As of this writing, Southern California is in the midst of a Grocery Workers’ Union Strike. Von’s, Ralph’s, and Albertsons are all affected. Managers and scab workers are attempting to keep the doors open. Specialty grocers and other competitors are experiencing a small windfall, as shoppers choose to patronize the fully stocked stores with no picket lines out front. The strike is not isolated to California, but has spread to workers in West Virginia, Ohio, and Kentucky. Votes are being held in other states, such as Indiana and Missouri. Nevada workers are choosing to stay at work. The strike is already having an economic impact on the companies involved.
The biggest single issue in all these strikes is Health Care Insurance, specifically what percentage of the cost should fall to the employee. Some of you probably know my opinion of insurance, and health insurance in particular: it drives up costs. Health insurance is doubly inflationary because it adds at least 2 middlemen. Yet it has become a necessary evil.
The Grocers and their unions are not the only ones struggling with this issue, either. There is also a Transportation Union strike in Southern California. There has been an attempted “sick out” of Los Angeles area law enforcement officers. Clinic workers and steel workers in Duluth are considering a strike over the same issue. Even states are having to address this issue. When people from all over the country from various walks of life agree something is a problem, from California to Minnesota to West Virginia, you may be assured that it is a problem.
Nor is this a problem isolated to large businesses. Small businesses and the self-employed are even harder hit by rising healthcare insurance costs. These people — the true backbone of lasting growth in the American economy — are being forced to consider drastically cutting or even eliminating benefits. Or closing up shop and getting a “real job” that provides benefits.
There have been many proposed solutions to the interrelated problems of rising healthcare costs, rising insurance costs, rising out-of-pocket costs, the 43 million Americans with no health coverage whatsoever. They range from expanding government programs that provide health coverage to children to adopting a single payer system. A few believe healthcare costs can be reigned in by streamlining the system and demanding efficiency. Some believe that simply offering choices — telling employees that if they want the best care money can buy it is as simple as paying for it — market forces will drive down the cost of care. This seems like exactly what companies like Kroger and Safeway are trying to do, without success. Some even believe that capping the amount of money malpractice insurers have to pay will be the magic bullet that sets everything right by stabilizing the doctors’ cost of doing business.
While many consider the lack of insurance to be the biggest problem, I tend to see insurance itself as the biggest problem. I therefore think that one of two extremes is the solution: either provide basic and necessary healthcare services as a single payer system, where consumers are free to purchase additional coverage; or eliminate employer provided health insurance altogether.
That sounds radical, doesn’t it?
It would be accompanied by rules saying that insurance companies had to treat all insureds in a given area as a single group, and maybe replacing the corporate health insurance tax break with an individual tax break — the line already exists on the 1040. Wage scales would also have to be initially adjusted upward substantially to account for the shift in responsibility. Let’s do the thought experiment and think about what might happen.
Unless you have made COBRA payments or purchased an individual policy, you probably have only the haziest idea what health insurance costs. That’s because most people have coverage partially subsidized by their employers, who in turn have it partially subsidized by a tax break. So sure, a lot of people would drop coverage when confronted with what policies actually cost. However, insurance companies would very quickly get wise to the idea that they have to do something to keep policies quickly or watch their revenues be decimated. Low cost major medical policies would be all the rage in short order, covering medical emergencies of all types but not necessarily every runny nose.
The people who work in your doctor’s office would no longer have to deal with insurance companies every minute of the day, and could concentrate on their primary customer: you! The reduced paperwork means your doctor might actually make more money while reducing the cost of an office visit. This benefits even those with no insurance at all. Hospitals would still have to deal with insurance companies, or course.
Corporate America would even benefit, because no money would be sucked off to ever-increasing health insurance premiums. They would still have to raise incomes, but they still stand to profit on this “outsourcing” of responsibility. Wall Street will love the initial profit increases, and the reduction of uncertainty.
It will never happen, but it was an interesting thought experiment.