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What Health Care Can Learn From Whole Foods

PH2009080402380.jpgI've gotten a couple requests to respond to John Mackey's op-ed advocating a series of health-care reforms that wouldn't solve anybody's health-care problems. The ideas in there aren't interesting and aren't new. The archives of this blog contain plenty of posts explaining why, for instance, it wouldn't help matters for the federal government to declare it illegal for Arizona to mandate that insurers cover mammograms and diabetic care.

What is new to people is that Mackey is writing the op-ed. Mackey founded Whole Foods, a traditional favorite of liberals, and so his libertarianism comes as a surprise to some. But the interesting insights on health-care reform don't come from the CEO of Whole Foods. They come from the stores.

Food is more like health care than it is like cable television. We worry if people don't have enough food to eat. We worry quite a lot, in fact. So we have a variety of programs meant to ensure that people have sufficient food. If you don't have much money, you rely on these programs. As of September 2008, about 11 percent of the population was on food stamps. It's probably somewhat higher now. Millions more rely on the Women, Infants, and Children nutrition program, and reduced-price school lunches.

The insight that people need food has not led us to simply deregulate the agricultural sector (though that might be a good idea for other reasons) or change the tax treatment of food purchases or make it easier for rich people to donate to food banks, which is what Mackey recommends for health care. It's led us to solve, or try and solve, the problem directly by giving people money to buy food. And that works. These programs, as every Whole Foods shopper knows, haven't grown to encompass the whole population or set prices in grocery stores. If you have more money, you shop for food on your own. And if you have a lot of money, you shop at Mackey's stores. That's pretty much the model we're looking at in this iteration of health-care reform. We're also laying down some rules so grocery stores -- excuse me, health insurers -- can't simply refuse to sell you their product, or take it away after it's already been purchased..

Mackey, playing to type, has offered a Whole Foods solution for health care: It makes the system even better for the rich and the young and the educated -- the sort of people who shop at Whole Foods, in other words -- and doesn't do a lot for those who really need help. But the existence of a vibrant institution like Whole Foods within a broader system that considers it unacceptable -- at least in theory -- for the poor to go hungry, and so subsidizes their purchase of food, does have lessons for heath-care reform.

Photo credit: AP Photo/Stephan Savoia.

By Ezra Klein  |  August 12, 2009; 4:02 PM ET
Categories:  Health Reform  
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Comments

The thrust of Whole Foods plans has been to put people on an High Deductible plan with an HSA. Whole foods covers the entire premium for the HDHP and 2/3 of the deductible in the form of HSA contributions. The criticism of these plans is that they self select and only advantage the young, healthy, and wealthy. The only part of that criticism that seems valid is the fact that an HSA is inherently more beneficial to someone with a higher income but unfortunately this applies to all employer provided health care so long as the employer contribution remains intact. It would be interesting to see you back up the rest of your assertions with actual research, maybe such as the following study:http://www.actuary.org/pdf/health/cdhp_may09.pdf which found that not only did such plans show long term cost reduction but also better performance on measures such as utilization of prevantive care and chronic care.

Posted by: conrad5 | August 12, 2009 4:30 PM | Report abuse

The government already pays for over half of all medical care in the country. It therefore already has the financial wherewithal to cover the cost of caring for the medically indigent many times over. Instead, most of the government's health care spend goes to cover middle- and upperclass (elderly). The elderly happen to be the wealthies segment of our populuation.

In other words, to use EK's formulation, most of the spending today benefits people who don't need help (or wouldn't if they hadn't been themselves heavily taxed during their working years to pay for others above them in the pyramid scheme). So our current system is a lot like Whole Foods. A better social insurance system would truly *only* offer coverage or subsidies to who lacked the means to pay for it themselves and wouldn't discriminate on the basis of age. Medicaid for all (who can't pay for their own cover)!

Posted by: tbass1 | August 12, 2009 4:34 PM | Report abuse

Why are conservatives so obsessed with tort reform?

