Author Archives: afscme

The hidden costs of U.S. health care: Consumer discretionary health care spending

Source: Deloitte Center for Health Solutions, 2012

from the summary:
In 2010, total U.S. health-related expenditures were an estimated $3.2 trillion or 23.9 percent higher than reported in the National Health Expenditure Accounts (NHEA). This translates to $10,392 per person.

An additional $621 billion in direct and indirect costs was estimated for goods and services above what is captured in NHEA accounting. Of this additional amount, $492 billion (79 percent) is the imputed value of unpaid supervisory care given to individuals by family or friends.

The hidden costs of U.S. health care: Consumer discretionary health care spending. a study by the Deloitte Center for Health Solutions, estimates U.S. health-related spending by taking a broad view of direct and indirect costs as well as items such as alternative medicines, functional foods, and the imputed cost of supervisory care.

State Chart Book on Wages for Personal and Home Care Aides 2001-2011

Source: Paraprofessional Healthcare Institute (PHI), October 2012

From the abstract:
Provides a state-by-state look at trends in wages for PCAs, the fourth fastest-growing occupation in the country, and a key job title within the direct-care workforce. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the data underscore the problem of low wages for PCAs, factors which contribute to workforce instability and near-poverty incomes for this high-demand workforce.

The “Fiscal Cliff” and the American Taxpayer Relief Act of 2012

Source: Mindy R. Levit, Margot L. Crandall-Hollick, Jim Hahn, Jim Monke, Janemarie Mulvey, Julie M. Whittaker, Congressional Research Service, CRS Report for Congress, R42884, January 4, 2013

The federal budget deficit has exceeded $1 trillion in each of the last four fiscal years (FY2009-FY2012). Concern over these large deficits, as well as the long-term trajectory of the federal budget, resulted in significant debate during the 112th Congress over how to achieve meaningful deficit reduction and how to implement a plan to stabilize the federal debt. Numerous expiring provisions, across-the-board spending cuts, and other short-term considerations having a major budgetary impact, were scheduled to take effect at the very end of 2012 or in early 2013. This combination of policies, estimated by CBO to reduce the deficit by $502 billion between FY2012 and FY2013, was referred to by some as the “fiscal cliff.” Had these policies taken effect, CBO projected that the economy would have returned to recession in FY2013….Despite the enactment of ATRA, many policy issues affecting the federal budget remain unresolved. Specifically, in early 2013, Congress will likely consider a debt limit increase, additional actions related to the postponed BCA automatic spending reductions, and appropriations for the final six months of FY2013. Finally, long-term fiscal sustainability issues remain unresolved….

National Health Spending In 2011: Overall Growth Remains Low, But Some Payers And Services Show Signs Of Acceleration

Source: Micah Hartman1, Anne B. Martin, Joseph Benson, Aaron Catlin, Health Affairs, Vol. 32 no. 1, January 2013
(subscription required)

From the abstract:
In 2011 US health care spending grew 3.9 percent to reach $2.7 trillion, marking the third consecutive year of relatively slow growth. Growth in national health spending closely tracked growth in nominal gross domestic product (GDP) in 2010 and 2011, and health spending as a share of GDP remained stable from 2009 through 2011, at 17.9 percent. Even as growth in spending at the national level has remained stable, personal health care spending growth accelerated in 2011 (from 3.7 percent to 4.1 percent), in part because of faster growth in spending for prescription drugs and physician and clinical services. There were also divergent trends in spending growth in 2011 depending on the payment source: Medicaid spending growth slowed, while growth in Medicare, private health insurance, and out-of-pocket spending accelerated. Overall, there was relatively slow growth in incomes, jobs, and GDP in 2011, which raises questions about whether US health care spending will rebound over the next few years as it typically has after past economic downturns.

Community Partnerships: Hope for an Embattled Labor Movement? A Conversation with Andrea van den Heever

Source: Nancy MacLean, Labor: Studies in Working-Class History of the Americas, Vol. 9 no. 4, Winter 2012
(subscription required)

From the abstract:
Contributing editor Nancy MacLean sits down with the remarkable union organizer Andrea van den Heever. A white South African who fled the apartheid regime, van den Heever fortuitously landed a secretarial job at Yale University in 1982, just as HERE’s organizing drive among clerical workers was getting off the ground. Soon she had been recruited to a struggle that has never let go of her, first as local steward, today as director of Community Organizing Project for the international union. In wide-ranging reflections with MacLean, van den Heever identifies both the strategies and sensibilities at the core of modern-day unionism as social movement. Among the many highlights of her account is the conceptual link she envisioned between the Freedom Charter in South Africa and the New Social Contract among New Haven workers; her emphasis on the need for twinned attention to African American and Latino community concerns; and the role of both clergy and student and faculty supporters in helping balance an uneven playing field in organizing campaigns.

