Universal healthcare: the tide turned today.

We're going to get universal healthcare.

The tide of the Civil War turned at Gettysburg. In World War II, the tide turned in the west when Hitler failed to conquer Britain, and turned in the east when he failed to capture the Caucasus oilfields.

In the American War for Universal Healthcare, the tide turned today, when the good guys captured . . .

Wal-Mart.

Good news from the front, below the fold.

From today's New York Times:

WASHINGTON (AP) -- Executives from Wal-Mart and three other major U.S. employers on Wednesday joined hands with union leaders in setting a goal of providing ''quality, affordable'' health care for every American by 2012. . . .

Joining Wal-Mart Stores Inc. CEO Lee Scott and Service Employees International Union leader Andrew Stern at a Washington press conference were top executives from Intel Corp., AT&T Inc. and Kelly Services Inc., a temporary staffing agency.

Now, I don't believe for one second that Wal-Mart has gotten on board out of the goodness of its heart. I suspect it has made a cold-hearted, flinty-eyed decision that universal healthcare would be good for its bottom line, for two reasons:

1. Sick workers are less productive.

2. Having a largely uninsured workforce leads to bad publicity.

I further suspect Wal-Mart hopes to steer the debate towards ending our employer-based health-insurance system in favor of universal government- provided coverage. Wal-Mart's workers tend to be low-paid, which means neither they nor Wal-Mart can really afford the full costs of their health coverage. (Certainly not while insurance companies suck up a lot of health care expenditures -- isn't it 31%? -- on profits and administrative costs.) Universal government-provided coverage would simply get Wal-Mart off the hook. More from today's Times article:

[The Wal-Mart and other CEOs] did not propose any specific policies to achieve this goal, or commit to spending any extra money in the near-term to provide health coverage to more workers. . . .

But [Wal-Mart CEO] Scott and others did not lay out a detailed plan, and in response to a reporter's question he said Wal-Mart is not committed to spending more on health care or making any immediate promises to provide health coverage to more workers.

The SEIU funds campaign group Wal-Mart Watch, which as recently as last month said Wal-Mart's health plans were a raw deal for employees. But [SEIU president] Stern said he joined Wal-Mart and the other employers because America's health care system requires fundamental change.

''It's time to admit the employer-based health care system is dead,'' Stern said.

If, like me, you think employment-based coverage is fundamentally a bad idea, the CEOs' unwillingness to spend more money is actually a good sign. It means they intend to push the government to pick up the slack.

And Wal-Mart tends to get what it wants.

Why Ford (which lost $12+ billion last year), GM, DaimlerChrysler, and the UAW didn't beat this Wal-Mart cabal to the punch is certainly a puzzlement to me. The major U.S. automakers now spend more on health care than on steel, and they're shedding jobs like crazy. Overseas competitors' workers have government-provided health coverage, and even the U.S. operations of Toyota, Honda, Subaru, et al. don't have the massive retiree health costs of the U.S. Big Three. Toyota announced last year it was locating a plant in Canada rather than the American South, partly because the Canadian government provides health care. (Story here. Better education was the other major factor.) But I predict it's only a matter of time before GM, Ford, DaimlerChrylser, and the UAW join the call for universal government-provided coverage. Resistance is futile.

There was a lot of bloody fighting left after Gettysburg, after Stalingrad, after the Battle of Britain. As Churchill said, "it was not the end, or even the beginning of the end, but it was the end of the beginning."

Today, the beginning of the fight for universal healthcare has ended.

It's about time.

P.S. Why employer-based health coverage is a bad idea:

1. If you lose your job, you lose your coverage.

2. If you lose your job because you're too sick or injured to work, this is precisely when you need coverage the most. Lack of coverage can mean you don't get the treatment you need to get better and return to work. In theory, you can extend (for a limited time) your old employer's coverage under COBRA, but your premium will go way up -- and you can't pay it because you've just lost your income. No income, no treatment, no improvement -- you lose your life savings, your home. I've seen it happen.

3. If you or a member of your family have a serious pre-existing condition, you're pretty much stuck with your old employer -- no leaving for a better job at another company, and no way would you dare to start your own business. Even Republicans should be able to understand this is Bad For Bidness.

•  Tip jar.

  I'm still trying to save up enough mojo to get a DailyKos travel mug at the Trusted User online store.

  by HeyMikey on Wed Feb 07, 2007 at 11:42:47 AM PDT

  •  HeyMikey, nice diary. Thanks.

