There are lots of reasons to oppose the Senate bill in its current form, and hope that, if the Senate does pass a bill, that the final form of the bill is closer to the House version (I am leaving aside for the moment the argument, pro or con, that anything short of "Medicare For All" will not fix the system). But here is a key issue rarely discussed–the Senate bill will encourage companies to increase its workforce of LOW-PAID workers, already exacerbating the plunge in wages for workers and speeding our country to a Wal-Mart vision of America.
Let me try to explain this simply: both the House and Senate stay with an employer-based model for health care (which is insane, but that’s another story). The basic policy is explained by the Center for Economic and Policy Research in a terrific analysis, that has so far, as I can tell, been ignored. Companies would be required to:
either provide affordable health insurance to all of their workers or to contribute to the costs of providing publicly subsidized affordable health insurance to uninsured workers.
The problem is that the Senate bill does not require employers to contribute any money to publicly subsidized health care for any employees who are under 133 percent of the poverty line–which one in ten workers in America are under. That’s 6 million families in 2008, according to the CEPR study. And it is utterly wrong to assume that we are talking about part-time workers–2.5 million of those families had one person who worked full-time.
What that means is that there will be a huge incentive for employers to adopt the Wal-Mart model: meaning, pay people a poverty-level wage to work full-time in order to avoid having to pay any health care costs.
Ultimately, then, the Senate bill is another nail in the coffin for any semblance of the middle class in America.
One can, and should, criticize employers who pursue a low-wage strategy. But, they will do so in reaction to poor public policy. If we lifted the burden of health care from employers and made it into a public good, based on a rationale economic argument, then, we would solve both the moral and economic crisis in health care.
