Jobs, Not Health Care Reform?

Source: Health Partners, February 2010 (graphic from MinnPost)
When the recent Massachusetts Senate race gave Senate Republicans their 41-vote majority, pundits, pollsters and political consultants told us that President Obama and congressional Democrats had to give up on health care and instead focus on jobs.

After all, that was what was written on the modern day stone tablets delivered from the mountaintop – public opinion surveys. Jobs and economic development were topping the polls, while health care was much further down the list.

Ee gads. Almost immediately, you started hearing pollophobic pols dutifully repeating the word “jobs” like trained cockatiels. Forget “affordable health care,” the political consultants lectured the political class. Focus on “jobs, jobs, jobs!” The word “jobs” quickly became to 2010, what “terrorism” was to late 2001.

To inform the new “jobs” policy proposals needed to accompany this rhetoric, the logical thing to do would seem to be to ask small business owners, who create most of the jobs in America, what they need to expand their businesses. Stimulate the economy with more government spending? Cut business taxes again? Stimulate better access to capital? Create more consumer demand, by, for instance, giving consumers another tax break?

Well, in a survey of Minnesota and Western Wisconsin small business owners released today by Health Partners, all of those things were on the list of things named. But at the very top of the list, topping the aforementioned job creation proposals by more than 3-to-1 margins, was, drum roll please…

…”affordable health care.”

So, it looks like it’s déjà vu all over again. It turns out we don’t need a focus on jobs instead of affordable health care. We need a focus on affordable health care in order to create jobs.

And new numbers released today show that the health reform bill bottled up in the Senate could help. For instance, an estimated 72,400 small businesses in Minnesota could be helped by a small businesses tax credit proposal that makes premiums more affordable.

Which begs the question, what do the cockatiels do now?

– Loveland

6 thoughts on “Jobs, Not Health Care Reform?

  1. Brilliant. This is the kind of analysis that is one step too complicated for most politicians, journalists and voters. Most of those folks can handle one-step thinking. Government is bad. Taxes are bad. Health reform is commie.

    Two steps — create jobs by helping business with health care costs — ooooh, this requires a shaman to explain.

    And three steps — help cut the deficit by controlling costs by reforming health insurance — good god that requires a new messiah and religion.

    While four people are absorbing the wisdom of this survey, four million are applauding Half-Governor Palin warning that government is taking over everything.

    The one-steppers are winning. Alas.

  2. Dave says:

    No disagreement that heath care costs are hurting businesses of all sizes. Sadly the bill that was killed did nothing to solve the problem, if anything, it would have made it worse.

    The bill added coverage for many that are uninsured (which I favor by the way) but it did little to actually lower overall costs. The rhetoric was that the insurance companies were not competing or controlling costs. While that is true for a few companies, many employers are self-insured and the profit margins on that is fairly small.

    So — the bill would have caused additional job losses as medical costs continued to rise and more people were getting healthcare.

    There is only one solution to the problem for me. Rationing of care and some very difficult decisions on life saving events. The “rich” may indeed end up with better care since they could afford something over the minimum.

    As long as we demand Cadillac care for everyone, costs will not go down. The bill that was being debated addressed none of this, it added more coverage (pre-existing conditions plus numerous goodies).

    So Bruce, it is more complicated. Granted the right/left rhetoric is doing nothing to improve things, but anyone who thinks that mess of a bill was going to solve anything is very poorly informed.

  3. Joe Loveland says:

    Dave, thanks for the thoughtful reply. I agree that more should have been done in the congressional bills to control costs. And contary to the fear mongering, it wouldn’t have taken a death panel or draconian management to do it.

    Other countries manage their way to paying significantly less for pharmaceuticals, devices and specialist caregiver salaries than we do, and still get better outcomes than we do. Given their experience, I think we have to admit that that kind of cost control management is just a matter of political will. And some say that we waste up to $700 billion every single year in medical costs, and that can be reduced by better care management and only paying for care that is evidence-based and non-duplicative.

    Someone in the system has to be politically insulated enough to take on the medical interests and poor care management practices that keep costs high, and a democratically elected Congress just isn’t a good candidate for that kind of day-to-day care management. I like the idea of creating a sort of medical version of a Federal Reserve — a group of respected medical experts who are subject to political appointment, but not constant and direct political pressure — to take responsibility for these kinds of cost containment and care improvement issues.

    While I agree the pending congressional reforms don’t do enough to contain costs, the bill did do a few good things on that front. An estimated 747,000 MN seniors would receive free preventive services. An estimated 519,000 MN residents who do not currently have insurance would be covered. Given the informal rule of thumb that 20% of (often unmanaged or undermanaged) patients in crisis generate 80% of medical costs, don’t you think that getting all of those people coverage and preventative care will reduce costs downstream, by keeping more ailments from being ignored or undermanaged until they are more expensive and dangerous crises?

    Again, I agree that the congressional bills’ weakest links are cost control. But on both a humanitarian and fiscal/financial level, don’t you think the reform would be much better than the status quo?

  4. Joe Loveland says:

    In Governor Pawlenty’s State of the State Address today, he noted that the Legislature should ask small businesses, who actually create jobs, what they want.

    Pawlenty assured legislators that small business people would tell legislators to “get out of our way!”

    The only Minnesota small business people in this poll who seem to be demanding this kind of purely laissez faire approach are the 12% who want fewer regulations, and perhaps a few of the 9% who want their taxes cut (though, if past polls are predictive of current results, many want their taxes cut and their services increased).

    1. The 12 percent who said “get out of our way” in the survey you cite were the second-largest group, so that’s not a crazy thing for the gov to have said.

      I’d be really curious to learn about the different perspectives people in the 21 percent have about just how they might get that more affordable health care.

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