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News & ArtsWednesday, February 3, 2010
Politics Our Health Care System Is Bad for Business
Posted by Dan Savage on Wed, Feb 3, 2010 at 7:59 AM
McJoan at DailyKos:
In a call with progressive media yesterday afternoon, House Speaker Nancy Pelosi reiterated her determination, in no uncertain terms, to keep pushing to pass comprehensive healthcare reform. (Crooks and Liars has the audio.) Pelosi referred to healthcare reform as "first among equals" in Democratic initiatives to create jobs, stressing that it's a major competiveness issue for the United States, and that our current system hampers job growth and entrepreneurship.
This is what I've never understand about the health care debate: why aren't Democrats—from the president on down—constantly hammering at this point? Our employer-based health care system places a huge burden on American businesses and makes US companies less competitive and makes the US a less attractive place for multinational corporations to do business. Sitting on an airplane at the moment so no time to Google it up, but I recall that a few years ago a major foreign automaker opted to build a new North American auto plant in Canada, and not a US state, because the company didn't want to take on the costs of administering and providing health care benefits for its employees. And so long as health care is tied to employment, as it is in the US, someone who might want to start a new business—a new business that could create desperately needed new jobs—can't strike out on his or her own so long as quitting the current job means losing your families' health care coverage.
Our health care system is insane. It bankrupts and kills people, which offends liberals, and it hurts businesses and stifles entrepreneurship, which should offend conservatives... but somehow doesn't.
1
I've always wondered why this argument isn't put forward more myself. This is America, where entrepreneurship is encouraged, and yet it's accepted that businesses should carry the enormous health care burden. I called b.s on that when I was, like, 12 years old. It's so obviously unfair to me.
2
I'm in this trap right now. My COBRA runs out soon, and there is nothing I could possibly afford to follow it up, and benefitted jobs are pretty much unavailable to me. So I guess it's bankruptcy and sleeping in a friend's basement whenever my next (and final) serious illness occurs. God Bless America.
3
Conservatives aren't really interested in small biz or entrepreneurship. They're interested in protecting the interests of enourmously powerful corporations. They just say they care because most Americans are stupid enough to believe it. If republicans/conservatives had any shred of a soul, the US would have had health care reform years ago. They don't.
5
The problem is that it's not black and white. Trade patterns are based on comparative not absolute advantage, and our health care system simply alters our comparative advantage so that we are relatively more competitive in industries made up by large firms with employee turnover. We are realtively less competitve in industries made up by small firms with employee cohorts that are more fixed over the long run.
E.g. Microsoft, lots of young people coming in the door every year, big firm - very competitive. A stamping plant in Sterling Heights MI with a fixed and aging cohort and already expensive medical coverage with an ever incraeasing cost, not so competitive.
The problem is that when you have winners and loser the winners have no interest in change, and in this case many of the loser don't have much political clout. Big firms mean big politics, and so the relative winners inordinately influence the political scene to maintain the status quo.
E.g. Microsoft, lots of young people coming in the door every year, big firm - very competitive. A stamping plant in Sterling Heights MI with a fixed and aging cohort and already expensive medical coverage with an ever incraeasing cost, not so competitive.
The problem is that when you have winners and loser the winners have no interest in change, and in this case many of the loser don't have much political clout. Big firms mean big politics, and so the relative winners inordinately influence the political scene to maintain the status quo.
7
Great post, Dan. It's also a sign of the vapidness of the Washington media that they've parroted the Republican talking point that we should focus on jobs instead of health insurance when they are really one and the same.
You see the same chutzpah factor when the Republicans say the president should focus on deficits instead of health insurance when the biggest driver of long-term deficits is Medicare and Medicaid.
Barack Obama and Nancy Pelosi are interested in governing. The Republicans are interested in spouting talking points that fall apart at the slightest examination. And hey, good for them. They have every right to. The Republicans know damn well that most of the media and public don't do the slightest examination.
You see the same chutzpah factor when the Republicans say the president should focus on deficits instead of health insurance when the biggest driver of long-term deficits is Medicare and Medicaid.
Barack Obama and Nancy Pelosi are interested in governing. The Republicans are interested in spouting talking points that fall apart at the slightest examination. And hey, good for them. They have every right to. The Republicans know damn well that most of the media and public don't do the slightest examination.
8
@ 5 - If I'm not mistaken, Microsoft avoids providing health insurance by declaring a large portion of their workforce 'private contractors'.
9
There's another group that should be ashamed here, and that's unions. The biggest win we could achieve for American labor in this whole debate is to gradually decouple employment and health insurance, or at least shift compensation from benefits to $$$. And yet, the unions have fought the excise tax on health benefits.