It doesn't seem like a partisan issue to me, but conservatives/libertarians are always bringing this up as a top issue while it doesn't seem to be brought up often at all by liberals

Posted by: JohnSnider | August 12, 2009 4:35 PM | Report abuse

in what ways might it be good to deregulate the ag industry? environmental regs are too lax now, hence the pollution from crop production and factory farms. antitrust laws are not being being enforced, hence the concentration of the livestock industry into the hands of a few meat processors. we don't need to deregulate ag, we need more regs and better enforcement of current regs.

the root issue, of course, is all the subsidies and tax breaks that corporate ag takes advantage of to further their dominance. take away the misguided subsidies and tax breaks, the more fair and sustainable food system we would have.

Posted by: mohloff | August 12, 2009 4:37 PM | Report abuse

I think some tort reform should be included because there are savings to be had and there are a lot of savings needed. It's a small percentage of the pie, but it's a big damn pie. That said the big reason the right is obsessed with tort reform is easily explained: trial lawyers. Trial Lawyers give money to democrats overwhelmingly. It's not without merit but it is largely a political sideshow.

Posted by: conrad5 | August 12, 2009 4:41 PM | Report abuse

Mr Klein, are you saying Mackey's employees are rich?? I know the company has been ranked as one of the top 100 places to work for 10+ years, but I expect the average wage is in the 15 dollar an hr range! His plan works because it puts consumers in charge of their health dollars.

Posted by: JimBobT | August 12, 2009 4:44 PM | Report abuse

a few thoughts on whole foods market...

john mackey recently said of his stores, that they now sell "a bunch of junk."
do you want someone who confesses this about his business practices, to be influencing your health care reform?

how has whole foods" boosted their sales? by abandoning the principles of selling healthful foods.
a "whole foods' market opened recently in my area.
i am not a "whole foods market" shopper, and upon visiting, i was quite surprised to see the large number of conventionally grown fruits and vegetables, and the extraordinarily high prices throughout the store.

it is a beautiful market, with interesting and expensive merchandise... but it doesnt seem to be primarily about "whole foods."that seems to be something of a misnomer.
also, you would need to be a rich person, to be purchasing your groceries there.
they sell organic cotton sweatshirts for over a hundred dollars, sparkly colorful salt crystals that look like they came from marco polo's silk route....rich and cholesterol-laden puddings and desserts....and it seems that they had a ban on high fructose corn syrup, which seems to be lifted.
i went there on a special day, and wasnt paying close attention to prices. i filled a cardboard container with interesting cole slaws, just captivated with all of the interesting things.
when i got to the cashier, i realized that my cardboard box of cole slaw was costing me eleven dollars!!!!!!
eleven dollars!!!!!!!!!!!

mr mackey is not catering to people like me.
when people raise prices and lower standards to make more money, it makes me want to take their health care reform advice, with a "grain of salt!"

Posted by: jkaren | August 12, 2009 5:45 PM | Report abuse

John Mackey didn't say he boosted his sales by selling junk. He plans to raise sales by focusing more on organic products. What irks liberals is that the employees at Whole Foods like their health insurance. This really caught my attention in his op-ed today!

"At Whole Foods we allow our team members to vote on what benefits they most want the company to fund. Our Canadian and British employees express their benefit preferences very clearly—they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an "intrinsic right to health care"? The answer is clear—no such right truly exists in either Canada or the U.K.—or in any other country."

So his employees in Canada and Britain want more health care dollars they can control themselves!! This is what upsets Klein and his fellow progressives.

Posted by: JimBobT | August 12, 2009 6:03 PM | Report abuse

Why would we need a law to force Whole Foods to sell? They'll gladly sell to anyone who can pay. And those who can't pay get food stamps. The price of food has collapsed since 1960 because of innovation and competition. Can you imagine if we'd let the government set up "Nutricare" for seniors and "Nutricaid" for poor people back in 1965, and forced the rest of us to get "food benefits" from our employers? Instead of 47 million so-called uninsured, we'd have 47 million starving!

