April 22, 2011 | Leadership, Workplace Culture + Practices

Over a longer-than-I-care-to-admit business career in businesses of various sizes and in various stages of development, my colleagues and I have struggled mightily with the challenge of providing affordable, effective, and fair health care insurance to our employees.  As a result of this experience, I cannot for the life of me understand why the business community is not rising up as one and investing a substantial portion of its “Citizen United” largesse to lobby aggressively for single-payer health care, also known as universal health care.

What’s not to like?

From a business perspective, what’s not to like?

    • Costs become relatively stable and known over time versus being renegotiated year over year in a highly volatile market usually to the great disadvantage of the shopper.
    • The scope and balance of health insurance is well defined and established so it is no longer a source of conflict within the organization – single coverage versus family coverage being a common such conflict source.
    • The health benefit playing field is leveled across all businesses regardless of location, population, size, and credit worthiness, etcetera.
    • And last on my list but not least, a substantial, non-value-add administrative burden is lifted from the organization.

We can only improve on what we have now

No matter how cynical one may be about the ability of GOVERNMENT to operate efficiently, it is hard to imagine how a single-payer system could be less fair and less efficient than the current system of multiple insurance providers maintaining multiple organizations to procure services, establish costs and prices and administer and regulate (some would say avoid) claims while, in addition, every business commits its own precious resources to do essentially the same thing.

Two reasons for opposition?

Unfortunately I can think of two reasons why “business” does not support this eminently sensible and proven approach.  I say unfortunately because it reflects poorly on the ethics and good sense of my chosen profession.  The first of these reasons is that many businesses do not currently provide any coverage so any cost associated with a new system will be an incremental burden on short term profits.  Of course in the current environment of high unemployment, this position has little downside.  Folks need any job they can get even if at great risk to their long term financial and physical health.  But in a competitive labor environment, which will come again, these businesses operate at a great disadvantage versus their competitors who offer health care insurance.  However, that long view is not often taken.

The second reason for not supporting single-payer health insurance is typically held by larger businesses, which can use their market power to negotiate insurance rates that their smaller competitors cannot match – a sort of “beggar thy neighbor” approach.  I have not done the analysis, but I suspect that the return on their overhead investment is not justified by their competitive advantage in the labor market.

Selfish scare tactics

My final gripe is the assertion that single-payer health insurance results in all kinds of terrible outcomes – rationed care, death panels, poor health outcomes — none of which is true in most of our fellow “first world” nations that provide single-payer coverage.  Those who assert these claims are fools or knaves, fools because they have not done the research or knaves because they have, but ignore it for their own financial benefit.

It is time for the business community, the whole business community, not just the Social Responsibility part, to step back, take the long view, look at the facts and do the right and smart thing – support universal health care provided by a single payer.