[Vision2020] Health Insurance

[Ron Force]

Paul Krugman's column in today's New York Times takes off on Peter Drucker's
"Age of Discontinuity" on the dilemma facing corporations (and individuals)
in an age of economic insecurity:

"... Many of the corporate giants of the 1960's, companies whose
pre-eminence seemed permanent, have fallen on hard times, their places in
the business hierarchy taken by new players. General Motors is only the most
famous example.

So what? Meet the new boss, same as the old boss: why does it matter if the
list of leading corporations turns over every couple of decades, as long as
the total number of jobs continues to grow?

The answer is the reason Mr. Drucker's old book is so relevant to today's
headlines: corporations can't provide their workers with economic security
if the companies' own future is highly insecure.

American workers at big companies used to think they had made a deal. They
would be loyal to their employers, and the companies in turn would be loyal
to them, guaranteeing job security, health care and a dignified retirement.

Such deals were, in a real sense, the basis of America's postwar social
order. We like to think of ourselves as rugged individualists, not like
those coddled Europeans with their oversized welfare states. But as Jacob
Hacker of Yale points out in his book ''The Divided Welfare State,'' if you
add in corporate spending on health care and pensions -- spending that is
both regulated by the government and subsidized by tax breaks -- we actually
have a welfare state that's about as large relative to our economy as those
of other advanced countries.

The resulting system is imperfect: those who don't work for companies with
good benefits are, in effect, second-class citizens. Still, the system more
or less worked for several decades after World War II.

Now, however, deals are being broken and the system is failing. Remember,
Delphi was once part of General Motors, and its workers thought they were
totally secure.

What went wrong? An important part of the answer is that America's
semiprivatized welfare state worked in the first place only because we had a
stable corporate order. And that stability -- along with any semblance of
economic security for many workers -- is now gone.

Regular readers of this column know what I think we should do: instead of
trying to provide economic security through the back door, via tax breaks
designed to encourage corporations to provide health care and pensions, we
should provide it through the front door, starting with national health
insurance. You may disagree. But one thing is clear: Mr. Drucker's age of
discontinuity is also an age of anxiety, in which workers can no longer
count on loyalty from their employers."