Posted by: marincanuck | August 12, 2009 6:17 PM | Report abuse

"John Mackey didn't say he boosted his sales by selling junk."
jimbob t:

"mackey told the wall street journal, basically we used to think it was enough just to sell healthy food, but we know it is not enough. we sell all kinds of candy. we sell a bunch of junk."
mark tran
guardian.co.uk
august 5, 2009


http://www.guardian.co.uk/business/2009/aug/05/whole-foods-boss-junk-

Posted by: jkaren | August 12, 2009 7:03 PM | Report abuse

http://online.wsj.com/article/SB124941849645105559.html

Posted by: JimBobT | August 12, 2009 7:15 PM | Report abuse

jimbob t

i tried to follow your link, but i am not a subscriber to the wall street journal.
in any event, whatever intentions he has to change his business model, he did in fact say "we sell a bunch of junk."
there are several sources for his quote on the web.

lowering quality in order to make more money.
that plan doesnt work too well for consumers of groceries or health care.

Posted by: jkaren | August 12, 2009 7:35 PM | Report abuse

"So his employees in Canada and Britain want more health care dollars they can control themselves!!"

Uh huh. What are the other benefit options available for employees to choose from? Free lifesize portraits of John Mackey? The argument about "permission to spend" is at best a non sequitur, at worst dishonest -- standard libertarian fare.

In any case, what he's talking about are dental and optical supplementaries, where state provision and reimbursement is more limited. Last time I checked, most American insurance plans don't pay for your dental work or eyeglasses either.

"Why are conservatives so obsessed with tort reform?"

Because they want their corporate masters to get away with slap-on-the-wrist settlements for screwing people over?

Medical tort claims are usually the last resort to get relief. It's well-documented that insurers will wait until a plaintiff's day in court to settle, just because they hope that the legal bills will become too high, or the person affected will die.

Posted by: pseudonymousinnc | August 12, 2009 7:53 PM | Report abuse

Ask Doctors why they favor tort reform? As for British and Canadian employees wanting more money they control, in both countries people can go to private care physicians where there is no wait. They're way more expensive for sure thanks to government demands on health care.

Posted by: JimBobT | August 12, 2009 8:08 PM | Report abuse

You don't like Mackey because he's a successful businessman. He's a successful businessman because he gives his customers choices (healthy food and candy too), and he gives his employees choices (health plans that allow them to get the type and amount of care they choose, without screwing them into subsidizing their unhealthy and hypochondriac coworkers). Those choices don't conform to your idea of their best interests, so of course the whole operation is evil capitalism.

There is another type of successful "business" person, who is successful because he owns politicians in both parties and can get whatever bailouts he wants. The customer and taxpayer get exactly what is decided in some committee room by shills and wonks, and they can take what they get or they can emigrate. That isn't capitalism, but it's guaranteed to always make the "right" choices, so you love it.

And of course we have Ezra's SOP here, in which he claims some minor detail of a comprehensive essay was already declared dead by all the wonks last week so why would we even pay attention to all the rest of the essay? That's a neat trick, but why does it only work in one direction? Why can't Ezra respond to any of the other six points besides mandated coverage? Actually clicking through to Ezra's lame Prospect piece on mandated coverage, it's all about what he and some other random guy "think". Well that was convincing; thanks for putting that link in there.

Posted by: JessAustin | August 12, 2009 8:29 PM | Report abuse

You mention "for instance, it wouldn't help matters for the federal government to declare it illegal for Arizona to mandate that insurers cover mammograms and diabetic care."

If it is not helpful, why is that very provision -- absolute Federal prohibition of State mandates for care -- in each and every heath insurance reform proposal now pending??

Posted by: rmgregory | August 12, 2009 9:31 PM | Report abuse

John Mackey has made a huge mistake. He has angered his customer demographic by revealing his right wing views on health care and using his company to promote them. The boycott starts today. He has five stores in progressive Portland, Oregon. He is going to lose big time in the pocket book. And he has viable competition in his market, New Seasons and Trader Joe's.

Posted by: cmpnwtr | August 12, 2009 9:54 PM | Report abuse

Mackey isn't a right winger. He's a libertarian. Is in favor of drug legalization, prostitution, gambling, gay marriage etc etc. If that's a right winger you could have fooled me. Again the progressives are upset because the employees at Whole Foods really do like their health insurance. Get over it.

Posted by: JimBobT | August 12, 2009 10:15 PM | Report abuse

I'm not upset because employees at Whole Foods like their health insurance.

