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Health Care Should Not Be a "Benefit"

Marriott International -- the company behind the hotels -- is considered among the best employers in the country. Low turnover, good benefits and good access to the higher-ups. Forbes ranks it at #72 on their "Best Companies to Work For List." And reading this blog post by CEO Bill Marriott, it's easy to see why. "During these tough times," he writes, "it has become more difficult for employees at many U.S. companies, including Marriott, to work a sufficient number of hours to continue to qualify for health benefits." As such, Marriott has "suspended measuring hours worked to maintain health care benefits."

That's a good, humane policy. But in being the exception to the rule, its very existence is an excellent argument against the employer-based health-care system. Access to health care should not be dependent on the kindness of your employer. It should not be dependent on the value that the marketplace attaches to a worker's precise set of skills. It should not be dependent on choosing an industry that doesn't go through wrenching change and downsizing 20 years after you first entered it (as happened to any number of manufacturing workers or, for that matter, California state employees).

It can seem like a gauzy platitude, but in the 21st century, the richest nation the world has ever known should be able to make health-care coverage a given; not a perk, not a gift, and certainly not a "benefit."

By Ezra Klein  |  July 13, 2009; 9:05 AM ET
Categories:  Health Reform  
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Comments

Mr. Klein:

Your remarks are absolutely correct. Health care should not depend on the largesse of the employer, or the fact that the individual has a job that gives him access to needed care. It is a necessity, and the responsibility of any nation that calls itself a compassionate one. Every individual works for the welfare of the entire society.

Posted by: jrileym | July 13, 2009 9:48 AM | Report abuse

Health care should be seen as a social good, like public education -- the entire society benefits from health care for all, not only in better health but in lower costs overall. We don't argue about funding public education because it is commonly agreed that all benefit (although that argument didn't seem to play in California when they passed Prop 13 and derailed the state education system). The country as a whole needs to get our heads out of the 'for profit' model and rethink the approach.

And I don't want to hear that govt run health programs will lead to rationing of health care -- we already do that, we just base it on who can pay rather than on other perhaps more health relevant criteria.

Posted by: johnsondeb | July 13, 2009 10:02 AM | Report abuse

johnsondeb: Man, I wish I lived in the world you live in, where people don't argue about funding public education. Ok, I shouldn't be so snarky, but conservatives have been trying to dismantle the public education system for decades, if not since its inception.

But I *DO* agree that we shouldn't have to argue about publice education funding or healthcare. Some things just shouldn't be about making a buck.

Posted by: MosBen | July 13, 2009 10:24 AM | Report abuse

I agree, but it seems to me that Americans are so concerned with appearing virtuous that, whenever faced with a choice of doing the right thing in a collective, systemic way versus smaller, less effective actions that make more of a personal statement, we always, always go for the self-aggrandizing option even though it's far less likely to actually achieve the results we hope for. It's more straightforward for corporations (which, as citizens, are basically sociopaths that are only concerned with their own benefit); they devote miniscule amounts of their profits-- that seem large to individuals-- to community endeavors because it helps their business. We like to flatter ourselves far more than we like to contribute to the public good per se.

Not that I don't applaud Marriott for this-- I do. But there is a set of assumptions behind these seemingly illogical small-bore actions, and a host of issues related to self-image that dominate in American psychology.

Posted by: latts | July 13, 2009 10:27 AM | Report abuse

I do not understand why, when we're seeing the highest unemployment in decades (perhaps the highest since the Depression), we're moving to chain health care to employment.

It makes no sense whatsoever. Especially when there's considerable discussion about our "jobless recovery" that we're moving toward.

With regard to public education - in my state, public education is definitely very much a tiered offering, in that educational quality tends to be dependent on the incomes found within a particular community.

The more affluent a community, the more funding the schools get. So income disparity tends to become institutionalized by the school system. A child at a neighborhood public HS in Chicago will never achieve the same educational experience as a child at New Trier HS in the Chicago 'burbs.

We see a similar disparity institutionalized in today's health care system - those who work for the biggest companies get the best and most comprehensive and most affordable health care. Those who work for smaller organizations or for themselves are at a distinct disadvantage when it comes to the procurement of health care - both in terms of costs and access to care.

What we need is equality of access - let the smaller organizations have access to the same policies at the same cost that employees at large companies or the federal government can tap into.

http://wardonwords.blogspot.com

Posted by: anne3 | July 13, 2009 11:15 AM | Report abuse

So what else is new?

Posted by: lensch | July 13, 2009 11:33 AM | Report abuse

I think there is literally zero chance that our political system could contain costs on something that people think that Government owes them. I have no problem with rationing- my worry is that our system will not be able to hold the line on rationing. There is no one in the system with the incentive to decline to pay for something. People want to be covered for more things, doctors want to be paid for more things, politicians just want to make everyone happy. Its a one way street all in the direction of it costing more and more. There is no one there to put the brakes on and keep a budget.

Posted by: spotatl | July 13, 2009 11:47 AM | Report abuse

I'm going to agree heartily with the post and with "latts" comment about Americans being suckers for virtuous acts rather than systemic reform. I'm afraid that the proposed health system will continue to overlook the virtues of revising the frameworks in favor of preserving "the narcissism of small differences" by setting the value of "choice" above access and risk pooling.

Posted by: michaelterra | July 13, 2009 12:31 PM | Report abuse

What latts said: the "let private charity handle X, Y and Z" line that's repeated across much of the American right seems to translate into "let small, flashy gestures preserve a dysfunctional status quo."

The healthcare fundraiser should not warm your heart. Even well-meaning efforts can be limited by scope and circumstance, and subject to capricious judgements on who deserves assistance.

(It's the same instinct that defends the role of tips in augmenting poor base pay for jobs built upon master-servant relationships, as opposed to a decent wage.)

Posted by: pseudonymousinnc | July 13, 2009 4:32 PM | Report abuse

Arguing that health care should function like the public schools is probably not a political winner.

Posted by: tomtildrum | July 13, 2009 5:31 PM | Report abuse

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