First Dollar, Last Dollar: An Employer’s View of the Shameful Campaign of the Left Against Whole Foods’ John Mackey’s Health Care Alternative

In the midst of the storm over health care in the U.S., the left’s reaction to John Mackey’s call for an alternative to the Obama health care proposal is one of the most shameful and idiotic things I’ve seen.  But it’s predictable.  In spite of the fact that Whole Foods is a purveyor of liberal food par excellence, the tantrum being thrown both speaks volumes to their real objectives and their ignorance for the realities of paying for health care in the U.S.

Mackey has paid for far more health care for his employees than any of his detractors have.  As an employer, he has staked out a workable plan to cover his employees.  And retail is a place where many go without this kind of coverage.  That’s something I share with him: in my family business, I signed many checks for health insurance for my employees, organised (Machinists) and otherwise.   You learn a few things about it doing that.

Obama’s claim that the vast majority of funds in health care go to end of life care is wide of the mark.  When it comes to health care costs, the distribution is in reality a “dumbbell.”  One the back end you have the expensive life saving procedures (the “last dollar.”) But on the front end you have the initial access to health care during the year (the “first dollar.”)  Anyone who has purchased health care individually or for a group (and I’ve done both) knows that, as you lower the deductible, the cost for each dollar of health care you purchase increases to the point where it’s cheaper to pay for the care directly than insure it.

That’s why high-deductible plans like Mackey’s are successful in cutting health care costs.  They also make it possible to do the one thing that health insurance needs to do: prevent bankruptcy in the event of a catastrophic illness.  They place in the hands of of the employees basic decisions as to how to handle their basic health care in an economic way, and protect them from real disaster.

In the U.S., however, with the generous health care plans we have had since World War II, the mentality has emerged that health insurance should cover everything from the first dollar (or “every runny nose,” as my plant superintendent used to say) to the last dollar.  That’s hard to break; I admire Mackey for having sold it to his employees.  In the mid-1980’s, I had a hard time selling any kind of deductible to my employees, but our insurance simply quit carrying the old “comprehensive” coverage, leaving everyone with no choice.

The left knows how hard to break that is, which is why, in simple terms, the current proposal has “first dollar” coverage and would make high-deductible plans next to impossible.  That’s a piece of political calculus that–along with buying off the drug and insurance companies–the Democrats thought would make this proposal a slam-dunk.  Unfortunately they didn’t cover their demographic back end, because when you throw away controlling first dollar coverage the only place you have to go is the last dollar.  That’s what the VA has found out, and its “death book” response is getting the publicity is deserves.  The left hates to admit it, but without “death panels” or other premature induced life terminations, there’s no way to swing their idea financially, especially in the “zero-sum” economy which they are constructing through higher taxation and regulation.

Unfortunately the left’s political calculations overlooked one important fact: the declining birthrate and greater longevity of our population, coupled with the Boomers coming into Medicare in a big way, produced a natural and vociferous opposition to this plan.  That’s the reason for the rowdy town hall meetings.  The left turned a grand piece of social engineering into an existential threat for a large portion of the population.  Nice going!

Mackey’s proposal is, IMHO, the way out.  Obama’s is not, and that’s why I oppose it.

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