Setting value judgments aside, the loser here, as smarter people than I have pointed out, is the federal budget. And, by extension, the federal taxpayer.
Wal-Mart wins. By cutting benefits to some of its part-time workers, they shed millions of dollars in costs, at what will amount to very little risk, since few of these employees will be willing — or able — or flee the company for greener pastures (that likely don’t exist).
Carriers win. They’re still gonna get the business. Doesn’t matter to them who’s paying the premiums. Just look at the stocks of the big major medical carriers.
The employees win. They suddenly qualify for federal subsidies they didn’t before, whether they took what their employer offered or not.
But the budget just took another big hit. Sure, it’s simply the latest in a series of many new expenses and is almost certainly not the last. And these new expenses aren’t going away anytime soon. It’s far too early to tell, but I have a hunch it’s going to be next to impossible to get some of the subsidies even after a single enrollment. I mean, who walks away from free money, right?
Which is why, in the bigger picture, we all lose. Or, at best, we stay mired in the status quo. The government keeps picking up more of the tab for the nation’s health care, while consumers remain blissfully (willfully?) unaware of what happens after they leave the doctor’s office. Spending, of course, will continue to rise, driving up costs.
We often talk about unintended consequences, and the Congressional Budget Office knows all about them. They’ve been making their PPACA budget estimates look pretty silly every year. It’s as if they’re watching a different movie than we are. Sure, moves like this may be unintended, but they certainly weren’t unanticipated. It’s a shame it took by surprise the people who should’ve known best.
Every time I hear about one of these employee dumps, though, I feel like it’s another opportunity lost. Before this dramatic step, were there any conversations about high-deductible health plans or any other consumer-driven alternative? Did they discuss any of the dizzying private exchanges options?
Separating the end users of health care in this country from the providers — and more importantly, the payers — is what got us into this mess. The fact that consumers complain about how expensive insurance is when they have to actually pay for it tells you what sheltered lives they’ve led. Health care was never free. It was always expensive. And it’s littered with tough decisions, difficult people and sometimes pretty raw emotions. It’s no wonder we haven’t figured it out yet.
But, my God, sending employees to their room while Mom and Dad fight over the doctor bill isn’t going to help anyone. Besides, the rich uncle who pays for everything isn’t going to live forever.