Sunday, October 14, 2012

More Data for More Reflection on Health Care and the Market

In my last post, I asked this question: "If [employer-provided] health insurance grew as a benefit because there were more jobs than workers, what can we expect when there are more workers than jobs?" Well, I think we have an answer, and it isn't a happy one. 

Take a look at this article from Associated Press, picked by the Huffington Post: "Darden Restaurants Tests Hiring Of More Part-Time Employees To Avoid Obamacare Costs." Darden Restaurants, Inc., best known as owners of Olive Garden and Red Lobster, is making a deliberate choice to reduce its costs for employer-provided health care by reducing the number of employees who work enough hours to qualify. The authors of the article also note that other restaurant chains are making the same decision.

Now, there's nothing illegal about this. I think it's immoral, but in one sense that's neither here nor there (and, in the classic trilogy, I would worry about "fattening," but that's for another time). I simply hold this up as the other side of depending on the market and competition to provide access to health care. If we believe that universal access to health care is a good thing, and should be seen as a civil right, we simply can't depend on the market and competition to bring it about.


June Butler said...

Marshall, you're right. Depending on the market for health care is buying and selling what should be a right for every citizen. A single payer plan is the only way to go, but I don't know when we'll get there.

Walmart had the jump on a good many businesses by hiring many of their workers only part-time from the start.

Jay Croft said...

I read somewhere that whenever Wal Mart moves into a community and "hires" people, welfare and other costs rise for that community. Most of the workers cannot earn enough to make a decent living.

Marshall Scott said...

Jay, I'm not sure that's correct. While Walmart's benefits aren't as high as other employers, they do exist. I'd have to see the research. There are conflicting stories, and you might be interested in this or this

In the meantime, Walmart's role in health care more generally is complicated. Their pharmacies have challenged costs for medication by the broad selection they've offered of generic medications available for $4.00. Moreover, they have begun to offer in-store clinics staffed by Advance Practice Nurses, and offering many primary care services at published prices (and, from what I've seen, pretty reasonable prices). Read about that here. It may well be that for the less well off, Walmart may well become a significant provider of health care.

Anonymous said...

Small business owners, restauranteurs,farmers,bankers and yes, box store managers, have predicted this since Obamacare was put into the public eye. That's why there have already been over 1000 exemptions for some companies,unions, etc. Part time employment is almost the only kind available here now, and not just in Walmart(though, I admit, they have lowered their hours every time the Feds lowered the definition of full time, which is several times in the last decade). Even the local college and schools and police,union territory, are hiring part time to save money on benefits. I begin to wonder if the Republicans and Libertarians saying Obamacare was designed to fail in order to force universal coverage aren't right.

From personal experience, up until a few years ago during the recession, 70% of the Wally workers here were full time and still any worker over 19hrs/week is eligible for the usual--vacation, sick/personal time, quarterly profit bonuses,401k with 6% match and health insurance that, here at least, is equal to what the local hospital provides. Do they have problems? Definitely, but I do wish some wouldn't act like Walmart has destroyed the entire U.S. economy by itself or that everyone who works there is a beggar in rags. In this state you can make $34,000(average income here is $31,000) and still get various types of gov't aid, depending on how many kids you have and what problems exist. It's not all Walmart.

Marshall Scott said...

Some of these dynamics were going on before the Affordable Care Act was passed, and would have continued one way or another. For example, colleges, and especially state schools, small schools, and and others have been hiring contact faculty instead of opening tenured positions for perhaps twenty years and more. It's varied from place to place and from time to time, but there have been more folks with PhD's than there have been tenured positions for them.

So, I think there will be a fair amount of shuffling. However, I also think that over the next four years we'll see a set of rules implemented that are consistent across the country, or at least more consistent. That will, I think, make difference than we can yet see.