Horse-and-Buggy Health Coverage

As a union member and leader who has walked countless picket lines, sat at numerous bargaining tables and even been arrested for standing with workers struggling to win or maintain health insurance, it's time to admit the simple truth: The era of employer-based health care is rapidly becoming extinct.

Sure it's still breathing in some places, but the system is on life support, and we can't wait for the patient to die before we do something about it.

Forty-five million Americans are uninsured, 35 million of whom are working. Millions more are underinsured. Costs are exploding, coverage is eroding, the majority of businesses are cost-shifting, and many working families are one serious illness away from bankruptcy.

It's a disgrace that in the 21st century in America, we still have so many people who get sick and die - not because their illnesses aren't treatable, but because they are too poor to see a doctor.

That's why today, in the op-ed pages of the Wall Street Journal, I proposed an unlikely partnership with top leaders to face down this problem.

I called upon this powerful, influential group to come out of hiding, take a stand, and join me to help build a new, modern and uniquely American system that covers everyone - affordably.

But I was not addressing the 535 members of Congress. Politicians in Washington, who, rather than doing something, shortsightedly debate incremental stop-gap measures that won't fix the problem.

Instead, I issued a challenge to the Fortune 500 - the guys in grey suits who privately lament that our health care system has collapsed and long to get rid of it. The guys who wince every time their HR director comes around with the quarterly report showing health care costs rising.

Those skyrocketing costs even prompted McKinsey Quarterly to recently predict that soon the "average Fortune 500 company may be spending as much on health benefits as it earns in profits. Something's got to give."

So I keep asking: Where are the CEOs? Where are the innovators, the inventors, the visionaries who propel American business? What are they afraid of?

Imagine if a group of CEOs had the courage to join a labor leader to call for an end to the employer-based health care system, and instead build a structure in which government, business, and individuals all affordably contribute their fair share. If they joined with labor and policy experts to develop something new, our elected officials would be forced to take note, and we could establish a new blueprint for America that covers everyone, controls cost, offers choice and promotes preventative care.

It can be done. Look at Vermont or Massachusetts. Or the insurance offered to federal employees with its affordable multi-payer system and wide range of options in private plans.

Unless U.S. employers find the political will to explore real solutions that help their businesses and our workforce benefit from today's economy, giant companies like GM will be the latest - but by no means the last - casualty of an ailing, 20th century system that America never got around to fixing.

The country is waiting for a true story of leadership. That happens when Wall Street unfastens the cuff links, rolls up their sleeves, and gets in the game