The $7 Trillion Question

Over the next decade, this country will lose $7 trillion worth of productivity due to sick days and disability leave. The greatest country on the planet will continue to rank in the middle of industrialized nations in death rate, life expectancy, and infant mortality. Local public hospitals will continue to struggle to meet their obligations, and the states and counties that support them will continue to suffer under massive budget shortfalls due to medical costs.

Nowhere in the industrialized world do businesses have to deal with the costs and consequences of health care that businesses in the United States encounter. Like most of the real domestic issues in our nation today, health care is a matter of deferred maintenance; how long can we go without fixing an issue before it cripples our operations. The American people understand this, and they express it in polling every day.

Dozens of polls over the last two months done by both liberal and conservative leaning pollsters, have come up with a remarkably consistent vision for how we feel about this issue. We are split on the label; if the question asks about “health care reform”, or the “plan that Obama…”, or the “plan that Congress…” is proposing, the country is generally 45%-48% in favor and 49%-51% opposed. Note that “undecided” plays a roll in those totals. However, when asked about the specific provisions in the plan without the political labels of either party, the results change dramatically. Between 51% and 55% of Americans are in favor of a government-run plan that would compete with private insurers. Between 60% and 75% of Americans are in favor of a mandate that all Americans hold health insurance, provided that mandate includes support for lower income families. For reference, all of the supporting data can be found quite easily at

Not surprisingly, nobody wants to pay for these plans (and by nobody I mean that less than 40% are in favor of the various tax proposals). We Americans have mastered the art over the last three decades of complaining about taxes while demanding services. Because of this tendency, the burden of taxation has shifted to the working family as we have successfully labeled higher taxes on businesses and the wealthy “punitive” or “restrictive”. I mention this reality in irony, because it is the businesses and wealthy who will eventually pay for the lack of productive workers that is the obvious outcome of these politics.

All of the plans proposed over the last several months have been attacked as “Socialist” or worse. Politicians and the good senior citizens who have supported them have simultaneously attacked Democrats for proposing Medicare cuts while criticizing the “Public Option” as Socialism. Medicare, of course, is the closest to socialized medicine we get in this country (it is mandatory, after all, where the public option would not be). Medicare has also been opposed, as a matter of party platform, by the Republicans since its inception. George W. Bush tried to privatize it (which would have cut more from the program in 4 years than the Democrats plan in 10), and Ronald Reagan cut his political teeth opposing its creation as….Communism.

The two items in the current bill that are most controversial (outside of the purely semantic abortion amendments) are the anti-trust exemption and the public option. The House included a revocation of the insurance industry’s anti-trust exemption because you can’t call it a “free market” when an anti-trust exemption exists. The Senate did not because it had to placate Ben Nelson of Nebraska, a Democratic Senator and wholly-owned subsidiary of the nation’s health insurers. The CBO has repeatedly scored the public option as a deficit and total cost reducer. The more aggressive the option is, the more the deficit is cut and health care costs are reduced. Period. This is the same CBO that Republicans have pointed to when Cap and Trade was scored as raising costs on the middle class, and the initial health bill in the House (HR 3200) was scored at $1.6 trillion. They were OK with the CBO then, they better not crawfish their bet now.

A well-written compromise bill that reconciles the House and Senate legislation will reduce our deficit by over $150 billion over the first ten years, and over $600 billion over the next ten years. It will increase worker productivity by reducing sick and disability time, and it will pave the way for a small business expansion by providing easy access to health care for entrepreneurs who, right now, can’t afford to chase their dreams and risk losing their employer’s coverage.

It is time to get over the hysteria and over the top labelling that has pervaded this debate. It is time to pass this bill into law and move on to new challenges.

The rational middle waits for your thoughts…