I wanted to address one theme I keep seeing in the diaries and debates regarding what the effect will be on employment should we eventually get a true public option or single payer health care. I feel I have at least a partial qualification to discuss this since I worked for a year as a computer programmer in that industry, a staff member of United Health Group that worked in a division that contracted with states to help with processing of Medicare and Medicaid claims.
First, let me say that the vast majority of people I worked side by side with were not vile and unscrupulous jerks trying to take advantage of the ultimate customers. Many in claims processing had been former health care professionals that truly cared about patients and the quality of service they could get. Of course as one got higher and higher up the corporate ladder, it became obvious where the greed and indifference to suffering existed.
I worked in a huge corporate center surrounded by hundreds of employees of all stripes and cultures. We had a large staff of workers from India since they seem to be well trained in data processing and worked cheaply. The vast majority of the staff of actual American citizens though were female. Most had children at home. Talking with them, one came away with the impression that a great many of them had the job (and this is important) for the medical benefits.
Now that particular division of UHG probably would continue since it wasn't part of UHG's own insurance section but I think it's reasonable to assume that the demographic I saw in our division probably existed throughout the company.
If and when (and I have to be an optimist) we actually get a government-run health care system, companies like UHG will have to restructure. Their customer base will shrink drastically and jobs will be cut. You can be sure that the first cuts will not be within their bloated management structure but instead in their claims processing staff.
Now just as states today often contract out Medicare and Medicaid services to private contractors, there will be an increase in those contracts as more people end up in government systems so some of the workforce will merely be moved around.
I would imagine, as so often happens in corporate restructurings, that early retirements with some sort of buyout would occur and many of those employees that were simply there for the medical benefits would leave happily. If, along with new health care legislation, the Obama administration also makes the rules tighter for companies wishing to outsource their labor, I would imagine a number of the job cuts could also be within those foreign workers I saw around me.
But I think the message I'm trying to get out here (and I believe it's an important talking point in our debate that isn't getting sufficient attention) is that we have a huge portion of our national workforce (many of which work in the health insurance field) that show up at work each day for one giant reason - they want health insurance for their families. A nationalized health insurance program gives these people flexibility. Republicans continually push that whole "family values" meme on us and here's a chance to throw it back in their faces. If mothers (or fathers) don't have to join the workforce to provide health care for their children, they can stay at home and raise their children themselves.
How many more families will be able to once again have just one breadwinner in the family once this occurs? The number could actually be staggering. If that occurs, a significant burden could be lifted from not only families but also governmental programs for the child care required when both parents work.
One final note. I was really excited when I first went to work for United Health Care because I assumed I would get very affordable and quality health insurance from them. What a stupid assumption. It sucked. I ended up with thousands of dollars of medical bills in that year because of the creative ways they crafted their internal insurance plans. By the time I left that job, I despised the upper management for their greed.