A national health plan is just good business

April 03, 1991|By Robin Miller

HASSAN, an immigrant from Pakistan, had to quit his job. The problem wasn't discrimination. The convenience store he managed was owned by a fellow Pakistani. It wasn't salary, either. While not great, Hassan's income was adequate to meet his simple needs. The problem was health insurance. Hassan wanted to get married, so he had to find a job that offered health insurance for himself and his new wife.

Businesses that can't offer medical benefits have trouble finding and keeping quality employees, especially those with children or non-working spouses. For many Americans, the choice between welfare and a no-benefit job is no choice at all, especially if taking a job means loss of government-sponsored medical care.

The problem is especially acute for single mothers. One described her experience bitterly: "I went to school to learn to be a word processor. I was working through a temporary agency and had stopped getting [welfare] and was expecting to get a full-time job, with benefits, from one of the companies I had worked for through the agency [when] my daughter got asthma. I couldn't afford the doctor bills, and I made too much money to get Medicaid when I was working, so I had to go back on welfare."

This is not an uncommon situation. I have no statistics, but I've heard the same sad story from several welfare mothers who wish they were working, not rotting in housing projects. If we had a national health insurance system that covered all citizens, regardless of employment, these women would have jobs. And they aren't the only ones who would benefit if health care were considered a national birthright. Owners of small businesses and entrepreneurs would benefit even more.

With the cost of non-group family health care insurance ranging from $300 to over $500 a month, depending on locale, it's hard to start a business unless you have a spouse who works for a company large enough to offer health benefits. Even with the new stripped-down health insurance plans proposed in some states, non-group family coverage will still cost at least $250 a month, or $3,000 annually.

If you want to go into business for yourself, and you have a family, you must allow for this cost. And $3,000, while it may not seem like much to a senator, is a lot of money to a single mother who wants to start a home-based business. If she wants to expand that business, and has any kind of a social conscience, she must spend the same amount for every new employee she hires.

How many new businesses haven't been started because of the high cost of health insurance? How many willing workers haven't been hired or have turned down jobs because the businesses that wanted to employ them couldn't afford health insurance? This issue is almost never mentioned when we talk about business competitiveness or productivity.

A single mother in Germany or France who wants to start a small business doesn't worry about obtaining medical care for her children. A retail store owner in Italy doesn't worry about his employees quitting because they have to find jobs that offer health benefits. Canadian computer programmers don't worry about going off on their own and losing their precious health benefits. In these countries, as in every industrialized country other than the U.S. and South Africa, health care is a basic right, available to all citizens at no cost.

The care given by government clinics in countries that consider medical treatment a basic right may not be the best available. Those who can afford better often choose to patronize private hospitals and physicians, but basic care is available to everyone, whether they work for big companies, work for small companies or don't work at all. Even if we don't care about the individuals who suffer from our lack of national health insurance, should we not look at the possibility of instituting a universal medical access program as an aid to the formation of new businesses?

Why are the conservative politicians who claim to be on the side of small business so adamantly opposed to universal health care? Can't they see that fear of losing health benefits is one of the greatest barriers to new business formation?

I'm pro-family and pro-business. I'm a Republican, so I believe in individual empowerment and individual freedom -- including the freedom to start one's own business. This is why I believe in national health insurance. I don't see national health insurance as a reduction of individual freedom. Rather, I see it as the key to financial independence for myself and millions of my fellow citizens.

Robin Miller drives a taxi and lives in Baltimore.

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