    And I would like to take this moment to ask all Repub and Dem candidates for 2008 to refrain from proposing any interim, transitional, evolutionary, whatever kind of actual UHC plan short of endorsing hearings on HR 696. No details, please. No "this is the best we can realistically do" proposals. The nation is  engaged in a transformational dialog, the corporate community is shifting in toward the common good, so please, don't shortchange us just while the movement is gaining traction.

    by kck on Wed Feb 07, 2007 at 12:32:08 PM PDT

    •  Actually . . .

      . . . I had an initial negative reaction to the Edwards healthcare plan, just for the reason you state, until I read nyceve's diary about it. Edwards's plan mandates that everybody have a choice of several plans, one of which must be a Medicare-like plan.

      If you believe, like I do, that Medicare is inherently more efficient, then the other choices will eventually fold, leaving only the single government provider. Edwards's plan is a single-payer Trojan horse.

      by HeyMikey on Wed Feb 07, 2007 at 12:48:24 PM PDT

      •  Not a Trojan Horse, But A Mirage

        Single payer will not win out becuase it is the most efficient and everybody will flock to it.  For one, it won't be the most efficient - the presence of competing, private, cherry-picking plans in the marketplace will not have the "everybody into the same pool" underwriting advantage of a true single payer system.  

        Nor will people want to be in it.  The insurance companies will paint the government plan - successfully - as a bare bones government program that only people on welfare will find adequate.  

        by Fungible Chattel on Wed Feb 07, 2007 at 01:20:57 PM PDT

        •  It depends. If the cost to the employee is less

          than the other plans, it won't matter how the insurers market themselves. The important thing is to make sure that the gov DOES NOT SUBSIDIZE the private insurers in any way.

          I'd rather take the gov. plan and fill in with gap insurance. One of the biggest headaches for me is my employer changing providers every 2-3 years shopping for better rates. It would be nice to be able to change jobs without worrying about my insurance changing.

          by davewill on Wed Feb 07, 2007 at 01:27:28 PM PDT

        •  Community rating.

          Part of the Edwards plan is REQUIRING "community rating." This means the private plans have to agree to accept everybody and charge everybody the same rate. No cherry-picking allowed.

          by HeyMikey on Wed Feb 07, 2007 at 01:32:35 PM PDT

  •  Thanks for writing this diary

    ...which is much better than the one I wrote earlier.  I don't post much, but I saw some of the negative reaction at Think Progress and it really pissed me off.

    Based upon the limited reaction I've seen here, it seems like people are more or less in favor of this.  I'm hoping nyceve will weigh in on this -- that it'll really get the debate started.

    by meliorist on Wed Feb 07, 2007 at 12:36:13 PM PDT

•  It's hardly a done deal.

  Kaiser, Aetna, Blue Cross, and the gang are not goin without a fight. But I will agree that this is the way it will happen if it can happen.

  by davewill on Wed Feb 07, 2007 at 11:43:47 AM PDT

  •  True but for Kaiser Permanente

    True but for Kaiser Permanente, a staff model HMO, it will remain intact with Single-Payer/Universal Health Care albeit even leaner without its insurance division. The KP network has its own hospitals, facilities, and physicians, etc. so they would still be in business under SP/UHC, perhaps more profitably. Kaiser needs to get onboard with SP/UHC and break free from their nearly obsolete industry cohorts in the AHIP.

    by kck on Wed Feb 07, 2007 at 12:00:45 PM PDT

•  Not too much of a puzzle....

  Why Ford (which lost $12+ billion last year), GM, DaimlerChrysler, and the UAW didn't beat this Wal-Mart cabal to the punch is certainly a puzzlement to me.

  Sadly, when have the U.S. automakers beaten anyone to the punch in past three decades?

  by Battling Maxo on Wed Feb 07, 2007 at 11:45:35 AM PDT

  •  damn it

    Battling Maxo, you're on point ... makes me wanna cry ...

    a recommend is earned

    by wystler on Wed Feb 07, 2007 at 12:21:07 PM PDT

•  Wal-mart already gives its impoverished employees

  ... seminars in how to apply for welfare benefits.

