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	(First in a two-part series on health care issues in North America)

Santa Rosa, California, Local 551 health and
welfare fund trustees had two choices and both
of them were bad. With health care costs mounting,
they had to convince members to voluntarily
sacrifice an additional $2.05 hourly out of their
checks, about $4,600 a year, or face a cut in benefits,
starting with retiree health care.

A month later, a special meeting revealed a split in the membership along generational linesthe younger workers struggling to make ends meet in a difficult economy versus their older, more health care-dependent counterparts. In the end, by one vote, the membership voted to keep their benefits and cope with a significant hit to their paychecks.

"Its very ugly and it doesnt seem to be getting any better," said Steven Benjamin, former Local 551 business manager, who said the bitter feelings over the premiums caused him to decide against running for a second term. "If something doesnt change here pretty soon, our trust is in serious jeopardy. Our wages have been stagnant for four years. Most of the money is going to the health and welfare plan because thats where it needs to go."

There is nothing unique about the predicament faced by Local 551. The same agonizing choices are being made by locals, multi-employer trust funds and businesses across the country.

Today It Costs Approximately $9,000 a year for a family health care plan in the United states. in six years, that cost is on track to double. within 12 years, if the present situation continues, a family health insurance Plan will cost $36,000 a year.

Health Care
Conditions Critical

A looming health care crisis is the elephant in Americas living room, growing bigger and more menacing every day. Health care spending in the United States, already the highest in the world, will soon double to more than $2.6 trillion, the National Coalition on Health Care (NCHC) estimates. Gobbling up more and more of the gross national product, runaway health costs threaten to drive the United States back into unsustainable deficits, the General Accounting Office says.

As health insurance premiums rise at five times the rate of inflation, health care represents the single biggest issue in labor negotiations today. Whether its coverage provided by employers or multi-employer construction benefit funds, no IBEW member remains untouched by this crisis.

Good benefits, which have always been a hallmark of union membership, are threatened by the disintegrating system. Several high-profile strikes have centered on health care costs, including the recent five-month action by California grocery workers. Negotiators in every branch of the IBEW have struggled with the health care crisis and are bracing for tough talks to come.

"Its no longer a choice," said IBEW International President Edwin D. Hill. "The United States failure to address this catastrophe-in-the-making has only served to feed the beast. The future of our country depends on whether we find the collective strength and will to seek a bold national solution to this problem."

Today, it costs approximately $9,000 a year for a family health care plan in the United States. In six years, that cost is on track to double. Within 12 years, if the present situation continues, a family health insurance plan will cost $36,000 a year.

Every day, as the ranks of the uninsured increasecurrently 43 million and countingthose with coverage pay a larger and larger share while earning fewer and fewer benefits. The overwhelming majority80 percentof those without coverage comes from working families.

With jobs in short supply, particularly in places hit hard by a new wave of global outsourcing, and rising inflation and gasoline prices making everyday necessities even more expensive, IBEW members and all workers have been on the losing end of the equation across the country.

From One Crisis
to Another

About 330,000 of the IBEWs 750,000 active members work in the construction branch, where health benefits are usually administered by labor-management health and welfare funds with contributions from both workers and participating contractors. As partners in the operation of the multi-employer plans (also called Taft-Hartley plans), union leaders play an active role in fund management.

Leland Butler, plan administrator for Local 995s health and welfare fund, faces tough choices every day.

"Our experience has been almost from one crisis to another within the past three or four years," said Leland Butler, plan administrator for Local 995 in Baton Rouge, Louisiana. "We put in strict controls, increased deductibles and out-of-pockets but if we have a run of real sick people or accidents, then were dead in the water. It doesnt take much to bust a fund."

The hurdles are no less severe in other industries where health care is administered by employers (single employer plans). For example, telecommunications members employed by AT&T, Verizon and SBC have been forced to assume a greater share of health care costs while enduring cutbacks in benefits. Pressure by nonunion competitors has caused IBEW-represented companies to scale back on spending, particularly on retiree health care.

Even good pension plans are not enough to assist retirees whose health care benefits have been slashed, said Telecommunications Department Director Martha Pultar.

"If you are a telephone operator who retired in 1992 and your pension is $700 a month, you cant afford to be paying $600 monthly premiums," Pultar said. "Were going to be going back to the days when seniors are eating cat food to survive. Thats what weve been up against at the bargaining table for several years."

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