Some commentators have seized on the notion that health care and jobs are competing priorities, and that the president made a big mistake in putting health care ahead of jobs. In a nutshell, they are saying, "It’s jobs, stupid". They might have had a point had the president made such a choice during his first year and a half in office, but he did not.
He didn’t have the luxury. No sooner had Mr. Obama won the election, than the global recession took hold. It was a result, in no small part, of former President Bush’s eight years of deregulation. During Mr. Bush’s two terms, Wall St. made so much money on repackaging subprime mortgages that not one well known economist predicted the end of the party. But property values dropped, joblessness rose, and a rash of mortgage and credit card holders defaulted—all at once. The unexpected happened, and it gripped the economy like a boa constrictor. With the largest banks unwilling to lend, Mr. Obama and his team worked overtime even before the inauguration to erect a series of emergency rescue operations: to save Wall St. banks and investment houses, the auto industry, homeowners about to default on their mortgages and credit cards, the unemployed in need of benefits, and those without health insurance--for whatever reason. Then with President Obama’s federal stimulus package government propped up the economy until it could correct itself. The patient still needs assistance.
President Obama started with a health care overhaul largely for economic reasons. Health care costs as a percentage of GDP threaten to sink the economy. Even with the reform legislation, major cuts in health care costs must still be made. Otherwise workers will barely be able to pay for their insurance and the government could be forced to borrow to meet its other obligations when tax revenues fall short. The reform may have pushed back the stroke for nine years or so.
Jobs and health care are not competitors. Rather they are intertwined and overlapping, connected in ways that the health care reform left largely intact. Most Americans with health insurance—some 80 percent—for example, have employer-sponsored policies. They did before the reform and they do now. That’s why the charges of “socialism” are so patently absurd. Does socialism insure people through private corporations? (The millions with Medicare, Medicaid, Veterans benefits, and children with S-CHIP coverage, can thank the government for their coverage. Too few government dependents are willing to do so.)
Before health care reform, keeping one’s coverage depended on keeping one’s job. Policies were not very portable. One could purchase an interim policy through COBRA at a rate higher than the employer-sponsored rate, but lower than insurers charge private customers. But COBRA coverage doesn’t last long. Before the reform, insurers could refuse to cover workers whose employers would have enrolled them: the sickest people: workers or their family members who had pre-existing conditions, chronic conditions, and those whose health care had already reached an annual or lifetime cap.
For a majority of workers, employer-sponsored insurance worked—at least until they fell chronically ill. Other workers, however, like the self-employed, those who work in small businesses, seasonal or migrant workers and part-time workers, seldom enjoyed the discounts given to big employers. Although they worked, such workers often could not afford insurance. Only the young and healthy could take their chances and forgo paying the high premiums for health coverage.
The jobs-health connection never worked for millions of other Americans, either. Take the long-term unemployed, left without any affordable insurance at all. Emergency room care was an option, but it is the most expensive care of all. And the cost of “free emergency care” has always been paid by those who worked. Health care reform will extend coverage to some 30 million Americans and will rectify most of these ills eventually.
Now the president has said he has put job creation at the top of his list. Yet the stimulus itself and the federal budget both set aside money for states and localities, gave breaks to employers who hired, and targeted infrastructure projects to create jobs. More jobs must be created. They must be if—and here’s that link again—the nation is to regain its health.
Karen Sue Smith