Wednesday, May 2, 2012

Obamacare’s biggest problem? It’s small-ball.


Obama is thinking way too small.  He needs to venture outside the box.  There is a way to provide universal medical insurance for all, and simultaneously end unemployment in the U.S.  To see the way, Obama needs to think big.  Then, with enough hope, he can change everything.

The key concept is “single-employer” i.e., a universal employment system.

This does not exist today in the U.S. Instead, we have tens of thousands of separate employers, each with its own employment practices and payrolls. Every grocery store has its own staff – plus separate stocking, pricing, and purchasing arrangements. This separate-grocery business model causes food access and cost problems. For example, some grocers do not offer fresh produce in low-income neighborhoods while suburban grocers stock an ample supply of fresh foods. But more important, the "separate enterprise" business model causes the same access and cost problems for every other type of enterprise, public and private.  This is why high cost is such an obstacle to consumers who want – but often cannot afford - the products of auto manufacturers, drug stores, retail outlets, banking, insurance, hospitals, physicians’ offices, schools, local governments, and thousands of other enterprises.

It is common sense that the more consolidation, the cheaper the cost. Therefore consolidation of the separate-enterprise business model should be the goal. And that means a national, single employer.

Single-employer would be administered by the federal government, and would be our sole national purchaser of labor. Government single employer would eliminate the duplicative and needlessly expensive overhead of our present independent and poorly coordinated employers. The cost of business administration and related payroll costs would drop by 50%.

The trillions saved would permit our government single employer to employ everyone above age 15.

In fact, no one who wants to work would be denied a job. Not just junk jobs, but meaningful, high-paying jobs. The government would assign people to jobs using modern, efficient planning processes without regard to gender, race, national origin or ability to work. Every working-age American will have a job and earn a decent living wage paid from public funds. Result: the curse of unemployment is gone forever, financed by savings from the change to single-employer.

Implementation would be simple – just delegate the details to the Senate and Department of Labor (thus also avoiding one of the Obama’s biggest mistakes in 2009 – permitting the House to write the Obamacare law).

Everyone could then have medical insurance through their employer - the federal government - at less cost than today, giving citizens even more spending money as well as making American goods more competitive.

Mr. Obama – think big.

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