Most of them look young and healthy to me, so they probably don't have to use it very often. In fact, I don't think I've ever seen an overweight WF employee, but I haven't shopped there in a while.

Good for them, though.

Posted by: KathyF | August 13, 2009 1:46 AM | Report abuse

When you've guaranteed me food, clothing, and housing, as well as medical care, let me know. I'm retiring. And don't forget the beer and television.

Posted by: dglesvic | August 13, 2009 3:32 AM | Report abuse

"Last time I checked, most American insurance plans don't pay for your dental work or eyeglasses either."

Neither me nor my husband has worked anywhere that doesn't cover both of these. Are we that unusual?

"In fact, I don't think I've ever seen an overweight WF employee,"

Maybe you've answered your own question? But seriously - those people are on their feet all day...being overweight wouldn't make that easier. You don't really see overweight people working at any supermarket do you? What's the difference - in terms of 'who you see working' between any supermarkets?

Whole foods, from what I've read, has done a fantastic job of controlling their health care costs *and* their employees are happy. It does seem that the government is unhappy with this type of solution. Given that they want to stick with a system (employer based coverage) that most people think is outdated. They don't want to offer us care. They want to take over 20% of our economy.


Posted by: atlmom1234 | August 13, 2009 5:02 AM | Report abuse

The comparison between food and health care doesn't work. In large part, we address food insecurity through vouchers (food stamps) that let the needy choose where to shop. Ezra would never agree to any such plan with regard to health care.

Posted by: tomtildrum | August 13, 2009 10:02 AM | Report abuse

Whether he's "right wing" or a "libertarian," John Mackey is a rich man whose views reflect his economic status. People like my son, who has Type 1 diabetes through no fault of his own, do not factor into his mindset.

If an insurance company won't insure my son at an affordable rate -- and they won't of their own accord -- he should look to charity for support, according to Mr. Mackey.

So whatever you call it, this is pretty much the same view that would have been put forth by Cornelius Vanderbilt or any of the other Gilded Age plutocrats. It is a disgrace in our era. People who aren't rich and yet agree with Mr. Mackey are dupes.

Mr. Mackey, you may be smug about the high-deductible policies you offer your employees, but this is the end of my support for Whole Foods.

Posted by: ejastarte | August 13, 2009 10:40 AM | Report abuse

Young people who can't afford soup-to-nuts gold-plated coverage get high-deductible plans if their state allows such, or they go without insurance (I'm one of those people). Young people who have chronic ailments and therefore can't afford their regular treatments go on Medicaid.

Don't get mad at me for suggesting Medicaid. I know it sucks. I'm just not sure why making everyone in the country get the same miserable coverage will be an improvement.

Posted by: JessAustin | August 13, 2009 11:07 AM | Report abuse

Mackey's op-ed reveals a significant blind-spot when it comes to the realities of low- and moderate-income people’s lives and the barriers they, particularly women, face to accessing health care. The eight health reform policies that he recommends fail spectacularly to address the challenges women face in accessing affordable, comprehensive health care—and in some cases, exacerbate them.

For a point-by-point analysis of how Mackey's vision of health reform would affect women, check out: http://www.womenstake.org/2009/08/whole-foods-ceo-fails-to-see-the-whole-picture-when-it-comes-to-health-reform.html

Posted by: JulKaye | August 13, 2009 1:05 PM | Report abuse

Mackey has over 30 thousand employees. Are you suggesting none of them have kids with type one diabetes?? Dumb dumb dumb.

Posted by: JimBobT | August 13, 2009 1:15 PM | Report abuse

Health savings accounts are the way for low income people to get insurance. We need to get rid of the regulations that make it difficult for HSA to flower.

Posted by: JimBobT | August 13, 2009 1:46 PM | Report abuse

Cashiers and other employees at Whole Foods are given talking-points by management instructing them to tell customers that they like their healthcare plan.

Whole foods also relies heavily on part-time workers who are not eligible for health insurance coverage.

They make their prepared food out of spoiled produce they cannot sell.

They are the Walmart of the upscale class.