U.S. Conference of Mayors 2012 Status Report on Hunger & Homelessness

Source: U.S. Conference of Mayors, December 2012

From the press release:
The annual assessment of hunger and homelessness conducted by The U.S. Conference of Mayors found continuing growth in the demand for emergency food and housing in 25 cities whose mayors are members of the Conference’s Task Force on Hunger and Homelessness. Not surprisingly, unemployment and poverty lead the list of causes of hunger cited by officials in the survey cities; lack of affordable housing, poverty, and unemployment are seen as the main causes of homelessness. … Emergency kitchens and food pantries in nearly all of the cities had to reduce the quantity of food a client could receive during a food pantry visit or in a meal at an emergency kitchen. In fact, lack of resources meant people had to be turned away in need in nearly 90 percent of the cities. On the homeless front, 60 percent of the cities said they saw an increase in the number of people experiencing homelessness; across the cities, the increase averaged seven percent. ….

Room for Debate: Should Social Security Cuts Be on the Table? (5 essays)

Source: New York Times, January 2, 2013

Leave It Alone; It’s Irrelevant To The Deficit By Dean Baker, Center For Economic And Policy Research
Social Security, with its own revenue, is totally separate from the budget. Our large deficits were caused by the collapse of the housing bubble.

Act Now To Prevent Future Debt By Alice Rivlin, Former Federal Budget Official
Modest adjustments would prevent an increase in debt as revenue from workers continues to fall short of what’s needed to pay benefits.

No Need To Cut The Little That Recipients Get By Jeff Madrick, Roosevelt Institute
A modest increase in payroll taxes and a slight rise in the incomes covered by those taxes will largely take care of any future shortfall.

Major Changes Are Needed By Andrew Biggs, American Enterprise Institute
Raising the retirement age and other measures would guarantee the program’s solvency and ease our debt burden.

Too Important To Ignore By Alicia H. Munnell, Center For Retirement Research
Fear for the system’s future, as outlays are projected to exceed income, leads many to retire early, with reduced benefits.

Book Review: AFSCME’s Philadelphia story: municipal workers and urban power in the twentieth century

Book by: Francis Ryan, Philadelphia, Temple University Press, ISBN 143990278X, 2011
Review by: Joseph Hower, Labor History, Vol. 53 no. 4, November 2012
(subscription required)

From the revelation in January 2010 that government employees constituted a majority of all union members in the United States to the political campaigns to curtail union rights in Wisconsin, Ohio and other states, few issues have commanded as much attention in the past two years as public sector union power. Francis Ryan’s AFSCME’s Philadelphia Story thus comes at a key time. A revised doctoral dissertation, the book is part of a welcome recent surge in interest in public sector labor history. But it is much more than a local study of the American Federation of State, County and Municipal Employees (AFSCME). As the subtitle implies, the book is also self-consciously a work of urban history. The evolving relationship between the union and the city is Ryan’s central analytical thread….

Compensation of Foreign and Domestic Nurses in the US

Source: Richard McGregory, James Peoples, Journal of Labor Research, December 2012
(subscription required)

From the abstract:
This study tests the union skill homogeneity hypothesis by examining whether the erosion of foreign-domestic wage differentials reported in past studies varies by union status. We argue that the common practice of unions negotiating standardized wages promotes skill homogeneity that allows high credential-low unmeasured skill foreign nurses the opportunity to receive wages that match high credential domestic nurses without foreign nurses relying heavily on their labor mobility. Findings show returns to domestic experience accrue faster for foreign nurses belonging to a union compared to returns for non-union foreign nurses. In general, findings on pension coverage indicate foreign nurses also benefit from belonging to a union, while findings on employer sponsored health care benefits indicate a lack of any notable differences in the receipt of this compensation by foreign and union status.

Retirement Costs For Defined Benefit Plans Higher Than For Defined Contribution Plans

Source: U.S. Bureau of Labor Statistics, Beyond the Numbers, Pay & Benefits, Vol. 1 No. 21, December 2012

Beginning in the 1980s, a dramatic shift occurred in employer-sponsored retirement plans. This shift was away from traditional defined benefit plans and towards portable defined contribution plans, such as the popular 401(k). Reasons for this shift were due, in part, to costs and flexibility for both employers and employees. Employer contributions required for defined benefit pension plans can fluctuate based on plan investment returns. By comparison, employer costs for defined contribution plans are often based on a fixed formula that matches employee contributions.1  According to the Bureau of Labor Statistics (BLS) March 2012 Employer Costs for Employee Compensation (ECEC), private industry employers now spend more per employee hour worked for defined contribution plans than for defined benefit plans.2  However, a slightly different picture can be revealed when ECEC data are averaged by plan participants only (those employees that use or are enrolled in a plan).