  It's only natural that they should come out for universal health coverage.  Now we just have to extend that to single-payer government-provided universal health coverage, of the sort provided by every other first-world nation.

  by tbetz on Wed Feb 07, 2007 at 11:49:46 AM PDT

•  Walmart's motives

  A federal appeals court in California said today that a class-action lawsuit that alleges Wal-Mart discriminated against female employees can go forward. With 1.5 million workers affected plus the potential for billions in punative damages, that should "Wake Up Walmart!" LOL

  Now, I don't believe for one second that Wal-Mart has gotten on board out of the goodness of its heart.

  by KnowVox on Wed Feb 07, 2007 at 12:01:06 PM PDT

  •  Hey, its just business

    As the corporate community lines up behind SP/UHC, they will do so by the spreadsheet, because it makes them more money, raise  shareholders value. They will all have different reasons for supporting UHC, the end result being that the cost of a plan like Conyers HR 696, is better than any other option and way better than the current worsening course. The for-profit Health Insurance Industry will not be "murdered by spreadsheet". No, that would be hyperbole. These are just business decisions. But as the columns are expanded and the greater business community like WallMart and Ford recalculates with the new Medicare-for-all model, the  for-profit Health Insurance Industry will nevertheless suffer "death by spreadsheet", as in the ultimate foist by your own petard.

    by kck on Wed Feb 07, 2007 at 12:19:15 PM PDT

    •  It's actually "hoisted" on your own petard,

      but that's nitpicking. You're right that money makes the world go round, and it's nice when ordinary people can hitch a ride.

      by HeyMikey on Wed Feb 07, 2007 at 12:41:28 PM PDT

•  Is that really good news, though?

  If WalMart writes the the health insurance policy, I doubt corporations and the rich are going to end up paying their full share.

  by RequestedUsername on Wed Feb 07, 2007 at 12:01:34 PM PDT

  •  Good news - compared to what?

    There is NO WAY we will ever get universal coverage without major corporations having a large say in what that coverage looks like. Under no political party, under no circumstances, no way.

    Given that reality, do you want corporations pushing for universal coverage, or against it?

    I'll take "pushing for," and be grateful.

    by HeyMikey on Wed Feb 07, 2007 at 12:10:27 PM PDT

  •  What...

    is "their full share"?

    by pee dee fire ant on Wed Feb 07, 2007 at 12:11:55 PM PDT

    •  For WalMart, it's

      as little as possible. Nothing would be the ideal.

      They're much better off paying a little more per employee in taxes than they would be trying to pay for healthcare. Their employee base tends to be older, and/or less healthy (likely because they don't have insurance), than a lot of other places. They also don't usually stay very long, at least not at the retail level.

      Which is probably part of the reasoning for not offering much in the way of health insurance. Not only would it cost the company a bunch, the employee probably couldn't afford it. Often what the employee REALLY needs it to cover is a pre-existing condition, and wouldn't be covered anyway. We won't even talk about the paperwork and management nightmares it would create for WalMart.

      All of that goes away if the govt handles that stuff. So it costs a little in taxes - it's worth it to them.

      I'm surprised they didn't figure this out sooner. Maybe opening stores overseas showed them the light...

      by mmacdDE on Wed Feb 07, 2007 at 12:59:57 PM PDT

  •  To be honest...

    most of the corporations are paying, and paying through the nose. They have passed more and more costs on to employees, but that hasn't meant that they've been skating.

    That isn't Wal-Mart, however. Wal-Mart is in the fight because they're afraid that Universal Healthcare is going to mean that they have to provide insurance to all their employees, mostly on their own dime. They have essentially been living the single payer dream, by pushing their employees into Medicaid, and they like it.

    As far as I'm concerned, anything that builds momentum for single-payer is good. We can then fight the corps on taxes, instead of taxes and healthcare.

    by davewill on Wed Feb 07, 2007 at 12:12:16 PM PDT

    •  They didn't sign up for Single Payer, did they?

      Universal is fine, but they wibbled on about 'shared responsibility' which I translate as "a problem that we couldn't get anyone to agree on so we won't actually come up with a proposal."

      by freelunch on Wed Feb 07, 2007 at 01:05:37 PM PDT

      •  No, but

        I find the statement,

        ''It's time to admit the employer-based health care system is dead,''

        to be a step in the right direction. Most "Universal" supporters talk about subsidized insurance for the poor, not in changing the employer's role.

        by davewill on Wed Feb 07, 2007 at 01:17:40 PM PDT

  •  Depends

    Right now, the most likely funding is an expansion of payroll taxes either as the federal supplemental or for a single payer. I'm not persuaded that this is the best way to go, income or VAT can be more progressive because of what they tax.

    My guess is that WMT is looking for a chance to offload some of their costs onto their employees -- with employee-share payroll taxes mixed with mandatory insurance.

    by freelunch on Wed Feb 07, 2007 at 01:02:51 PM PDT

    •  Offloading onto somebody, anyway.

      My guess is that WMT is looking for a chance to offload some of their costs onto their employees -- with employee-share payroll taxes mixed with mandatory insurance.