Posted by: harold3 | August 13, 2009 2:18 PM | Report abuse

89 percent of Whole Foods employees are full time. Mackey's ideas on health care are serious. Obama's aren't. We are on the verge of bankruptcy and Klein and his fellow Progressives don't live in the real world!

http://www.youtube.com/watch?v=3EPd2i4Jshs&feature=player_embedded

Posted by: JimBobT | August 13, 2009 2:47 PM | Report abuse

I think it's interesting that many of you talk about how happy Whole Foods employees are with their health insurance--how they even voted for it--yet I've seen very little other than statements issued by Whole Foods or Mackey himself that talk about the issue. When the issue was put to a vote, what were the other options? What do employees actually think of the plan/policy?

It will be hard to find many employees who are willing to speak out. For one, Whole Foods has a history of firing anyone who speaks out, even if it is just to other employees. Whole Foods workers have tried to unionize (one can only assume to fight for better pay and benefits--or they're just bored, whichever makes more sense to you), but those efforts were quashed, largely by using tactics that are illegal under national labor law. Most unhappy employees are quickly sent packing and the rest remain silent in order to keep their jobs, or make positive statements on behalf of management to obtain promotions.

Of course, your employees are "happy" when all reports of happiness either come directly from or are strained through the oppressive presence of higher-ups. It doesn't take rocket science to figure that one out.

Posted by: katie84 | August 13, 2009 2:57 PM | Report abuse

If separation of Church and State, why the merger of Medicine and State? Is the State any less dangerous in the one area of our lives than the other?

But you're right not to call this socialism. "The rich entitled to no more medical care than the poor," and "from each according to his abilities and to each acording to his needs" is not just socialism but out and out communism.

Posted by: dglesvic | August 13, 2009 3:39 PM | Report abuse

A poster on Daily Kos writes:
"I have worked for whole foods for nine years. Until recently, we did not hire part time employees - employees might move to part time for what ever reason, but we did not hire them at the outset as part time employees. This was company policy. This year stores were told they must achieve a 30/70 part time/full time split, and that they could not hire full time employees until this split was achieved. Obviously, the company has decided it is too expensive to maintain a full time staff with benefits, which shows the true hypocrisy of John Mackey's WSJ editorial. Please, ask him why.
john.mackey@wholefoods.com"

Even full-time employees at Whole Foods must wait several months before they or their families will be covered by health insurance.

Posted by: harold3 | August 13, 2009 3:51 PM | Report abuse

Here is a link that might be useful:
http://www.fairfoodfight.com/blog/el-drag%C3%B3n/whole-foods-hates-obama-health-care-plan

Posted by: harold3 | August 13, 2009 3:57 PM | Report abuse

Well Katie, Whole Foods has been ranked as one of the best places to work in the country for 10+ years in a row. I think this shows has satisfied employees are with the company.

Posted by: JimBobT | August 13, 2009 5:55 PM | Report abuse

So the conservatives and libertarians here are basing their case for Mackey's reform plan on "Whole Food employees like their coverage" - as compared to what? People who make $10-15/hour aren't generally in line for the gold plated plans. I suspect their other options are significantly worse at comparable employers. And maybe that means Whole Foods is better than average, but not everyone can work there, and I doubt Walmart is about to implement WF's health care plan voluntarily.

The whole problem is, their health care coverage is still tied to the fact that they are employed. As a Canadian, I find it hard to imagine what it must be like to worry about your health care coverage when you're between jobs. What if you develop a "pre-existing" condition? Good bye to ever being covered again. Just awful.

It's really hard to put a price tag on the kind of peace of mind universal health care as a right of citizenship gets you. I never ever worry about health coverage. How many Americans can say that?

Posted by: Scientician | August 13, 2009 11:42 PM | Report abuse

As a second thought, Mackey's post reminds me of what is so damn depressing about libertarians. Even if Mackey's proposals work fairly well, the very best that would come of it, is still an employer based system of better-than-crappy-but-still-expensive coverage with high deductables, and still the burden of losing coverage if you lose your job.

Are libertarians the children who actually dream of getting sweaters and socks at Christmas? Way to shoot for half a loaf Mackey. I really hope we can all live in libertopia some day, where we can live out everyone's social darwinist fantasies in a highly efficient rat maze to see who gets the cheese.

