> This absense of cheap and accessible quality health is
> something that puzzles me, too. I've always assumed we'd get
> national healthcare when unions had the cloat to either
> demand it or win real private health insurance back, so
> business would look to shift the cost and get on board, too.
> It's never happened. Okay. But why at least some US
> corporations don't use a cost-benefit analysis in supporting
> national health is a puzzler. From the early 80s on, unions
> such as the UAW and Steelworkers were faced with the
> Hobson's choice of getting either raises or better benefit
> funding as health costs soared for business. If the burden of
> health care is indeed so onorous, and the unions developed
> the muscle to make health care a priority, why wouldn't some
> Iacocca or other maverick type come out for dumping the cost
> on the government. You say it's "ideology." Could be, though
> when ideology trumps self-interest it's the ideologue who suffers.
I don't think it is ideological. It's self-interest at a foundational class level. Tying health care to employment has a particular benefit for the investor class: it increases employers bargaining power over labor, which in turn keeps wages lower than they otherwise would be across the board. (In other words, if you want health care, you have to go to an employer to get it.) That's why that particular arrangement was established from the jump. It certainly isn't natural. And it's actually kind of weird -- if you pause and think about it -- to obtain health care from an employer. But it's set up that way to create a dependence of labor on capital. In a world of single payer health care severing health from employment, labor no longer needs an employer to have health care, which significantly lessens the employers' bargaining power vis-a-vis labor and in turn should cause real wage increases across the board (and correspondingly reduced profits across the board). And I think when it comes to such fundamental interests, capitalists are particularly on guard.
But with health care costs rising, it becomes advantageous, from a competition standpoint as between capitalists, to try to reduce the share of health care costs shouldered by the employer and put them on the worker. This might be their undoing, however, because as employers continue to shift the cost of health care directly on the worker, a movement for single payer health care will grow stronger. It will be interesting to see what the response of capitalists is to that movement, but my guess is that they will never, ever support single payer health care or any plan which severs health care from employment.