      I suspect it's more like offloading onto the taxpayers at large, who probably have a higher average income than Wal-Mart employees.

      Also, Wal-Mart may have become convinced that if single-payer becomes law, the profits and administrative overhead of private insurers would just evaporate -- they wouldn't have to be unloaded onto anybody.

      by HeyMikey on Wed Feb 07, 2007 at 02:56:56 PM PDT

    •  ugh

      that makes so much sense
      no wonder walmart will jump on board
      nouveau-regan policy for healthcare - great

      by Taunger on Thu Feb 08, 2007 at 07:17:56 AM PDT

•  Your enemy's enemy.

  Pitting Walmart and the like against the insurance industry? You bet.

  Corporations of course are going to be trying to pay as little as possible. But a much smaller corporate share or tax into the system is going to be far less than if they paid in on private plans for employees.

  Walmart is being pressured to provide real health insurance or else. That kind of pressure is good. They are also looking for any way possible to revive their reputation. If they were able to get everyone real universal coverage they think it would help their PR. It probably won't much but let them think it will. Sometimes evil selfish acts have unintended good side effects. In this case possibly universal coverage.

  BTW. I am living proof of #2 on your list.

  by SDstuck on Wed Feb 07, 2007 at 12:19:41 PM PDT

  •  Sorry about #2.

    Are you getting Social Security or SSI disability? Have you made it through the 29-month Medicare waiting period?

    Do you know a bill was just introduced in Congress to abolish the 29-month wait? I hope to do a diary on it when I get time.

    by HeyMikey on Wed Feb 07, 2007 at 01:06:24 PM PDT

    •  the problem is the money: complexity overload

      Reading your post about a 29-month waiting period, I've just come to an interesting conclusion.  

      The whole purpose of money is suppose to be to facilitate transactions, not to block them.  In a barter system the butcher can't get bread from the baker if they first need to do a trade via the candlestick-maker, but money is supposed to make that simpler.  

      Now instead what we have is that money is what's causing all of this stuff to get terminally constipated.  The need for all these parasites to suck their little share of blood is adding up to the death of a thousand mosquito bites.

      You say 29-month wait.  What that suggests to me is, someone is sick and poor, needs a doctor or hospital visit now, and can't get Medicaid for 29 months.  In the meantime they end up in Emergency, get their treatment, and then get a huge stack of bills they can't pay until Medicaid steps in.  But then Medicaid seond-guesses the doctors and treatment, and it's a great big cluster-f---.  

      It's not that it was ever impossible for a doctor to see a patient, but the need to push all the pennies through the right slots first is what makes it impossible.  This is like having a fire engine arrive at a fire only to be stuck waiting while the firefighters dig through their uniforms to find pennies to push into the parking meter to avoid getting towed by the  tow truck which is waiting eagerly down the block!

      It would be faster at that point to just go back to barter!

      What's happened is that the money-based economy has hit complexity overload.  And that is another sign that it is about to break.  The whole damn thing.  

      by G2geek on Wed Feb 07, 2007 at 03:03:57 PM PDT

•  Correction...

  If you or a member of your family have a serious pre-existing condition, you're pretty much stuck with your old employer -- no leaving for a better job at another company, and no way would you dare to start your own business. Even Republicans should be able to understand this is Bad For Bidness.

  The first part is not true, thanks to Ted Kennedy...

  However, the second part is very true...  you are a slave to health insurance...

  Of course, that's what the Republicans want... easily controllable slaves that they can abuse... they certainly don't want any more uppity entrepeneurs...

  Thanks,

  Mike

  by LordMike on Wed Feb 07, 2007 at 12:45:19 PM PDT

  •  Read the fine print.

    If I understand Kennedy-Kassebaum correctly, you can't be turned away because of a pre-existing condition, but (a) there's no limit on what your new premium can be, and (b) there can be a waiting period during which it's not covered. So if you can't wait a long time and then pay a gazillion dollars, you're stuck.

    by HeyMikey on Wed Feb 07, 2007 at 03:01:00 PM PDT

    •  Incorrect...

      ...if you've had health insurance for more than a year prior to getting a new plan, then you cannot have pre-existing conditions excluded....

      This only applies to group plans... group plans have fixed rates, so, yes, you can get another job without fear of penalty.

      Thanks,

      Mike

      by LordMike on Wed Feb 07, 2007 at 03:13:35 PM PDT

•  If you can get the chambers of commerce...

  ...on board (wchih will be easier now that Wal Mart's int he fray), UHC will become a reality.

