Jobs Tied to Health Care

January 25, 1994|By ROBERT RENO

NEW YORK — New York.--If there are 37 million Americans without health-care coverage, how many are there who are stuck in jobs they detest, in positions that may be wholly unsuited to their wants and talents, simply because they are scared witless of losing health insurance for themselves or their families?

No one is sure, but if they could be precisely counted it is fairly certain they would swell by several million the constituency that would benefit directly and quickly from health-care reform.

One Gallup Poll found that a fifth of American families had a member who had passed up a job or stayed in a job simply to keep health-care coverage. And a study conducted for the National Bureau of Economic Research estimated that the turnover rate among insured employees is reduced by as much as 25 percent purely because of insurance considerations that are extraneous to the normal reasons that cause people to decide where they want to work -- things like salaries, possibilities for advancement, working conditions and location.

It is also a safe guess that large numbers of Americans are discouraged from self-employment -- a rich source of entrepreneurship, job creation and economic growth -- simply because they're frightened of having to insure themselves or their families against getting sick. It should not surprise us, therefore, that Gallup also found that given a choice between guaranteed health coverage and complete freedom to choose a doctor, 75 percent prefer the former.

On balance, of course, greater job mobility ought to mean more people in jobs they like or jobs that are appropriate for them, and this ought to mean a more efficient and competitive economy and a higher rate of economic growth. But Brigitte Madrian, the Harvard economist who did the study for the bureau, warns that these overall economic benefits may be relatively small and in any event difficult to measure, hardly enough to be a major argument for health-care reform.

Why not, she suggests, be for greater job mobility on the grounds it makes for a more agreeable society? ''It would make individuals happier even if it didn't affect the gross national product,'' she says.

Anyway, even by the time the special-interest jackals get finished pulling most of the meat off it, the health-care reform bill likely to emerge from Congress this summer is almost certain to move in the direction of universal or guaranteed availability of basic coverage with some degree of assured affordability. It may or may not live up to the vaster promises of the 1,342-page Health Security Act that the Clinton administration has submitted. If all the money the health-care industry has poured into this battle means anything, the final bill almost certainly will not fully address the issue of cost containment.

But merely releasing millions of American workers -- both the insured and the uninsured -- from the tyranny of the uncertainties of health-care coverage will be a large stride toward a fairer economy in which people can make decisions about where they work and what they do for the right reasons.

Robert Reno is a columnist for Newsday.

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