We all deserve better than the very best you could hope for from a libertarian system.

Posted by: Scientician | August 13, 2009 11:48 PM | Report abuse

"Mackey isn't a right winger. He's a libertarian."

Probably the stupidest thing I've read all day, but then again, it's early.

Posted by: rick_desper | August 14, 2009 2:41 AM | Report abuse

"If separation of Church and State, why the merger of Medicine and State? Is the State any less dangerous in the one area of our lives than the other?"

Yes.

This has been another answer of simple answers to complicated questions.

It's really a cheap rhetorical trick to say "why the merger of X and state?" The reason we oppose "merger" of church and state is because, historically speaking, it's been shown to be a bad idea. OTOH, merger of, say, "fire coverage" and state has historically been shown to be a good idea, as have merger of "national defense" and state, merger of "tax collection" and state, merger of "education" and state, merger of "police" and state, etc. All of these enterprises started out as private functions and then were nationalized when it was discovered that nationalization made for a more efficient system, since "competition" added little value to the marketplace.

One true sign of a committed right-wing libertarian is that he understands jack about history.

Posted by: rick_desper | August 14, 2009 2:47 AM | Report abuse

Scientician,

You wrote,

"We all deserve better than the very best you could hope for from a libertarian system."

But, if there isn't enough of it to go around, all you can do is take it from some to give to others, from those who have earned it to those who haven't, from the rich to the poor.

Even if you don't like the rich, and would rather the poor had the service, you're just going to make things harder for the poor themselves. For, if the only way to get medical treatment is to be poor, you're going to have a lot more poor people, and a lot fewer rich people to house, cloth, feed, and employ them.

And not all the medical care in the world is going to save you if you're starving and freezing to death.


Posted by: dglesvic | August 14, 2009 2:49 AM | Report abuse

rick,

You wrote,

"these enterprises started out as private functions and then were nationalized when it was discovered that nationalization made for a more efficient system."

Then why must you force them on others?

Posted by: dglesvic | August 14, 2009 2:54 AM | Report abuse

Why would the liberals want to guarantee health care for the poor, but not food, clothing, and housing; don’t they want food, clothing, and housing for them?

If there were enough health care to go around, the poor would already have it; and, since there isn’t, who should it be taken from; or, to provide enough for everyone, given up for it, food, clothing, or housing?

The choice is not between health care and no health care, but health care and other necessities, and, for some and for others.

What the liberals want for the poor, apparently they don’t want for others; and whatever for the poor, certainly not the freedom to make their own choices

Posted by: dglesvic | August 14, 2009 3:02 AM | Report abuse

I live on the Upper West Side of Manhattan 2 blocks from the Whole Foods Market scheduled to open on August 27. I would like to propose there be an action on opening day highlighting this very typical arrogance toward people who need access to health care. It is ironic that Whole Foods attracts progressive patrons--it is a great way to act locally.

Posted by: denafisher | August 14, 2009 8:32 AM | Report abuse

Whole Foods' standing as the 2nd largest anti-union retailer in the U.S. beaten only by Wal-Mart shines a less than fair light on the grocery store chain. For nearly 2 decades Whole Foods CEO and co-founder John Mackey has managed to maintain his multimillionaire status while Whole Foods employees remain in the $8 - $13 hourly wage. With a turnover rate of 25% per year and an average employee span of only 4 years, most "team members" will never reap the benefits of seniority.

Posted by: harold3 | August 14, 2009 10:13 AM | Report abuse

The contention that a Wal-Mart could afford higher wages and greater benefits is immaterial. Profit is the engine of progress and the compass of the market, and, anything less than the greatest possible profit, a weakened engine and defective compass. So while you may be as charitable as you wish, after business hours, the company itself has a social duty to minimize costs and maximize profit.

Posted by: dglesvic | August 14, 2009 12:21 PM | Report abuse

Hey which supermarkets pay their workers $40/hour? Maybe they would take on all the laid-off autoworkers, after a couple of years of retraining.

Posted by: JessAustin | August 14, 2009 3:04 PM | Report abuse

Actually dglesvic, there is more than enough to go around. We long ago exited the Malthusian era of scarcity and entered the Galbreithian era of Affluence.

