Why do bosses pick up the tab?

I write this hours before the president speaks to a joint session of Congress. I'll go out on a very short limb to predict that he'll still plead for cooperation across the aisle to reform health care, even though most leaders on one side of the aisle seem committed to his failure.

If you need a ray of light, Mr. President, look over here in Oregon. Exhibit A: A current Rolling Stone story reports that one proposed public-sector insurance "exchange" would accept only people who have no job-based insurance: "Sen. Ron Wyden of Oregon was looking at an early version of the bill several months ago, when he suddenly realized that it was going to leave people stuck with their employer insurance. 'I woke up one morning and was like, "Whoa, people aren't going to have choices,' he recalls."

In other words, maybe it's not smart to expect employers, with their hands full figuring out how to survive this economy, to look out for our individual health care interests.

Exhibit B: A reader who regularly responds online to this column — a citizen, Mr. President, who is noticeably not a fan of you, me or, as far as I can tell, anything either of us have ever said — recently wrote this: "What happens to the small business owner? He will be forced to pick up the cost of health care for his employees and their families"¦ And that employee will be taxed at least double on his/her take home pay. What will that do to the cost of hiring a plumber, or a painter? Are you willing to pay $15 for breakfast at Denny's, or $6 for a Big Mac? And what small business owner can absorb that cost? How many millions of people will this put out of work? What the low-income, uninsured people have to lose is access to the best health care system on this planet. If employers are forced to pay their employees' health benefits, many of those low-income uninsured people will also be unemployed."

Quite different voices heading in the same direction. A big step in that direction would be to ask a question that gets surprisingly little attention: Outside of workers compensation, why should employers have any responsibility for their employees' health?

America's pretty much alone in the world in holding this expectation. (Seems like we stand alone a lot when it comes to health care, doesn't it?) This unique status costs us, sometimes with stark directness. Ask anyone in domestic manufacturing what it's like to compete with foreign firms that pay none of their employees' health costs. General Motors reports that every car off the line costs them more in health insurance than in steel. Toyota, Honda, Subaru, Mercedes, Kia, Hyundai, BMW all spend more on the cigarette lighter in their cars than they do on employee health care, unless they're co-manufacturing in America; corporate globalization has muddied some of these comparisons. But it's still true that American communities have lost auto plants to other countries simply because manufacturers could hand government the tab for health care.

Smaller businesses, the ones that worry my commenter above, take similar hits from this responsibility. It's a burden that has closed the doors of countless businesses and prevented countless more from ever opening. If we agree that a healthy economy needs plenty of people working at productive jobs, wouldn't we do better by lifting this whopping albatross from the necks of those willing to do what it takes to create those jobs?

This also plays out in practical political reality. One reason that a system this flawed has prevailed for so long is that the huge small business sector sees so-called liberals carry the banner for more "employer mandates" — i.e., more costs for them to cover without room to proportionately raise prices — and hunkers down to resist change. Wouldn't you? Just remove that wedge between business owners and the rest of us and see how fast momentum for real change starts to build.

Yes, the details have some devils. You'd want to know what employers would do with the cost savings from shedding their health insurance burden: Pass it on to customers through lower prices, to workers through higher wages or to themselves through higher profits? That needs answers before we can know if government-funded health care (in line with what the rest of the industrialized world has) would cost us more or less than employer-funded care.

But what possibilities would start to flow if we shifted this whole conversation away from the assumption that businesses will pick up most of the health care bill? Here's one: Some who contribute regularly to this column's forum would have one less thing to grump about.

Jeff Golden is the author of "Forest Blood," "As If We Were Grownups" and the novel "Unafraid" (with excerpts available at www.unafraidthebook.com).

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