Take That Wal Mart!

Legislators in Maryland took a novel approach to Health Care reform yesterday. Both the Senate and the House voted (registration necessary) to require that an employer with more than 10,000 employees spend at least 8% of their payroll on health care for their workers. Absent the 8% the employer must make a contribution to the state’s Medicaid program.

Apparently Wal Mart is the only company known to meet the criteria of the bill. Legislators seem fed up with Wal Mart’s corporate policy to finance “Always Low Prices” on the back of low wage associates. As many as half must take Medicaid because their wages are too low to afford health insurance. “The taxpayers are giving a health-care subsidy to the largest retailer on earth,” according to Democratic Kumar Havre who voted for the bill. The vote on Thursday, January 12, 2006 provided an override of governor Robert Ehrlich’s May 2005 veto.

Certainly Wal Mart should be a better corporate citizen. Did they not once advertise that they sold “Made in America?” Now what they sell is made in China because they chase after the lowest possible price and they pay the lowest possible wage. One can hardly blame Maryland’s legislators for being tired of a giant who feeds off the public trough by forcing their workers to take Medicaid. Their shady employment practices have included denial of lunch breaks and mandatory overtime off the clock.

Is this law good public policy? Why should a person’s employer be responsible for her health insurance? True, union efforts led to health insurance coverage in many industries during the previous century. Union members are justifiably proud of contracts that include complete health care coverage and other benefits.

However, we live in a world of global competition and giants such as Delphi and their former parent General Motors are beginning to choke on the competitive burden of health care. Face it; health care in the U.S. is broken. Just this past week I visited a high-rise office building owned by a local health insurer. Each person in that building is part of our health care system, but not one of them is providing health care, either preventative or curative. Instead they are pushing papers and interfering in doctors’ lives:

"Above all, a large part of America's health care spending goes into paperwork. A 2003 study in The New England Journal of Medicine estimated that administrative costs took 31 cents out of every dollar the United States spent on health care, compared with only 17 cents in Canada." (Paul Krugman, NY Times Op Ed Columnist, April 15, 2005)

President George W. Bush believes that global competition is good, that it will engender jobs in the end. Low paying jobs, that is. No wonder he has admitted that he does not understand the struggles of the poor. He was born not only with a silver spoon, but also with a free pass to the oval office. It is time that our government did something to protect the American way of life and stop the shrinking of the middle class. Health Care must be one of the first priorities in this effort.

The American worker and her family don’t have time to wait for the federal government to fix health care. Krugman points to ideology and vested interests as the two barriers to real reform in the Washington of the Republicans. So, the Maryland approach to corporate leeches has one thing going for it. The fix must begin at the state level. Thirty other states are reportedly watching Maryland closely on this one. You could also look at Kansas where Democratic Governor Kathleen Sebelius recently unveiled CommunityRx Kansas, to make medications more affordable to lower income citizens. Like Maryland’s efforts these are just beginnings.

I am no expert on health care reform, but I am working on learning all I can. What I have learned so far follows.

First, we need to begin at the state level as Maryland has done. We may be able to bring change to Washington, DC but it will take too much time. I am a member of the Working Families Party of New York (see my links). The party has made health care reform in our state our focus for this year.

Second, and this pains, we will have to have some private sector involvement. My Aunt, who spent her life in health care and was married to a physician, would kill me if I called for single carrier coverage by the government. Nevertheless, I believe that the richest country in the world should not have 46 million uninsured, many of them children. So, given the current political climate, the pragmatic approach is to involve the private sector. One caveat, we have got to get the administrative costs down.

Third, there needs to be some incentive for individuals to control the costs of their own care. Choose generic drugs instead of pricey new pharmaceuticals and visit the doctor regularly but not too often. Such choices should be a personal responsibility and rewarded in some way to help keep costs down.

Fourth we can no longer put the burden of health insurance on the employer alone. Toyota is building a new plant in Canada at least partly because of the stability of health care there. Global competition is by nature an unlevel playing field. To protect the American middle class and care for those most in need, we need to view health care reform as a national priority.

We also need to be proactive and speak for the poor laborer in China to ensure human rights and equity in the global marketplace.

I owe some of these ideas, including the one about involving the private sector to the Progressive Policy Institute. If you are interested in further study, check out the link at the end of this post.