In the vast middle ground—where many members of organized labor find ourselves—it seems clear that even families who are satisfied with their current insurance coverage are concerned about rising costs, or finding out that medical expenses that were covered yesterday are now their personal responsibility.

"There's a consensus among the members," says Phoenix Local 640 Business Manager Dean Wine, "that something needs to be fixed."

Fixing skyrocketing costs, expected to double by 2016, is at the heart of health care reform, says Dan Gardner, International Representative, Political and Legislative Department. The medical insurance industry—whose executives profit from price inflation—is pouring millions of dollars into advertising to "confuse and scare people," says Gardner. "So it's more important than ever for union members to get clearer on what change needs to look like."

Orlando, Fla., Local 606 organizer Larry Kidd believes that reform also has to address the needs of 47 million Americans, including 8.7 million children, who lack affordable health care insurance. It's not just a moral issue. Research studies show that premiums for employer-provided family coverage are inflated by $1,000 to cover care for the uninsured.

Kidd regularly reaches out to workers at nonunion electrical shops who receive no health care benefits from their employers, creating a competitive disadvantage for signatory contractors who contribute $5 per hour to health care and pensions. "It also shifts the burden for covering some of the uninsured onto taxpayers," says Kidd, who is concerned about Local 606 members who are on the bench paying exorbitant COBRA payments to continue their health care coverage while trying to survive on one of the nation's lowest unemployment insurance payments.

By requiring all employers to pay into a fund to cover uninsured workers ("play or pay"), another proposal in health care reform legislation, the playing field for costs between union and nonunion contractors will be more level, says Kidd.

Rising health insurance costs for domestic manufacturers versus their overseas competitors put a drag on our nation's economic recovery. And real pain is spreading as plants have shut down and workers are forced to choose between meals, housing and health care insurance.

In Cochran, Ga., outside of Atlanta, 550 members of Local 1132 who produce lighting fixtures at Acuity Brands know that with every open enrollment period to choose their health care, they will be facing rising costs. Business Manager William Hill has heard about more paycheck garnishments than ever before. Some folks are in financial trouble, he says, because of health care costs.

While reform's opponents label a proposed "public option" for health care insurance another step toward "socialized" medicine, members like Christy Miller, a member of Bellefontaine, Ohio, Local 1691, see it as a potential life line.

Miller, who worked for 19 years assembling electrical breakers at Siemens' Bellefontaine plant, lost her job in March as the company shifted production to Mexico. She will receive eight months of health care insurance before being forced to pick up the cost of COBRA coverage. "In my mind, I should then be able to be covered by a public plan," says Miller, age 50, who is now entering a two-year training program to be a medical administrative assistant. "Maybe [on my new job] I can help older people comprehend their health insurance options," she says.

A public option, says Gardner, could provide immediate help to workers like Miller, but it could also help employed workers by establishing healthy competition for insurance companies, driving costs down and improving quality. Among the beneficiaries would be IBEW members in the utility industry—many of whom work for highly profitable companies but already pick up 20 percent of the cost of their health care insurance.
"Health care reform can't wait," says International President Edwin D. Hill. He says rising costs and lack of access hurt our union and our nation's economic future. "Whether we're talking about a public option, ‘play or pay,' or cutting off legislators at the pass who want to tax our hard-won health care benefits, we need to get active." That means talking to friends and family members and contacting elected officials, says Hill.