Healthcare costs are rising at an unsustainable pace, and union leaders are on the front lines of trying to manage the fallout. From skyrocketing specialty care expenses to the hidden complexities of negotiated rates and facility fees, the system is becoming harder to navigate—for both members and the funds that support them. At the same time, unions are being called to innovate, ensuring their members not only have access to care but can actually use the benefits they’ve earned.
That’s where Lindsay Leeder comes in. As Senior Vice President of Labor Union and Trust at Lantern, she’s helping labor funds tackle one of their biggest challenges: delivering high-quality, cost-effective specialty care. On a recent episode of the America’s Work Force Union Podcast, Leeder joined host Ed “Flash” Ferenec to break down what’s driving healthcare inflation, how unions can take back control, and why a concierge-style approach to care navigation is making a difference.
Leeder brings a unique perspective to the table. A former family nurse practitioner turned healthcare executive, she’s seen the system from both the bedside and the boardroom. “I was seeing 30 patients a day and not really knowing where to send them when they needed a specialist,” she recalled. “Why is it so expensive and confusing?”
Increasing Healthcare Costs—What’s Going On?
Per-member, per-hour cost of benefits for union members has surged. In one example, that number has increased 91% since 2004 for a group of unionized workers in California. A major culprit is healthcare consolidation, Leeder says. “Certain groups are making money off of procedure volume,” she explained. “If financial incentives aren’t aligned, then a lot of costs can rise.”
Another issue? A shortage of primary care doctors. “When you don’t have access to preventive care, people end up needing higher-cost services,” she said. “We’ve lost that family doctor who could handle multiple issues in one visit.”
Specialty Care: The Hidden Giant
Specialty care—think surgeries, infusions and cancer treatments—accounts for a staggering 50% of healthcare spending, even though only 8–12% of members typically use it. “It’s high-cost, impactful procedures for a very small number of individuals,” Leeder noted. “And we’re all paying for it.”
She emphasized that most health plans negotiate rates that include not just the procedure, but also facility fees, no-shows and other overhead. “That $44,000 knee surgery? The surgeon might only get $2,000,” she said. “The rest is covering everything else.”
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How Unions Can Take Control of the High Cost of Specialty Care
Leeder is passionate about working with unions to design smarter, more accessible benefits. “Benefits matter in a way that’s more important for union members,” she said. “These are people who commit their lives to a trade, often because of the benefits.”
Lantern’s approach is all about connection and coordination. “We make sure members get to excellent doctors, that it’s a concierge experience, and that we save them money in the process,” she explained. “Great benefits don’t matter if no one uses them.”
Leeder highlighted partnerships with unions like 32BJ SEIU and the National Railroad Health and Welfare Plan, which collectively serve hundreds of thousands of members. “We were really intentional in making sure care is accessible—98% of our members can drive to care,” she said.
We were really intentional in making sure care is accessible—98% of our members can drive to care.
Looking Ahead: A Commitment to Helping Unions
Despite the challenges and high costs of healthcare, Leeder remains hopeful. “I’ve been in healthcare a long time, and I’ve thought many times, ‘It can’t get harder.’ But it does,” she admitted. “Still, I’m really committed to providing this opportunity to every fund in the country.”
Her message to union leaders? “Don’t get tired. Keep working. You’re in a position to do some really innovative things.”
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