One of the funnier things that comes up in the healthcare debate is the dire warning about wanting your health care managed by the same people who run the Post Office, DOT, or IRS. Some folks will even throw Katrina in for good measure. In many respects this reminds me of the Simpsons’ episode where Homer goes back to college, and he has a preconceived notion of what the dean is going to be like. It turns out the dean is a fun loving, live and let live sort of guy.
The funny thing is that America and Europe are near the polar opposite on something. Whereas America has a public highway system for the most part, Europe’s highway systems are for the most part privatised. Oddly enough, people get up in arms whenever a freeway is proposed to either by tolled for self sustainability or concession-ed (‘privatised’) to a private road company here. All of the sudden there is much bluster for solidarity and concerns about profiteering (as opposed to I guess regular profiting.) Of course the big objection is that people will have to directly pay a la carte for their driving habits and depending upon their lifestyle probably pay more.
Our health care system on the other hand in many respects is a wage subsidy for some. Places like Wal-Mart can transfer the medical burden of a significant number of their employees and families on to the public sector whereas companies like Ford have to provide for their own employees and are taxed like other companies to provide health care for Wal-Mart’s employees. The question becomes then why doesn’t Ford do the same? Ford isn’t, but there are numerous companies that are. Many companies that provided health benefits for employees making low wages have discontinued doing so. In some cases, these are small manufacturers that are reacting to wage pressures from China. In other cases, the employers are in low margin businesses like warehousing. Some will claim I’m picking on Wal-Mart here, but if you look at the Medicaid participants and parents, Wal-Mart is in the top 3 in most states.
So with a public freeway system, we end up subsidizing behavior we don’t want, people commuting from long distances without realizing the full costs, but we need to keep that to insure greater freedom. On the other hand, with limiting public healthcare to the poor we end up subsidizing low wage businesses by taxing higher wage businesses extra. Like Homer, we are desperate to hang on to preconceived notions.
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