Matt Miller - The Archives
Time To Scrap Employer-Based Health Care
Public radio's "Marketplace", May 11, 2009
The idea that we should look to our company, not our country, for health care, makes no sense.

Tess Vigeland: If you're lucky enough to still have a job in this economy, it's not only where you're getting your paycheck, but also your health insurance. We heard earlier from John Dimsdale about the health industry's offer to cut $2 trillion in costs over the next 10 years. Commentator Matt Miller says that while health insurance is obviously essential to financial security, the uniquely American idea that employers should provide these benefits is an idea whose time has passed.

Matt Miller: GM spends more on health care than on steel, and it's going broke. Starbucks spends more on health care than on coffee, and its business is reeling. Corporate America spends more on health care than it earns in profits. And health costs have soared from 5 percent of GDP in 1960 to 17 percent today. Is it any wonder companies are slashing health benefits? The press usually moans about this, as if firms were doing something awful. And the impact on families surely is. But the larger truth is this: while having health insurance is crucial, it's time we stopped looking to our companies instead of our country to help us obtain it.

No one else does, after all.

America is the only advanced nation that operates much of its welfare state through corporations. This may have made sense 50 years ago, when medicine was cheap, a single breadwinner worked at a big company for 35 years, and American business dominated the world economy so that companies could pass on, through higher prices, the cost of much of the country's safety net. But those days are gone. Today people switch jobs 10 times by the age of 40, and sky-high health costs make U.S. firms uncompetitive. Meanwhile, our archaic link between jobs and health care helps explain why 50 million people are uninsured, with millions more just a pink slip away from medical bankruptcy.

It's time we faced up to the fact that it would be better for business and for workers to shift the burden of health care from business to government. This doesn't mean we'll turn into France or Sweden or Canada. There are market-friendly ways to do this. Government could provide a voucher with which families could buy group coverage from among competing private plans. Lower income folks would get bigger subsidies. This is exactly how they do it in Switzerland and Holland; Massachusetts is pioneering such a system here.

None of this means business would be "walking away from the problem." But the capitalist mind will need a little rewiring. Linking health care to jobs is a dead idea, one of those old way of doing things that doesn't make sense in a 21st century economy.

Tess Vigeland: Matt Miller is a senior fellow at the Center for American Progress and author of the new book, The Tyranny of Dead Ideas.