IPFS
Menckens Ghost
More About: Healthcare IndustryWhy didn’t they heed the warning 15 years ago about medical care?
Fifteen years ago, the Wall Street
Journal published one of seven op-eds that I had written for the newspaper
under my real name. It made the case that it was a lose-lose for companies to
be in the business of providing medical insurance and other health and welfare
benefits to employees--not only because costs were becoming prohibitive but
also because the benefits put employers in conflict with employees and invaded
their personal lives.
The op-ed
also gave the history of how employers got into the benefits business in the
first place. As with most messes, this mess was created by government
policies, beginning in 1942.
Today, the publisher
of a newspaper in a mid-size city contacted me about the same subject. A
friend and former client, he lamented that medical insurance has become a sore
spot between the family-owned publishing business and its employees.
The business
has always been paternalistic over its century of existence, but skyrocketing
medical costs, regulatory burdens, and looming mandates of ObamaCare have
forced the business to shift more of the cost of medical insurance to employees
or risk going out of business. The
publisher now is thinking that it would be better for both the business and
employees if the business were to stop providing medical insurance and to pay
the penalties under ObamaCare for shifting employees to a state or
federal insurance exchange.
Coincidentally, a long and intelligent
letter to the editor in today’s Wall Street Journal is also on the same
subject. The letter writer makes
the astute observation that the chaos, confusion and unanswered questions about
ObamaCare are actually part of a brilliant strategy of Democrats to achieve
their end-game of a single-payer system (aka socialized medicine). The more frustrated that employers and employees
become, the more they will support such a system. The
writer goes on to say that Republicans are wrong-headedly praising the states
that have opted out of establishing insurance exchanges, because opting out
will simply shift people into a federal exchange, thus leading to more central
control over medical care, which in turn will make it easier to transition to a
single-payer system.
I suppose that I should be gloating about
being so prescient 15 years ago. Instead, I feel sick to my stomach, wondering
if I could have done more to change the conventional wisdom on the subject, and
pondering why business executives and the Republican Party wait until it’s too
late to try to fix something, thus conceding important issues to Democrats.
After all, if a less-than-brilliant person like me can see the problem so
clearly, why can’t those who are smarter and more successful and powerful see
the problem and do something about it?
Part of my nausea is from recalling the
many times that I addressed executive conferences and human resources
conferences about the problems of, and solutions to, the medical insurance
mess, including both the political and design aspects. I even organized my own
reform conference, where policy experts and politicians spoke. And I worked
behind the scenes with one of the nation’s largest employers on draft
legislation for Republican congressional leaders to consider in establishing a
true market-based medical insurance system.
It was an exercise in
self-flagellation.
The overall
reaction was negative, and it was due to more than the normal human and
institutional resistance to change. It was due to self-interest and an
inability to think strategically.
As an example of self-interest, a
red-faced business executive stood up at one conference, pointed his finger at
me and said, “I recently had a triple-bypass and only had to pay a few hundred
dollars out of pocket. I’m not going to let you or anyone else take my company
insurance from me.”
I was afraid that he was going to croak
and fall into his coffee and Danish.
The
self-interest of human resources managers was less open but just as strong. They would sit with their arms folded tightly and
their faces looking like prunes--not because they cared about the welfare of
employees, but because they cared about their own welfare if a big chunk of
their job no longer existed. Only the few who had other skills were open to
addressing the problem.
Even more disturbing was the lack of
strategic thinking among business executives and Republican politicians. It
was as if there was an inverse relationship between strategic thinking on the
one hand, and success, power and high income on the other: the more of the
latter, the less of the former.
To this day I
can’t decide the reason for this. Perhaps their brains aren’t wired to think
long-term. Perhaps they get ahead by ruffling as few feathers as possible and
by solving immediate problems instead of long-term problems. Or perhaps they
are out of touch with common folks, unlike Democrats.
Whatever the reason, the nation can’t wait 15 years for executives and politicians to address other serious issues facing the country, especially the unsustainable welfare state. In 15 years, the nation will be well past the point of no return, and I will be even more sick to my stomach. But on the bright side, I’ll be able to get treatment at a government infirmary that looks and operates like the Post Office.
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A former business executive, management consultant and business author, Mencken’s Ghost is an Arizona writer who can be reached at ccan2@aol.com.