Reporting on the race for the Democratic presidential nomination, the media have focused largely on the disagreements among the candidates. That is perhaps understandable, albeit not particularly enlightening because dramatic headlines about disputes typically attract more attention than stories of congenial agreement.
It was notable that only one candidate in the recent debate, Sen. Amy Klobuchar, pointed out an essential truth: that there are far more fundamental elements that unify Democrats than those perceived as sources of conflict.
Perhaps the single differential among the candidates that has drawn the most attention has been the approach to health insurance.
While Republicans seem still to be focused on their many failed efforts to repeal ObamaCare and thereby to deprive millions of Americans of coverage, there is near-unanimous agreement among Democrats (certainly including all of the candidates on the stage and probably all who didn’t qualify for that debate) on the basic concept that no one should lose their home, or be forced into bankruptcy, or have to choose between medical treatment or drugs and feeding their family, because they couldn’t afford the high cost of medical care.
The disagreement, then, is not whether but how to ensure universal coverage, and at what cost, and how to pay for it. The primary point of contention at present is whether or not private insurance should play any part.
In the discussions – on stage, in town hall meetings, and in TV interviews – about the subject, sight seems to be lost about the nature of the role played by employer-backed insurance. It should be kept in mind that businesses large and small offer a range of benefits to actual and potential employees in order to attract and maintain qualified workers.
Those “perks” may include paid vacation time, parental leave, retirement plans, and term life insurance policies as well as health insurance. There is, in my opinion, no reason to bar companies from including the health insurance plans among those options, provided of course that the policies meet minimum standards of coverage established by federal requirements.
However, it’s logically clear that, if the federal system should prove more attractive than the corporate plans in terms of such components like the cost of premiums; the choice of doctors, hospitals, and other service providers; the quality of care; and the co-pay requirements, the very nature of the competitive capitalist system is likely to persuade employers either to demand better conditions of coverage from their insurance carriers (which could well mean shrinking the insurance company profit margins) or, alternatively, to abandon their private insurance programs and enroll (and pay for) their employees in the federal plan.
In other words, it seems entirely possible – even likely – that enlightened self-interest would eventually motivate many if not all employers to shift employee health insurance, regardless of what it’s called, to some variant of “Medicare for all” or “single-payer insurance.”
On the other hand, if an employer considers it advantageous to offer a plan providing superior coverage (however that’s measured) at a higher cost to the company without increasing the cost to the employees, why shouldn’t those advantages be welcomed even if they contribute to higher profits for some insurance company?
After all, the principal motivation behind the various proposals is to assure that absolutely no one is left without protection.
If collaboration between an employer and an insurance company can provide better protection to employees and their families at a lower cost to the U.S. Treasury, why preclude it?
While each of the Democratic candidates clearly hopes that the appeal of his or her specific plan will attract voters in the opinion surveys and, more importantly, in the 2020 primaries, it may be more productive for the party’s 2020 election prospects to emphasize the common motive behind their proposals and their dramatic contrast to the entire history of Republican legislative efforts.
Robert I. Adler
Port Washington