It's just some people insist on having far too much for themselves. Liberals don't mind if some have more, once we ensure that everyone has enough.

And yes, liberals do want to ensure that the poor have food, clothing and shelter. The accusation that we don't is one of the strangest non-sequiturs I've yet read. Did foodstamps, rent control and welfare vanish when I wasn't looking? Those weren't conservative programs.

Posted by: Scientician | August 14, 2009 6:57 PM | Report abuse

Scientician,

If you're going to ensure that everyone has everything they need, by taking from those with more than they need in order to give to those with less than they need, how would you get anyone to work?

There would be two kinds of people:

Firat, those who would be satisfied with the essential minimum, and would have no incentive to work if it was guaranteed to them.

Second, those who would not be satisfied with the essential minimum, and would work for more than that. But, if you're going to take it away from them, how are you going to get them to work?

How are you going to get anyone to work?

Here's how:

"No system of the social division of labor can do without a method that makes individuals responsible for their contributions to the joint...effort. If this responsibility is not brought about by...inequality of wealth and income...it must be enforced by...direct compulsion...by the police."

Ludwig von Mises

Is a communist police state really what you want?

Posted by: dglesvic | August 14, 2009 9:21 PM | Report abuse

Saw the Bill Moyers television special on health care tonight, with all the tugging at our hearts. But that wasn't necessary. We already sympathize with the unfortunate. The question is not whether we should help them, but how best to do so, through public or private charity.

What happened to Charity in Hitler's welfare state, and what's happening to it in Schwarzenegger's today?

Just as essential as the separation of Church and State is the separation of Charity and State.

There is never any genuine charity in the state. It is a monopoly of the market.

Posted by: dglesvic | August 15, 2009 5:17 AM | Report abuse

On that Moyers program, the socialists displayed a small bedridden child deprived of the care he needed by our inadequate health care system. But he is merely a pawn. For if the history of socialism is any guide to its future, once it no longer needed him, the only mercy he could expect from it would be mercy killing.

Posted by: dglesvic | August 15, 2009 5:58 AM | Report abuse

Is there a statistically significant difference between the BMIs of the boycotters and the BMIs of the loyal customers of Whole Foods, which has been selling calorific indulgences for years?

If your BMI is 22 or higher, you should probably boycott all supermarkets.

Washington DC

Posted by: IanGilbert | August 16, 2009 10:31 PM | Report abuse

Ezra says "The insight that people need food has not led us to simply deregulate the agricultural sector (though that might be a good idea for other reasons) or change the tax treatment of food purchases or make it easier for rich people to donate to food banks, which is what Mackey recommends for health care."

Nor has it led us to pass "tort reform" that prevents people from suing food companies if they are poisoned or killed by contaminated food products.

Posted by: karin2 | August 18, 2009 11:26 AM | Report abuse

Interesting to compare food and health care. Ok, I'll give it a whirl...

Imagine an America where 60% of the country is given "grocery insurance" by their employers, partly because it's untaxed so it's cheaper than paying cash.

So now you've got people eating the best, most expensive food they can convince their grocer that they need. Why not? It doesn't cost any extra to eat filet instead of ground chuck. And the grocer gets reimbursed from the grocery insurers, so he's going to agree that you definitely need those truffles. The more you eat, the more he makes, and he knows it's not coming out of your pocket...some big corporation foots the bill.

Of course, the insurance companies will try all kinds of schemes to monitor the situation and negotiate food rates and look for fraud, but as long as the consumers aren't really paying for anything nothing will change. And food prices will go up and up and up.

So then somebody notices that the other 40% of the country can no longer afford to eat. What's the solution? Obviously not restructure health care and "insurance" to incentivize people to make wise spending decisions. Instead, let's give the poor free grocery insurance so they can eat filet and truffles, too.

The problem with health care isn't that insurance companies are greedy, it's that nobody (insured) ever has to make tough spending decisions. Fix that and prices will come down. Then I'll be more than happy to give the poor simple, nutritious, balanced meals. I mean health care.

Posted by: davidrea | August 18, 2009 4:39 PM | Report abuse

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