National Nurses United

RAD:May 9/30/08 2:03 PM Page 13 Rose Ann DeMoro Executive Director, CNA/NNOC McCain-Palin? Top 10 reasons to count me out for advocates of improvements in healthcare, retirement security, and such fairness issues as pay equity, there's a lot at stake in the November election. Amidst the nation's worst economic crisis since the 1930s, the prospect of a John McCain-Sarah Palin administration offers little confidence for the future. Here are 10 reasons why: 1. Bye bye employer health benefits? McCain wants to move people from employer group coverage to the individual private market. He'd get there by taxing current healthcare benefits. The steep rise in taxes would prompt many younger, healthier employees to give up their coverage, leaving the least healthy and most expensive workers under employer plans, wrecking any notion of a risk pool. The current trickle of employers dropping health benefits would become an avalanche. Analysts warn it could "lead to the death of company-provided health plans." 2. Those rapidly shrinking insurance plans. To supposedly offset the tax increase, McCain is offering a tax credit to buy private insurance. But the credit is less than half the present national average for family premiums – not counting deductibles, co-pays, and the 101 other ways the healthcare industry empties your pockets. The tax credit is also not indexed to inflation, nor does McCain propose to limit what insurers can charge. Look for even more people to buy junk insurance with few covered services that are too expensive to ever use. 3. Getting rid of those pesky consumer protections. McCain wants to allow insurers to evade all existing state minimum standards on what health services insurance companies must cover. In California, for example, that would mean an end to basic, hard-won requirements such as independent medical review of care denials, minimum hospital stays for new moms, access to cancer screenings, breast reconstruction, and hospice care. 4. What problem of the uninsured? To conservative healthcare economists, like McCain adviser John Goodman, the problem is not that people don't have health coverage, it's the public embarrassment of those high numbers. SEPTEMBER 2008 "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American as uninsured," Goodman told the Dallas Morning News. They can always go to the ER, said Goodman, ignoring what happens to people's health when they delay care. While we're at it, one blogger suggested, maybe the way to solve our vexing cancer problem is to just stop calling it cancer. 5. Social What Security. McCain has called the financing system of Social Security "a disgrace," even though it has operated this way for 80 years. Now he's encouraging young people to divert their Social Security payments into risky Wall Street investments (meet Lehman Brothers), undermining the financial foundation of our national retirement program. He also says "all options" for Social Security cuts are on the table, including raising the retirement age and cutting benefits. Good thing we still have those stable and secure 401(k) plans. 6. Medicare's promise, slip sliding away. McCain was absent on the vote to repeal the Bush administration ban on government using its bulk purchasing power to negotiate lower prices from drug companies for Medicare recipients. He's been silent on the doughnut hole, under which seniors must pay 100 percent of the next $3,000 in drug costs after Medicare pays 75 percent for the first $2,700, and mum on insurance industry price gouging in the Medicare Advantage program in which payments to private plans average 113 percent of the cost of regular Medicare. 7. The "fundamentals of our economy are strong," or maybe not. When Wall Street was implodingSept.15,McCainsaid"thefundamentals of our economy are strong." It's a safe bet the 59 percent of Americans who told pollsters in June they are having a "serious" financial problem struggling with household bills don't share that sunny optimism. McCain also recently said, "It's easy forme togotoWashingtonandfrankly, be somewhat divorced from the day-to-day challenges people have." That seems evident. 8. What workplace discrimination? McCain opposes two significant Congressional bills, the Lilly Ledbetter Fair Pay Act and the Paycheck Fairness Act, intended to end the W W W. C A L N U R S E S . O R G disparity in pay between men and women. The Ledbetter bill is named for a woman who sued and won against Goodyear Tire & Rubber for paying her less than male coworkers. The case was appealed to the Supreme Court where it was, surprise, overturned on a technicality, which brings to mind... 9. If you like the Scalia-Thomas-Roberts-Alito court, just wait. Quizzed about which Supreme Court judges he would not have appointed, McCain named the four justices who have been most sympathetic to issues like workplace protections, women's rights, and civil rights. In addition to Ledbetter, the present court has issued numerous decisions intended to throw working people under the bus, such as the Kentucky River decision, which threatened the collective bargaining rights of nurses who make clinical assignments. At least two of the judges McCain finds most distasteful are likely to retire during the next administration. 10. How about that vice president? Palin offers some reassurance, right? Maybe not. On healthcare, her most visible stance has been to rail against regulation and push to repeal the state's certificate of need program which is intended to protect community medical centers from being financially undercut by businesses such as boutique clinics and high-end surgery centers. Her record on other issues is, shall we say, thin. But there's cause for concern: her lessthan-forthright statements on the campaign trail about earmarks and that famous bridge to nowhere (yes, she kept the money); her heavy-handed use of state executive powers for a personal vendetta; and the decision of Wasilla, Alaska during her tenure as mayor to charge victims of sexual assault for evidencegathering medical exams. Palin may provide gender balance in a McCain administration, but looks to be in full lockstep with the philosophical and economic train wreck of the past eight years. A McCain-Palin administration would likely perpetuate that dismal record. If that's an advance for women or men, count me out. I Rose Ann DeMoro is executive director of CNA/NNOC. REGISTERED NURSE 13

• Cover