Americans are concerned about rising costs and declining quality

THE NATION'S HEALTHCARE system needs to be completely overhauled. That's the view of an astounding 95 percent of those who responded to the AFL-CIO's 2008 Healthcare for America survey. Nearly 27,000 people—including 1,600 AFT members—completed the online survey, and more than 7,000 submitted personal stories about their own healthcare woes.

There is widespread agreement that the nation's healthcare system is ailing, but the prescription for healing it has led to an on-going—and often highly charged—debate throughout the presidential primary campaign season. The responses to the AFL-CIO survey tell a sobering story about the breadth of the problem.

"I'm now more than $5,000 in debt due to an overnight hospital stay in November 2007," wrote Melissa, an AFT member from Oregon. "My doctor sent me to the emergency room due to tachycardia, and the resulting tests and observation put me in a deep financial hole. Ironically, my employer of 17 years finally started offering its employees insurance, six weeks after my hospital stay."

The survey, which was completed by union and nonunion members alike, shows that Melissa is far from alone in coping with the hardships of being uninsured. "Those of us with good healthcare coverage and pensions will not remain as islands of privilege," AFT president Edward J. McElroy reminds members. Among the survey findings:

• In the past year, 76 percent of people who lack insurance themselves, and 71 percent of people with uninsured children, say someone in their family who was sick did not visit a doctor because of the cost.
• Sixty-seven percent of the uninsured and 66 percent of those whose children are uninsured report skipping medical treatment or follow-up care recommended by a doctor.
• Fifty-seven percent of the uninsured and 61 percent of people with uninsured children had to choose between paying for medical care or prescriptions and other essential needs (such as rent, mortgage or utilities).
• Even those with health insurance (about three-quarters of all respondents) are deeply concerned about rising costs and declining quality of healthcare.
• About 96 percent of insured respondents say they worry about being able to afford coverage during the next few years.
• Ninety-four percent say they are dissatisfied with the cost of their current coverage, and 62 percent say they are dissatisfied with their healthcare quality.
• More than half of those with coverage say it does not provide vital health services, such as prescription drugs, preventive care and check-ups, or it makes those services unaffordable.

Judith, an AFT member in Missouri, worries about retiree coverage: "While I currently have health insurance through my employer, it seems that if I retire in a timely fashion, I will either be dependent upon Medicare or have to pay out a large sum of money to have full health coverage. The cost for my insurance would be about half of what my retirement income would be. That won't work."

The AFL-CIO plans to present the results of the survey to candidates for public office at every level, and increase its mobilization to help ensure that candidates who win in November have a mandate for real healthcare reform. Almost 80 percent of those surveyed say healthcare will be a major issue in the 2008 presidential and congressional campaigns; and 97 percent say they plan to vote this fall.

"We have to help candidates who support real reform become active champions for healthcare," says AFL-CIO president John Sweeney. "And we have to expose and hold accountable candidates at all levels who oppose real reform and propose false solutions."