I’m much more disgusted with both sides on the prop 72 debate than I was before this past week. I went to a “debate” on it at the Commonweatlh Club on Monday and then heard (and phoned into) an NPR show on it this morning. (The show wasn’t my finest hour, but then I matched the general level of debate and I’m on about 10 mins before the end of the show).
The opposition was the Allan Zaremberg from the American Chamber (at the debate) and a school board member Gabriella Holt (on the radio) representing public sector employers. The chamber of commerce’s major objection — and I am not making this up — was that the 20% of premium that Prop 72 would force the employee to pay (capped at 5% of income) would take away their choice to buy other things with that money! In other words the poor little poor minimum wage employee doesn’t want health insurance, otherwise he’d be buying it himself already! Obviously the Chamber hasn’t noticed how bitterly hotel and grocery workers in this state are fighting to maintain their health benefits, nor have they noticed how much employees in polls always favor health benefits over cash, nor have they noticed how shitty the individual insurance market is. This argument really reminded me of a southern lady I once sat next to on my first trip to the USA. I asked her about being in the south during the Civil Rights movement. The first thing she said to me was, “well I’ll tell ya one thing–the blacks didn’t want it!”.
My namesake from the public employer representative didn’t seem to realize that she was being a shill for the fast food companies and Walmart, which exposed its true colors by dumping $500,000 into the No on 72 campaign today. (I have a sneaking feeling that she’s a single payer advocate). She kept on claiming that the demands of 72 would increase labor costs for school districts, and therefore lead to lay-offs. I think she meant that there are some employees who do not get health benefits from school districts (my guess is that they are the lowest paid employees like the janitors), and that by covering them they’d run out of cash. However, even if that is right for a school district it certainly isn’t the case for other employers — especially the fast food chains and the Walmarts who cannot move their stores out of state, but would be forced to pay more in labor costs and TA-DA reduce their profits in consequence. That’s why they are opposing 72, and it doesn’t take a rocket scientist to figure out that they’d rather have the taxpayer take care of their employees than do it themselves. Worse, particularly in Walmart’s case, it’s forcing its competitors here (Albertsons, Safeway, etc) into the same behavior, which will force even more costs onto the taxpayer in the future in the absence of 72. This is a straight fight between allocation of revenue to labor versus corporate profit for immobile service businesses, whatever a certain Harvard PhD student might think.
The advocate of Prop 72 was the ex-head of the CMA and the AMA, Richard Corlin, and he wasn’t exactly a whole lot better. He delighted in consistently saying that he didn’t want government regulation, and that this was a tiny incremental solution that only worked for a few people (1 in 6 of the uninsured). He’s right but that’s not a good thing! As per usual you can expect organized medicine to protect its own arse first, and to only move very modestly in the direction of helping the people it serves.
So why am I for Prop 72?
1) It levels the playing field between big firms that can’t move (notably Walmart and the other grocery stores) preventing an ugly race to the bottom
2) The additional cost will start motivating large and medium sized business to finally get on the right side of this issue, pushing them to look for a universal solution that includes real cost containment and real universal coverage.
3) At the margin, as a value judgment, 1 million poor working people getting coverage is better than Walmart and McDonald’s shareholders getting slightly bigger dividends.
Meanwhile, polls have this Prop dominated by the undecideds.
Postscript: I have replied privately to the non-reply to my point by the Anna Sinaiko, the author of the Health Affairs article, and as she’s just a doctoral student I’ll give her a little while to respond to my attack on her dismal science. Of course if I don’t hear from her soon, there may just be one more little article on this topic before Tuesday. And it wont be pretty.