Let’s play pundit….
It looks like there’s going to be a health care reform bill, a weak one without a public option or a Medicare buy-in, for which the only vehicle for driving down costs is an insurance exchange. Let’s do a thought experiment inspired by Jonathan Chait of the New Republic:
Why can’t people afford insurance now? Well, either they don’t get it through work and can’t afford a regular insurance plan (say, a cashier at Wal Mart who doesn’t get insurance through her job) or they have a preexisting condition which means no insurer will sell them a regular insurance plan (say, a diabetic who can’t get insurance on the individual market.) Or sometimes both (a diabetic Wal Mart cashier, perhaps.)
A diabetic Walmart cashier should be delighted by the Senate Bill (the inevitable model for the final bill thanks to Ben Nelson and Joe Lieberman) as they’ll be able to buy insurance despite their pre-existing condition that they will certainly need. But what about the healthy Walmart workers out there?
Think about it. You’ve chosen not to buy insurance from Walmart because their cheapest plans, the only ones you could ever hope to afford on your meager salary, have incredibly high deductibles. Can a private insurance company do better than Walmart even with government subsidies and still make money from a bill that is supposed to save money in the long run? I doubt it. And even if the insurance exchange idea works (and I hope it does), the mandate in the bill forces some people to buy something that they didn’t buy otherwise. That’s a huge new out-of-pocket expense.
So what are you going to do? Blame the government? Of course you are, but that isn’t this going to make the mandate go away. Your wage, on the other hand, is something you can affect and it’s going to look even more shabby than it used to thanks to HCR. What can you do about your wages? Changing your job would be an easy solution, but maybe – just maybe – you might think about joining a union. After all, what do you have to lose any more? I strongly suspect that under the bill unemployed people are one of the few groups that won’t have to buy health insurance after the bill passes.
A strong health care reform bill would have taken one of Walmart’s biggest problems off its books and put it onto the books of the federal government. This one, on the other hand, might just make one of its other biggest problems (controlling an increasingly belligerent labor force) even worse.