December 28, 2004

Projo Schizophrenic on Healthcare & Employment

Justin Katz

As I noted at the time on Dust in the Light, the Providence Journal's editorial page recently made an astonishingly forward-looking suggestion:

The problem of job quality is complex, involving trade, education and other issues. But we hope that political leaders will take an especially close look at the health-care factor. Our employment-based health-insurance system is collapsing. Any policy that frees employers from the burden of insuring their workers -- and controls health-care costs -- would also free them to hire more people.

Today, however, it's the unacknowledged turnabout that's astonishing:

Meanwhile, employer mandates are not an untested idea. For three decades, Hawaii has required companies to cover their workers who put in at least 20 hours a week. The Hawaiian economy is doing all right.

It's become the fashion in America to portray every corporate mandate as anti-business and bad for the economy. But that's not necessarily true. When you let some companies shift their workers' health-care costs onto more responsible companies, you are in effect imposing a tax on your most desirable businesses. And when the uninsured end up on Medicaid or in hospital emergency rooms, the public pays more.

We urge Massachusetts leaders and citizens to clear the cobwebs of old thinking and try a bold approach to health care. The richest and most progressive states are doing it, and Massachusetts should be among them.

I don't know anything about Hawaii, but here in a New England border town, living in Rhode Island and working part-time from home for a company in Massachusetts, I'm finally about to enter that month when the infamous Northern specter of heating the home will break my already slipping grip on solvency. The wherefore is simple: I can't find full-time work in the range that I incurred so much debt (and lost so many years) to reach.

My family is fortunate to have healthcare (at a cost) through the employer that I do have, and as I managed in December, there is at least the chance to find non-career jobs to meet necessities. Considering my family's circumstances, I'd say I'm particularly justified in asking this question of fellow citizens who are desirous of a place among the "most progressive states": If healthcare costs do discourage hiring — and I don't doubt that they do — what bizarre calculus leads one to conclude that we'd be better off forcing the less "responsible" companies, those offering jobs that don't generally supply healthcare, to supply it?

From where I sit, on the decidedly non-academic side of the theoretical divide, it seems plausible, if not probable, that the end result of an employer-based mandate for universal healthcare will be a worst-of-all-worlds situation. In the first editorial here noted, the Projo lamented that the jobs that are available are increasingly of the low-paying variety. In the second editorial, it laments that people without health insurance become a significant burden on the taxpayers. Who's going to pay for healthcare when even low-salary jobs become scarce?