A classic case of an interest group's narrow self-interest preventing them from seeing the forest for the trees.
A classic case of an interest group's narrow self-interest preventing them from seeing the forest for the trees.
10
Republicans/conservatives/teabaggers ARE interested in helping small businesses and do want to keep jobs in the U.S.
The problem is that they're MORE interested in scorched-earth politics than anything else.
The problem is that they're MORE interested in scorched-earth politics than anything else.
11
The health care "reform" that our country needs is addressing why we spend so much on health care for so little result.
The past year has been wasted trying to find more money to pour down the existing rathole.
Addressing the core problem will require addressing the way hospitals/doctors do their thing, but more importantly and difficultly will require addressing Americans' health and lifestyle choices and their expectations about healthcare and where responsibility lies.
The current assumption, that people can live however they like, and when they inevitably get sick (diabetes, heart disease, AIDS- fill in the blank...) their illness is just something that randomly fell from the sky and they had no control or responsibility for it and it is their "Right" to the best health care (someone else's) money can buy and it is the responsibility of "Society" to see that they get it.
Financially that model is not sustainable. Allowing Obama to throw 50 million more people into the hopper of people "someone else" is footing the bill for is not the answer.
Someone has to have a frank unpleasant talk with the American people.
Obama and the Liberals have shown no clue that they even get what the core problem is, let alone are willing to tackle it.
So don't get your hopes up.
The past year has been wasted trying to find more money to pour down the existing rathole.
Addressing the core problem will require addressing the way hospitals/doctors do their thing, but more importantly and difficultly will require addressing Americans' health and lifestyle choices and their expectations about healthcare and where responsibility lies.
The current assumption, that people can live however they like, and when they inevitably get sick (diabetes, heart disease, AIDS- fill in the blank...) their illness is just something that randomly fell from the sky and they had no control or responsibility for it and it is their "Right" to the best health care (someone else's) money can buy and it is the responsibility of "Society" to see that they get it.
Financially that model is not sustainable. Allowing Obama to throw 50 million more people into the hopper of people "someone else" is footing the bill for is not the answer.
Someone has to have a frank unpleasant talk with the American people.
Obama and the Liberals have shown no clue that they even get what the core problem is, let alone are willing to tackle it.
So don't get your hopes up.
12
Republicans want businesses to be more competitive by having those businesses give up all benefits packages while also vastly decreasing employee wages. Keep 'em poor, stupid, and afraid, and you'll have majority rule forever. At least that's what Republicans assume.
13
Great post, but...
"Sitting on an airplane at the moment so no time to Google it up"
Hopefully, you're blogging only after you've made a mental note of where your nearest exits are. Remember, studies show folks have 90 seconds to evacuate an aircraft. Not a lot of time. Got to be ready to go and know where you're going.
People who are too stupid to know beforehand where the exits are and cause confusion during an evacuation are way more annoying than the nail polish lady you blogged about.
"Sitting on an airplane at the moment so no time to Google it up"
Hopefully, you're blogging only after you've made a mental note of where your nearest exits are. Remember, studies show folks have 90 seconds to evacuate an aircraft. Not a lot of time. Got to be ready to go and know where you're going.
People who are too stupid to know beforehand where the exits are and cause confusion during an evacuation are way more annoying than the nail polish lady you blogged about.
14
@11 I think I might be a little in love with you.
Health care reform starts in the HOME.
I had a woman tell me before Christmas that under no circumstances did she want the government telling her what she could and couldn't have in terms of healthcare. She comes from a family that has had almost every member have stomach/pancreatic cancer, and she wants all advance screening possible. She tells me this as she smokes a cigarette. I then needed medical care as my tongue was bleeding from biting it so hard.
Health care reform starts in the HOME.
I had a woman tell me before Christmas that under no circumstances did she want the government telling her what she could and couldn't have in terms of healthcare. She comes from a family that has had almost every member have stomach/pancreatic cancer, and she wants all advance screening possible. She tells me this as she smokes a cigarette. I then needed medical care as my tongue was bleeding from biting it so hard.
15
Sorry, but it much cheaper if neither companies nor the government have to provide insurance, and people just get sick and die. That saves large corporations money on health insurance and taxes! More for bonuses!
16
Conservatives aren't against healthcare reform. They're against healthcare reform that involves government provision of healthcare services and/or insurance. They want to see an end to employer-based health insurance as much as Democrats do, but they want to achieve it through different means, like tort reform, nationwide insurance competition, and individually-purchased insurance. They have a different economic ideology, which means that the means by which they want to achieve their goals are different than those with a liberal ideology, even if the goal - reform and improvement of our healthcare system - is the same.
