each with its own regulations on coverage, eligibility, and documentation.

The U.S. wastes more on health care bureaucracy than it would cost to provide health care to all of the uninsured. A single payer national health insurance system could garner these massive administrative savings, allowing universal coverage without any increase in total health spending.

Take a minute to watch this video, brought to you by our union friends across the northern border, the CWA-Canada*. Send this link to family and friends. America is in a healthcare crisis and it stinks.

*In 2007, CWA|SCA Canada became the new name of the country's oldest media union. Formerly known as TNG Canada/CWA, their new moniker contains bilingual initials (SCA stands for Syndicat des communications d’Amérique) and reflects their elevated, autonomous position within the Communications Workers of America.

Senator Barack Obama on Healthcare

During the Presidential debate last night Barack Obama firmly communicated why he thinks healthcare is not a privilege but a right. Citing a difficult moment in his own life, Obama spoke of his mother who, when diagnosed with cancer, found herself fighting her insurance company to prove her sickness was not a "pre-existing condition." "In a country as wealthy as ours," Obama said, "for us to have people who are going bankrupt because they can't pay their medical bills...there's something fundamentally wrong with that." more

Wonder Why The Cost of Health Care Is So High?

MINNEAPOLIS -- William McGuire is going to be OK, according to this Associated Press report. UnitedHealth Group Inc. will pay its departing chief $5.1 million a year for the rest of his life and a $6.5 million lump sum, according to a calculation of his severance benefits by The Corporate Library, a watchdog group that has criticized McGuire's pay before.

He also has stock options that were worth $1.78 billion as of the end of 2005.

McGuire has agreed to retire by Dec. 1, and he stepped down as chairman Sunday. The move came after a company-sponsored investigation determined that many company stock options were backdated to make them more favorable for recipients, including McGuire, other executives and thousands of UnitedHealth employees.

McGuire's 1999 employment contract, which has been amended since then, has been criticized as too generous, but the severance provisions came into sharper focus on Monday now that he is leaving.

In mid-April, McGuire asked the company's board to stop issuing new stock options to him and some other senior managers, to cap an executive retirement plan and to get rid of noncash perks. The company said in May that those changes had been adopted, although no amendments to McGuire's employment agreement were filed. Company spokesman Mark Lindsay did not return phone messages.

McGuire's base salary was $2.3 million a year, but he cleared more than $100 million in years that he cashed in stock options.

On Sunday, UnitedHealth said McGuire would reprice his options to the highest point in the year they were granted.

(The preceding Associated Press report was published by the Chicago Tribune on Tuesday, Oct. 17, 2006.)

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