  The chambers of commerce are what effectively killed universal health care in the 90's (the insurance industry didn't help, but it really was small business groups that effectively targetted Clinton's plan for defeat).

  So, now we have to go after them...

  But it is very good news... the Golden Jewel of the Republican economic crown is thrown a sucker punch to the Republican elite establishment--we've milked you for everything else, note give us free health care... or else!!!

  You can even toss the insurers a bone... with medicare for all, they can sell medigap and Part C plans to their hearts' content.

  Thanks,

  Mike

  by LordMike on Wed Feb 07, 2007 at 12:49:12 PM PDT

•  This is great news.

  I hope more corporations get on board soon.

  Think we could get Gore to talk to Jobs about Apple joining in?

  by Unbozo on Wed Feb 07, 2007 at 12:58:17 PM PDT

•  I (hesitantly) think this is a good sign

  I certainly don't want Wal-Mart writing the new health care laws, but the more large business that get on board with the idea of universal health care, the better.  The diarist noted that GM and other big companies should have beaten Wal-Mart to the punch.  The difference here is that GM et al. have provided insurance to most of their employees in the past, where Wal-Mart has not.  Where GM went wrong is by trying to put a band-aid on a giant sore.  They sought to reduce coverage, or benefits, or pay, or any number of stop gap methods to prevent their hemorrhaging profits.  What they should have done is say "Employee based health care, and the current state of the insurance industry, helps us all.  It's immoral and fiscally unfeasible."  I really can't blame GM and other companies for not wanting to offer insurance, but they can't think that the problem will go away if they just ignore it.

  Health care right now is such a bloated, broken system.  What's more, it's counterintuitive to what would constitute good health.  Reforming (radically) health care would ultimately reduce overhead costs, create a healthier workforce, and free Big Business for what it does best, unrestrained greed!  Ok, so that last part is still a bit dispiriting, but they are in the business of making money.  Health care should be non-profit, or at least limited profit.  Health and profit cannot comfortably co-exist.  

  On a side note, our government should stop acting like it's a for-profit entity as well.

  by Statius on Wed Feb 07, 2007 at 01:04:17 PM PDT

  •  Unrestrained greed.

    free Big Business for what it does best, unrestrained greed!

    Capitalism is a wonderful tool for creating money. Money is a great thing. Where people  go wrong is in thinking money is the only thing, or even the greatest thing. The Dem party is the natural home of those who believe it isn't, and that government should ensure everybody has a fair chance at the non-money great things. In other words, there's an important role for government, and everybody wins when we stop trying to get business to do government's job.

    by HeyMikey on Wed Feb 07, 2007 at 01:12:44 PM PDT

    •  I couldn't agree more

      by Statius on Wed Feb 07, 2007 at 01:19:34 PM PDT

•  More points to consider:

  Sick people put healthy people at risk, just like a house afire is a threat to the neighborhood.  That's why we all chip in to put it out.

  American society is predicated on individual mobility.  Employer-based medical care restricts that mobility.

  Universal medical coverage will make it possible to eliminate the medical component of workmen's comp and the litigation that's often associated with it.

  Universal medical coverage will make it possible to eliminate the medical liability component of homeowners and auto insurance.

  It's a win-win proposal.

  Finally, health care doesn't fit into the market model because the successful delivery of services means that the service will be needed LESS.

  by hannah on Wed Feb 07, 2007 at 01:08:56 PM PDT

  •  More market thinking.

    Finally, health care doesn't fit into the market model because the successful delivery of services means that the service will be needed LESS.

    Exactly. Also, consider the market incentive of a health insurer with a chronically, expensively ill patient. It may be cheaper to let the patient get so sick he can't work, at which point he loses his job and his employer-provided coverage, and is no longer the insurer's problem.

    If the insurer is the government, however, then the patient will never cease being the insurer's problem, so it's in the government's financial interest to return the patient to health and to work, so he can start paying taxes again.

    by HeyMikey on Wed Feb 07, 2007 at 01:17:13 PM PDT

•  Nice Diary, I'll read the story

  I really think that when other big business turns on the health insurance companies and big pharma, single-payer will go through.

  I've wondered why big banks like Citibank, Chase, Wachovia and Bank of America along with the investment firms haven't sought government assistance with healthcare costs as many of their workers are "pink-collar" jobs. Maybe it's because health insurers are their investment partners. When these mega-employers climb on board, we will see a green light for change.

  by JDWolverton on Wed Feb 07, 2007 at 03:12:19 PM PDT