Last night, I debated Andy Stern on the Jim Bohannon radio show. Stern is president of the Service Employees International Union, which represents 1.8 million nurses, health care workers, janitors, security officers, and public employees. He is definitely not a member of the Anti-Universal Coverage Club.
I was pleased to find that we agree that the employment-based health insurance system cannot last. What I found most interesting, though, were two weaknesses in the case he makes for universal coverage.
First, Stern argues that unless we have universal coverage, American firms won't be able to compete with foreign firms. To me, that claim is economic nonsense, as I explained in our debate and in Health Care News:
Employers don't need the government to save them from the rising cost of health benefits. Just as Dorothy always had the power to return to Kansas by clicking her heels, employers have always had the power to pare back their health benefits...
All else being equal, firms that contain their labor costs this way will beat the firms that don't. Those companies that support 'universal coverage' want to increase the labor costs of their competition, whether through higher taxes or health premiums. Universal coverage won't make America more competitive — it will cripple America's most competitive firms to protect its least competitive firms.
And, of course, that's the entire point.... Companies that support 'universal coverage' never bother to mention that covering all the uninsured would cause health spending to explode, because they don't really care about overall health spending. All they care about is that their competitors spend as much as they do.
Nor does Stern seem to mind if health spending explodes. I think that may be because...
Second, Stern argues that we could get a better deal on prescription drugs if Medicare were allowed to negotiate with drug companies. But seeing as how he represents so many health care workers, I don't think he's going to be leaning on Medicare to be that tough a negotiator. During our debate, I invited him to discuss SEIU's role in helping Medicare set the payment rates that affect his members. He didn't take the bait.