The Medicare Prescription Drug and Modernization Act (H.R. 1), passed Nov. 25, sets in motion the privatization of the traditional fee-for-service Medicare program. The legislation will fundamentally undermine the Medicare program and undercut employer-provided retirement health insurance, says the AFT and other labor groups.

The final bill is a bonanza for drug and insurance companies and a far cry from the original effort to reduce prescription drug prices for seniors, says the AFT. It specifically prevents Medicare from using the market power of more than 40 million beneficiaries to negotiate lower drug prices; prevents the reimportation of less costly drugs from Canada and other counties; and dilutes earlier strong language that provided for the increased availability of generic drugs.

More unsettling, however, is that the bill directly threatens the viability of the Medicare program, which serves more than 85 percent of the nation’s senior citizens, says the AFT. The legislation provides vast subsidies to HMOs and threatens to privatize the traditional Medicare program in 2010 by substituting a premium “voucher” in place of Medicare insurance, says the union. Sen. Edward Kennedy (D-Mass.), who led an unsuccessful effort to filibuster the bill, calls it “the first step toward a total dismantling of Medicare.”

The 54-44 Senate vote came after the legislation squeaked by the House in a roll-call vote, 220-215.  AFL-CIO president John Sweeney has denounced the measure, calling it a “partisan proposal that, under the guise of creating the much-needed and long-promised prescription drug benefit, would reward the pharmaceutical companies and HMOs that are the political backers of the plan’s sponsors.” He also charged that the AARP’s endorsement of the bill was an “extremely misguided decision of that organization’s leadership that is not supported by its membership, as polls and ample anecdotal experience show.”

The bill ultimately may jeopardize the retiree health plans that employers provide, warns the AFT. A Congressional Budget Office analysis shows that employers will drop this essential coverage in large numbers. “Our affiliates often have had to sacrifice salary increases and other benefits for our members to secure retirement health benefits that give members adequate security for their healthcare as they age,” notes AFT president Sandra Feldman in a Nov. 19 letter to members of Congress. “This bill undermines such health benefits, which are an essential part of a retirement package.”

Passage of this bill makes winning truly comprehensive prescription drug coverage more difficult and jeopardizes the traditional Medicare program, but all is not lost. In 1989, when details of the Medicare catastrophic bill were finally revealed, Congress was forced to repeal it.

Consumers can now access quality data about home health agencies via the Home Health Compare Web site. It is part of an effort by the Centers for Medicare and Medicaid Services (CMS) to report provider quality data and use quality improvement organizations to improve care.

The home health quality initiative, which follows the nursing home quality initiative launched in 2002, uses home health agency data to compare agencies in each state. Home Health Compare reports on 11 quality measures, a subset of the data that home health agencies regularly send to CMS.

The quality initiative began as an eight-state pilot project in February. Since then, more than 5,000 home health agencies have been trained in quality improvement techniques, according to CMS. For more information, visit www.medicare.gov/default.asp.

Labor organizers would face a less hostile environment under proposed new federal legislation unveiled by Sen. Edward Kennedy (D-Mass.) and Rep. George Miller (D-Calif.) in November. The bill, the Employee Free Choice Act, would ensure that a simple majority of employees in a workplace could form a union without facing crippling anti-union tactics.

"For too long, we have acquiesced in the anti-labor, anti-worker, anti-union tactics that are far too prevalent in the workplace," Kennedy says. "We like to think that workers are free to join a union, but too often that basic aspect of freedom is denied in our modern society because hard-line corporate managers succeed in denying a fair choice."

Miller adds that "something is obviously very wrong with our nation's labor laws when one side in a dispute has so many weapons at its disposal to thwart the will of the majority."

The bill would establish a streamlined card-check system that requires an employer to recognize a union as the exclusive bargaining agent if more than 50 percent of the unit has signed authorization cards. It also would provide for mediation and arbitration of the first collective bargaining agreement. This would be a key reform, since employers routinely drag their feet when it comes to negotiating a first contract-opting instead to exploit a drawn-out complaint process under the National Labor Relations Board. Penalties for violations of the National Labor Relations Act also would be toughened under the bill, which would strengthen key sections of the law.