By Jonathan Starr
If public opinion polls alone determined political outcomes, we would have single-payer public health insurance already, or at least some “robust public option.” But, unfortunately, some political actors have more influence on policy decisions than others.
Experience has shown that business leaders have exceptionally strong influence on legislative decision making. As such, pursuing the support of business leaders for single-payer health insurance could greatly advance its chances for implementation.
Fortunately, there are good reasons why businesses could benefit from single payer. Providing health insurance to employees is a substantial financial and administrative burden, especially for companies with large numbers of employees. In contrast, competitor companies from countries that already have single-payer health insurance are free of this disadvantage. Meanwhile, startups and small businesses find it particularly difficult to obtain health insurance at reasonable rates, especially upon annual renewal if an employee has begun drawing substantial amounts of benefits.
Consequently, having health insurance publicly and universally provided could be a huge boon to business viability, competitiveness, and profitability.
There is evidence of increasing recognition of this in the business community. For example, the new president of Health Care for All Pennsylvania is a Republican business owner named David Steil. He commented, “My commitment to a single-payer health care system has its roots in my 35 years of experience at the senior management level in several manufacturing companies. We must solve the health care dilemma if our businesses are going to compete in the international marketplace.”
The rising cost to employers of providing employee health insurance is an increasingly frequent topic of the business-related press, from the Wall Street Journal to online blog entries. Here in Silicon Valley, I am in communication with policy staff of a large and influential business-membership organization that is initiating preliminary evaluations of the business advantages/disadvantages of single payer.
The appeal of single payer to businesses will depend heavily on how such a program is financed. As I have argued here, supporting single payer through progressive corporate and individual income taxes, scaled by ability to pay, should be much more appealing to businesses (as well as to individuals) than using payroll taxes. And, bills that attempt to apply special financial burdens to particular areas of commerce (e.g. H.R. 1068, which would impose an excise tax on securities and commodities transactions) have been politically stillborn. A fair, reasonable, and viable financing mechanism will be critical to gaining business community support.
Gaining the support of some significant portion of the business community for single-payer public health insurance could make the political difference towards getting such a program enacted. Interest in the potential financial and competitive advantages of single payer for businesses seems to be increasing. As such, advocates for single payer could advance the cause by pursuing new, effectively designed outreach to the business community.
Jonathan Starr resides in Santa Clara, Calif.
