There is growing consensus that we have a problem. Then why, if there are so many possible solutions, are we stuck with this failing healthcare system? The answer: We have an entrenched and complex healthcare system that is hugely difficult to change. Historically, there has not been sufficient political capacity to create a plan and implement needed changes. Patricia Schoeni, Executive Director of National Coalition on Healthcare, agrees and points out, “There is no will to fix the problem right now. It is basically a lack of leadership in all levels of government and on Capitol Hill, and an unwillingness of elected representatives, the majority of them at least, to come to grips with the fact that we have a problem and we have to deal with it.”
If individual tragedies like those shared by Dr. Richter don’t provide impetus for change, maybe the business sector can. More and more business leaders are recognizing that the high cost of healthcare coverage is a major disadvantage that cuts into their ability to compete in a global market. Consequently, some business leaders are helping ignite the political will for addressing the healthcare issue with solid solutions. During the 2004 drive for comprehensive health coverage in Vermont, many businesses signed on to the effort and put signs in their windows that said, “This Business Supports Universal Healthcare.” One such business, based out of Waitsfield, Vermont, is Small Dog Electronics. Small Dog Electronics, one of the larger Apple computer resellers in the United States, sells new, refurbished, and used Macintosh computer products, as well as other related products like iPods.
Each fall, beautiful crimson maple trees frame the entrance to the Small Dog offices and warehouse. Dogs are allowed at work, and every day about fifteen of them clock in with their owners. Don Mayer, CEO, brings his bulldog named Hammerhead and his pomeranian named Fantail Shrimp to work with him each day, “The dogs are a sort of reminder to keep my business small and friendly. That’s why we named it Small Dog. I’ve been in business a long time and found that I always have less stress, more fun, and make more money when my business is small.”
He comments, “We take our dogs very seriously, and we have every kind of dog you can imagine. We have some small dogs, we have mixed breeds, huskies, two black labs, a golden, a yellow lab, and eskies.” There are dog bowls, toys, and dog beds throughout the offices and warehouse.
Small Dog Electronics, which prides itself in taking care of employees, currently covers all employees and their families with health insurance. This is beginning to be a problem. When Mayer started in business thirty years ago he notes, “The cost for a family healthcare premium was about $1,500 per year. Now it’s approximately $11,000 for each family’s coverage. This can amount to almost 50 percent of an entry level employee’s salary.” In fact, the cost of healthcare coverage is becoming a big factor in business decisions for Mayer, “No longer do I consider growth and opportunity as the criteria for expanding my staff. I have to consider the astronomical cost of healthcare as part of that equation as well. This makes the healthcare crisis an impediment to economic growth, which can be further illustrated by the number of labor actions and strife with healthcare as the primary element of dispute.”
From his perspective, supporting comprehensive coverage “was a fairly easy decision for us,” says Mayer. “The healthcare system as it’s currently configured is a mishmash that basically represents an accident of history.” Sharing his understanding, Mayer continues, “This employer based healthcare system is completely faulty. It was instituted in the 1940s as a way to get around the wage price controls from WWII and after so employers could offer health insurance as an incentive to retain key employees. It kind of stuck over the years to the point where we are now, which is a healthcare system on the verge of collapse.”
It’s not just small businesses that are starting to take serious notice of the implications of our healthcare system. In 2005, Toyota announced it is planning to build a second plant in Ontario that will hire about 1,300 workers and make 100,000 cars each year starting in 2008. The Canadian location was chosen over cities in the United States despite the fact that several U.S. states offered “hundreds of millions of dollars in subsidies,” as reported by CBC News.33 The CBC News article noted, “In addition to lower training costs, Canadian workers are also $4 to $5 cheaper to employ partly thanks to the taxpayer-funded health-care system in Canada, said federal Industry Minister David Emmerson. ‘Most people don’t think of our health-care system as being a competitive advantage,’ he said.” Some executives of big businesses, particularly those from the vehicle manufacturing industry like General Motors, Ford, and in particular DaimlerChrysler, are starting to bring up the fact that another type of healthcare system might be better for business.34
There still isn’t a full-fledged push for change from corporate America at this time. This boils down, in part, to a philosophical issue since many in big businesses are opposed to increased federal government involvement as a rule, and addressing comprehensive health coverage certainly entails more federal government involvement. However, as American healthcare costs continue to streak upward at an incredible pace, there’s no question that leaving our healthcare linked to employers is going to hurt our competitive advantage in a global economy. Our economy, our businesses, and our citizens are struggling. It’s long past time for a change.