Don't make the mistake of falsely dichotomizing everyone, and assuming that because they oppose one thing you stand for, they are the root of all evil. It shows a complete lack of understanding of the workings of the political process.
Don't make the mistake of falsely dichotomizing everyone, and assuming that because they oppose one thing you stand for, they are the root of all evil. It shows a complete lack of understanding of the workings of the political process.
17
MsLeading @16:
And where, pray tell, in the Senate bill is there any government provisioning of health care or insurance?
Conservatives aren't against healthcare reform. They're against healthcare reform that involves government provision of healthcare services and/or insurance.
And where, pray tell, in the Senate bill is there any government provisioning of health care or insurance?
18
@ 16: you are falling for their bullshit. Conservatives have zero interest in anything other than protecting the interests of their corporate masters. Tort reform =more $ for insurance companies (think they'll lower premiums if TR passes? HA!). nationwide competion = every provider incorporating in states that favor them the most, therby narrowing provider choices. Etc
They have a different economic ideology all right. Theirs is: any obstacle to maximizing profits for corporations is anti-freedom. Liberals actually want the corps to prosper, just not at the expense of the defensless
They have a different economic ideology all right. Theirs is: any obstacle to maximizing profits for corporations is anti-freedom. Liberals actually want the corps to prosper, just not at the expense of the defensless
19
@17: The parts where the government subsidizes health insurance for low-income families, and where Medicaid is expanded. You're right, though, that's not the only reason they oppose the current reform; they also get muddled up in the abortion issue, and stuck on the issue of mandatory insurance purchasing.
But the senate bill doesn't actually do anything to reduce the strain on businesses. It doesn't do anything to reduce the burden on employers to provide insurance, and it proposes extra fees on businesses if their employees receive any government subsidies for health insurance costs. So it's ridiculous to say that conservatives don't care about businesses because they don't want to pass this health reform bill: this bill does nothing to protect businesses.
(BTW, my info source for all this is CNN, in case you want to double-check me on these facts. I've been wrong before.)
@18: I'm afraid you're falling for the bullshit, too. Just so we're clear, I disagree with the conservative perspective on this issue. But it's a mistake write off the conservative motivation for dissent as crazy, selfish bullshit. They are acting out of self-interest and priorities that lie in free market economics. That might make them wrong, but it doesn't make them slaves to corporate masters. It's counterproductive to oversimplify the position of your opponents, and it's that attitude that's responsible for the rabid partisanship in politics and the inability to ever get anything done in government.
But the senate bill doesn't actually do anything to reduce the strain on businesses. It doesn't do anything to reduce the burden on employers to provide insurance, and it proposes extra fees on businesses if their employees receive any government subsidies for health insurance costs. So it's ridiculous to say that conservatives don't care about businesses because they don't want to pass this health reform bill: this bill does nothing to protect businesses.
(BTW, my info source for all this is CNN, in case you want to double-check me on these facts. I've been wrong before.)
@18: I'm afraid you're falling for the bullshit, too. Just so we're clear, I disagree with the conservative perspective on this issue. But it's a mistake write off the conservative motivation for dissent as crazy, selfish bullshit. They are acting out of self-interest and priorities that lie in free market economics. That might make them wrong, but it doesn't make them slaves to corporate masters. It's counterproductive to oversimplify the position of your opponents, and it's that attitude that's responsible for the rabid partisanship in politics and the inability to ever get anything done in government.
20
I started a business but never pulled the trigger. I was fearful of giving up my family's 100% paid health care and the consequences if I needed it in the future.
Regrets
Regrets
21
Conservatives oppose health care either on misguided principle (because they believe everyone should have to pay their own way; no free lunches; I don't want to pay for abortions and drug addicts; etc) or cold-blooded politics (because failing to pass health care hurts the Democrats). The reality of the situation, as usual, barely makes a dent in their analysis.
22
Neither the Dems nor the GOP want to reform healthcare. They simply want to change it. The Dems want to create the largest transfer payment in the history of the world by taxing business and "rich" to pay for health care for the middle class. The GOP is playing politics at the moment. But when in power they created the largest unfunded entitlement program (Medicare prescription drugs) EVER!
The real problem is the cost side of the equation. Insurance Companies, Hospitals, Drug Companies, Malpractice attorneys and Doctors are all about collusion and price fixing. Why do you think they keep the number of Medical School positions limited? When was the last time you saw a price list on the door of a Doctor's office? Why is it cheaper to import US made drugs from Canada than it is to buy them here? Have you ever heard Obama/Bush talk about changing the Malpractice laws?
