AFL-CIO President John Sweeney's reaction to the plight of those
without health insurance reminds one of a line from "Animal House":
"I think this situation absolutely requires that a really futile
and stupid gesture be done on somebody's part."
That's the message for state lawmakers in Sweeney's announcement
that unions are pushing to replicate Maryland's Fair Share Health
Fund Act in 33 other states this year.
"Fair Share" legislation would require employers with 10,000 or
more workers in a state to spend at least 8 percent of payroll on
employee health benefits or pay the difference in a tax. It passed
the Maryland General Assembly last year, but Gov. Robert Ehrlich
vetoed it. At the start of this year's session, the legislature
overrode the governor's veto.
The bill was originally cooked up by Andy Stern's Service Employees
International Union (SEIU) as part of its larger effort to unionize
Wal-Mart. That transparent ploy lead to it being quickly dubbed the
"Wal-Mart Bill."
Then, SEIU and the Teamsters bolted the AFL-CIO last summer.
Sweeney is now grabbing the anti-Wal-Mart banner in a bid to put
his AFL-CIO back at the head of the union parade.
But Fair Share is nothing more than symbolic politics. The unions
want legislators nationwide to replicate this futile and stupid
gesture in lieu of serious health reform. It's an opportunity they
should decline.
To start with, if employers are forced to pay more for health
insurance, they'll adjust cash wages to keep overall compensation
costs from rising. Future raises likely will be smaller, with money
that would otherwise go into worker paychecks diverted to health
insurance instead. That's effectively a hidden payroll tax, and
taxing workers to pay for their own coverage doesn't make them
better off.
But Fair Share is actually so ineffectual that it may not even come
to that. Non-compliant employers must pay the new tax or face a
$250,000 fine. You can bet employers will pick the cheaper
option.
Furthermore, nothing in the law requires employers to cover their
uninsured workers. A firm can simply spend more on health benefits
for its already-insured workers and achieve full compliance.
Finally, any new taxes or fines a state may eventually collect are
simply dumped into its Medicaid program. Nothing in the legislation
requires a state to use those funds to cover more of the
uninsured.
In offering no prospects for extending coverage to even a single
uninsured individual, Fair Share attains near perfect futility.
Only a cynical genius could devise a tax-and-spend policy so
utterly devoid of measurable effects.
The fraud and hypocrisy of the whole exercise becomes even clearer
when one considers that the bill exempts state and local
governments. According to Census Bureau data, Maryland's state and
local governments have 20,000 uninsured workers. That collection of
uninsured government employees is larger than the entire workforce
of any single private employer in the state. The same is likely the
case in many other states.
What's really going on is apparent from a report in the St. Louis
Post-Dispatch, which noted that, "After listening for weeks to the
pros and cons, [Delegate Sue] Kullen declared a few days ago that
she intended to vote for the override even though she doubted that
the bill would have a big impact on health care. 'This is a kick in
the pants for Wal-Mart,' she said."
And this is from a Democratic legislator with a Wal-Mart store slap
bang in the geographic center of her increasingly suburbanized and
Republican-tilting district.
Lawmakers in other states would be well advised to skip the futile
and stupid gesture of a Wal-Mart bill and proceed directly to real
health reforms.
Back in Maryland, State Sen. E. J. Pipkin proposes restructuring
his state's health-insurance markets to create personal, portable
coverage for all citizens through a state-wide "health insurance
exchange," and then redirecting $300 million of state and federal
money now spent on hospital uncompensated care into subsidies to
expand coverage. The exchange would mean a two-earner couple could
combine their employer contributions to buy and keep the plan they
want, while a worker with two part-time jobs could combine
pro-rated contributions from each employer to buy coverage, and the
government would have a single place to send subsidies for those
who need extra help.
The response from Pipkin's colleagues, in Maryland as well as in
other states, will reveal just how serious they are about covering
the uninsured.
Edmund F.
Haislmaier is a visiting research fellow in the Center for
Health Policy Studies at The Heritage Foundation.
Distributed nationally on the Knight-Ridder Tribune wire