I Am a Union Worker, and I Want Medicare for All

My union is in a perpetual battle for decent health care coverage. It’s a tactic of our employers to prevent us from striking against our terrible work conditions. If we had Medicare for All, we could demand much more at the bargaining table.

Protesters supporting Medicare for All hold a rally outside PhRMA headquarters on April 29, 2019 in Washington, DC. (Win McNamee / Getty Images)

In Contra Costa County, one of the nine Bay Area counties, I work in social services. As an elected union officer, I organize and represent our unit of eligibility workers and social workers. We are literally the ones who determine who is eligible to have access to what the United States has designed to be our social safety net. I have been in this job for more than five years.

Rappers make songs about us. If you want food stamps, cash aid, or Medicaid, you come to me and my fellow union members. If you’re a mandated reporter and you call the referral line to report suspected child abuse, we are the ones who pick up the phones and investigate, removing children from dangerous homes where need-be. We are the ones who determine whether an older person is eligible for in-home support services (IHSS) so that they can stay out of a nursing home. We are also disaster workers helping out fire-ridden neighbors, just to the north of us in Sonoma County.

Our jobs are sometimes dangerous because we visit people’s homes who may not always have the resources to maintain a safe home for themselves, their family, and other occupants. We are regularly subjected to emotional, verbal, and sometimes even physical abuse and danger. Usually, many things have already gone wrong in a person’s life before they land at our doorstep requiring government assistance. All this is to say our job is stressful, and the turnover in our unit is high.

What makes our jobs even more stressful is knowing that we’re only providing partial help. Many of the benefits we offer are means-tested instead of universally provided and adequately funded. Our clients need and deserve more help than what’s on offer from the feds and the state. This means we are frequently having to explain to people why they are no longer eligible to receive assistance. We have to delicately navigate hearings and appeals over benefits that were only partially meeting their needs in the first place, and have now been distorted and tampered with by whoever is in Congress or the State Assembly and State Senate those two years.

Compounding Stresses

If serving the public weren’t hard enough already, our employer makes our jobs even more difficult. We suffer from chronic understaffing which results in high caseloads, burnout, and high staff turnover. Our benefits package is expensive compared to surrounding Bay Area counties even though we are, according to my large public-sector union, the fourth-wealthiest county in the state, in the fifth-largest economy in the world.

As Contra Costa County employees, we pay a hefty amount toward our health, dental, and vision insurances, especially in comparison to our peer agencies. Health care is the top concern heard from our four-thousand-member labor coalition of nine unions.

Social services is highly gendered work so we have a lot of women carrying dependents on their plans. For those who are married, our spousal waiver rate is very high, meaning the county’s plan is being waived in favor of their spouse’s more affordable plan. The rates vary wildly, with no single plan being obviously more affordable. We are being robbed in Contra Costa County, as are so many workers across the United States.

As part of our contract extensions are now due to expire in June 2022, last fall, our union spent vast amounts of time bargaining health care. We know this is the number one reason that drives staff and potential new hires out of the county and into neighboring agencies like City and County of San Francisco, Alameda County, and Solano County, all of which offer far more affordable health care benefits.

The wage increases that we did win aren’t felt in our paychecks, because they have been eaten up by the January 1 increases to our health care plans. Year after year, our salaries continue to fall behind our peer agencies because of our exorbitant health care costs. In fact, we are still meeting over health care. Elected union officers and our union staff meet collectively every month with our employer to rework our health care system to move to a more sustainable solution.

Among ourselves, we union members know that we are wasting our time. We spend days and nights poring over spreadsheets, studying RFPs from health insurers, surveying our members about their chief health care concerns, and trying to divine why they chose one plan over another. Over time, this becomes an obstacle to bargaining for better working conditions to improve our public services. If we had Medicare for All, we could be marching on the boss about the numerous health and safety violations in our workplace.

It feels like (I don’t feel it, I know it is!) a union-busting move for employers to be opposed to Medicare for All: they know they can tie up our limited capacity and our members’ limited attention with health care. It monopolizes our organizing, so that we no longer have the means to strike back at the mean rich people in our county who don’t want their taxes raised.

Our union members are in these jobs to help people. We could have gone somewhere else to work, but we chose to work in social services so as to help provide for and protect some of the most vulnerable people in our communities — even if that means that some of our members make so little that their own kids qualify for the same Medicaid benefits we administer.

Our employer should want their employees to stay and perform their jobs well because it helps the community. Our employer is the government — not a private company stealing value from their employees to generate profits at all costs — so we should be on the same side. Unfortunately, we’re not.