Menckens Ghost

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Why didn’t they heed the warning 15 years ago about medical care?

By Mencken’s Ghost
Dec. 20, 2012

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.



A former business executive, management consultant and business author, Mencken’s Ghost is an Arizona writer who can be reached at

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