The ABA and health care industry give tens of millions of dollars a year to BOTH sides to keep the federal government from doing it's job and enforcing the anti-trust laws.
If they wanted to reform health care, create a one price rule. Services, Policies, and Products have one price. The vendor can set the price but it must be published and it must be public. If the Canadians negotiate a rock bottom price for a drug, then that is the price the people in the USA pay. If they want to give a drug away to Africa, then it is free in the USA. If a monopoly exists (i.e. Hospital), then the prices should be fixed.
But Congress and the President don't care about the people, all they are going to do is line the pockets of those that line theirs.
The real problem is the cost side of the equation. Insurance Companies, Hospitals, Drug Companies, Malpractice attorneys and Doctors are all about collusion and price fixing. Why do you think they keep the number of Medical School positions limited? When was the last time you saw a price list on the door of a Doctor's office? Why is it cheaper to import US made drugs from Canada than it is to buy them here? Have you ever heard Obama/Bush talk about changing the Malpractice laws?
The ABA and health care industry give tens of millions of dollars a year to BOTH sides to keep the federal government from doing it's job and enforcing the anti-trust laws.
If they wanted to reform health care, create a one price rule. Services, Policies, and Products have one price. The vendor can set the price but it must be published and it must be public. If the Canadians negotiate a rock bottom price for a drug, then that is the price the people in the USA pay. If they want to give a drug away to Africa, then it is free in the USA. If a monopoly exists (i.e. Hospital), then the prices should be fixed.
But Congress and the President don't care about the people, all they are going to do is line the pockets of those that line theirs.
23
@16 - I'd believe that if conservatives weren't against removing the health-care industry's anti-trust exemption. Why wasn't that in their protect-the-insurance-industry bill?
Please explain how this exemption helps the market forces that you think solve all problems? While you're at it, explain how an unregulated market prevented the recession we're in.
Please explain how this exemption helps the market forces that you think solve all problems? While you're at it, explain how an unregulated market prevented the recession we're in.
24
I always saw the health care crisis as something far more dire than our jobs problem. When someone doesn't have a job for an extended period of time they may get discouraged, they may turn to crime, they may have to do more with less, but chances are you're not going to die just because you have no job, if you're able and looking for work chances are something will come up or a government problem is able to provide you with at least the basics for life.
Health care on the other hand is a crisis, not only do people die because of lack of health care, it gets worse without treatment as time goes on. Without health coverage people get desperate, much like with a job, however the government has no safeguards in place for the middle class on health care. The suggestion touted by the republicans is to sell all your belongings and give them all to your health insurance provider until you have nothing and can seek government programs with the money you will never ever have again. Republicans want you to have more freedom, the freedom to live like a slave and die cold and alone because you couldn't afford the cancer brought on by the coal plant you live next too. Then when that person is on their deathbed the government needs to step in, ease suffering and keep them alive as long as possible per the law, sucking out money that could have been used to keep this person alive several years ago. Nothing about health care in this country makes any sense, and how anyone can defend the current system is beyond me, and they're probably just super greedy people taking the chance that their healthy. Why should they have to pay for someone else to get better, they want the freedom to ignore fellow citizens dying in the streets because they want a few extra dollars in their pocketbook, all hail the mighty dollar.
More...
Health care on the other hand is a crisis, not only do people die because of lack of health care, it gets worse without treatment as time goes on. Without health coverage people get desperate, much like with a job, however the government has no safeguards in place for the middle class on health care. The suggestion touted by the republicans is to sell all your belongings and give them all to your health insurance provider until you have nothing and can seek government programs with the money you will never ever have again. Republicans want you to have more freedom, the freedom to live like a slave and die cold and alone because you couldn't afford the cancer brought on by the coal plant you live next too. Then when that person is on their deathbed the government needs to step in, ease suffering and keep them alive as long as possible per the law, sucking out money that could have been used to keep this person alive several years ago. Nothing about health care in this country makes any sense, and how anyone can defend the current system is beyond me, and they're probably just super greedy people taking the chance that their healthy. Why should they have to pay for someone else to get better, they want the freedom to ignore fellow citizens dying in the streets because they want a few extra dollars in their pocketbook, all hail the mighty dollar.
25
Can someone Please find Evidence that "Our employer-based health care system places a huge burden on American businesses and makes US companies less competitive and makes the US a less attractive place for multinational corporations to do business." I am having this debate with a conservative friend and am scrambling to find Studies/Peer Reviewed Articles or anything to validate this point which i have read to be true. If only i would have saved all those articles i read in the past. Gerrrr... Help
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