Employees Will Pay a Big Cost for Government Care

From the Wall Street Journal (7/22/09)

Bravo for your July 21 editorial “Repealing Erisa” on what is likely to be one of the most stark impacts for all covered by that law. While everyone is screaming about taxes, the stark reality will come for the 177 million people who no longer have a route to take in making health-care decisions. For many of us, it is our employer that provides support in dealing with significant medical issues—and the ability to escalate issues regarding hospitalization costs and preauthorizations for treatments is a critical element. One can only imagine what happens when we are migrated to the new government bureaucracy. Will there be an 800 number to call and get the preauthorization request expedited for the life-saving surgery, that is, provided that we “qualify” for the benefit?

Cost is an issue we all struggle with, but to lose the one true benefit of the Erisa system and the advocacy of the employer that has negotiated the coverage is a blow. If the government is setting the standard for care, what pull does the employer have in the system? It would be the most significant tragedy of the health-care legislation, and unfortunately many won’t realize it until they are waiting on the end of the telephone line being directed to “listen to the menu, as the options have changed.”

R. Pendleton
Savannah, Ga.

Your closing words, “The more we inspect the House [health-care] bill, the more it looks to be one of the worst pieces of legislation ever introduced in Congress” are entirely true, but deserve greater emphasis and elaboration. Your reasoning as to the poor health-care policy embodied in this bill due to the erosion of consumer choice is correct and enlightening, but your nearby headline “New Burdens Will Crush the Engine of Job Creation” (Letters) understates the macroeconomic fallout from the financing mechanisms.

The surtax is bad enough under current circumstances which cry out for an increase in aggregate demand as opposed to its suppression which will result from this tax. But the drastic increase in payroll taxes will do more than inhibit job creation—it will destroy many jobs. Increasing employers’ costs of employing people will cause them to employ fewer people at a time when more jobs are the highest priority for this country. This will make many current jobs uneconomical, as well as inhibit the creation of new ones.

Perhaps the bill will ultimately cause a reduction in health-care costs which will offset some of this effect, but “ultimately” will be of little value to those losing their jobs when the bill takes effect, or to those who will not be able to get jobs which would have otherwise been available.

We have a bill which will destroy consumer choice, eliminate coverage options which are currently satisfactory to many, if not most, Americans, raise total health-care costs (according to the Congressional Budget Office) and destroy jobs in the process. I hope Congress will come to its senses and realize that your conclusion is correct.

Marty Robins
Buffalo Grove, Ill.

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