Sunday, December 14, 2003
National health-care anarchy isn’t serving Americans well
By Froma Harrop
Providence Journal columnist
The next person to call me liberal for advocating a national health plan is in for a tongue-lashing – or I’ll just hand him a copy of this column. What we have now is anarchy. We have government plans, private coverage, no coverage, not enough coverage. There are untreated illnesses, overtreatment, too many pills, pills that cost too much, federal regulators and state regulators.
It happens that the best arguments for universal coverage with a strong federal hand are conservative ones. But conservatives are the last ones to make them. Or, to be more accurate, Richard Nixon was the last conservative to make the case, and that was a long time ago.
Why should conservatives support making health insurance primarily a federal responsibility?
For starters, it would help American business. Asking America’s employers to pay for their workers’ health care makes no sense. Why not ask them to pick up their employees’ supermarket tabs or dry cleaning bills, as well?
The practice started during World War II, when the government froze wages. Factories desperate for workers offered health benefits instead of pay raises. The idea grew, and that’s why today’s employers are funding our allergy shots and heart bypasses.
Many also cover lots of hangers-on – workers’ spouses, children and domestic partners. About two-thirds of Americans younger than 65 now obtain coverage through someone’s employer. And some generous companies cover their retirees, also. General Motors, for example, now pays the medical bills of one-half of 1 percent of all Americans.
Businesses also end up paying for the uninsured. Because law requires hospitals to treat every comer, people without coverage go to hospitals for their medical needs, major and minor. Many don’t pay their hospital bills. Hospitals offset these losses by raising fees for paying customers – that is, the insured. The upshot is higher premiums for employers.
The system burdens America’s businesses in other ways. Companies must hire people just to administer their workers’ medical benefits. And the employer that spends money on good benefits is put at a competitive disadvantage to companies that do not. Health care raises its labor costs.
Our employment-based health-care system costs jobs: Health costs have spurred U.S. companies to move their operations elsewhere. For example, American automakers like making cars in Canada, because the Canadian government pays for medical care.
The cost of insuring workers makes companies wary of hiring more people. When business heats up, they prefer asking current workers to put in more hours. That’s because paying time-and-a-half wages is often cheaper than providing an expensive health-care package to a new worker.
There are strong “family values” arguments for universal coverage. Social conservatives want mothers to stay home with their young children. I know several young mothers who would do so, were it not for the health-insurance problem. They have husbands who work – but in jobs lacking family coverage. These families can plan for a year or two of a parent’s lost wages. But they won’t risk having a family member come down with a serious illness requiring $100,000 worth of medical care and no coverage.
It’s time to shatter several myths about a national health plan. One is that it must be a restrictive single-payer program, like Canada’s. The systems in France and Germany combine a basic government guarantee of coverage with the option of buying fancier care through private insurance.
Another myth is that a national health plan would be expensive. Actually, it would save the U.S. economy money. Our muddled system sends administrative costs skyrocketing and wastes medical resources. As a result, the United States now spends 14 percent of its gross domestic product on health care, versus the 11 percent spent in Germany and 10 percent in France.
A third myth is that workers don’t pay for company health benefits. They do. Money that their employer spends on their health coverage comes out of their paychecks. Without that expense, employers could raise salaries.
So let’s free the American corporation! Let Acme Widgets make widgets and not worry about its foreman’s asthma condition. Let’s free the American mother (or father) to stay at home with the kids and not have to work just for health coverage.
Today’s health-care system offers neither a liberal nor a conservative vision. It’s anarchy, pure and simple.
Froma Harrop is a Providence Journal columnist. Contact her by writing to
fharrop@projo.com.