Testimony to the Congressional Progressive Caucus, Universal Health Care Task Force, Black Caucus, and Hispanic Caucus,

May 1, 2001

Ellen R. Shaffer, PhD, MPH

Representative Bill Thomas said it in 1999: The voluntary, employment-based system of health insurance is fatally flawed.  Professor Donald Light notes that 43% of all businesses currently do not offer health insurance, and many that do are providing "Swiss cheese health insurance:" full of holes where in reality there is no coverage. 

We sat down with a group of 12 Latino janitors, who are mono-lingual in Spanish, to find out why so many unionized janitors and food service workers are uninsured.   

All the workers were working longer than a year, and not one of the twelve had succeeded in enrolling for health insurance. Employers don't take the extra steps required to assure enrollment, and in fact often work hard to evade it; and it is too hard, especially for workers who don't speak English, to understand and enforce their rights, and to navigate the system.  Getting coverage depends on the employer, often a small business subcontractor, informing the employee that he or she has become eligible, correctly filling out the enrollment forms, and paying the insurance company every month.  This had never occurred, for any of these workers. 

Every one of them had delayed getting necessary health care for themselves and their families because they could not afford it.  One man reported working for three weeks after dislocating his shoulder at work.  His manager ignored his requests for help, and the employer responded to a letter asking for medical attention by threatening to call the police.