Why aren't businesses clamoring for Single Payer?

[SHRED]

Medicare for all.

They'd save so much by getting out of the providing health insurance business.

[yortsed snacilbuper]

1. I'm not really sure,

but I think they are doing it to attract workers.

[genxlib]

2. You are correct

But I suspect the answer has to do with the fact that the decision makers (Officers, Boards, Stockholders) are the ones who might pay more in taxes. At least that is the way they might see it.

[genxlib]

3. The better question might be

Why aren't SMALL businesses in favor of Single Payer.

It might be one of the biggest competitive disadvantages that they have against larger more established companies.

[CTyankee]

5. It's the old "socialized medicine" routine.

Maybe they'll be the last holdouts against single payer.

[Weekend Warrior]

16. "Why aren't SMALL businesses in favor of Single Payer. "

Many small business owners are for single payer. Small businesses don't have an opinion. Their owners do and they are not even close to a monolithic group when it comes to these things.

[Angleae]

23. How many small businesses provide health benefits in the first place?

Those that don't will see their costs increase.

[Hassin Bin Sober]

15. Bingo

The same reason the Walton family spends Millions to try to save billions in inheritance tax and personal taxes.

Even though expansion of food Aid and other social programs benefits their business -- due to their near monopolisation of the grocery business, they are now the biggest recipient of food stamp money in their cash registers. Nice country, eh? The largest employer is the cause of, and the largest beneficiary of food stamps.

If Only They didn't have to share the business savings with those other grubby stockholders. The inheritance tax and personal taxes are all on them and that's where the savings is.

[yortsed snacilbuper]

4. It's harder for a worker to leave a job that provides medical insurance,

people stay in jobs they hate just for the coverage, single payer would give you some freedom,

[Mariana]

40. That's my thinking as well.

We'd probably have lots more people starting their own businesses and more people retiring early. With fewer people having to work full time just for the benefits, wages might increase and employers might have to treat people better.

[WhiskeyGrinder]

6. Because it will affect their pricing structures.

I can't remember or find the actual cite, but something like $5,000 of every new U.S.-made car cost goes toward employee and retiree health care, or something like that.

[taught_me_patience]

7. How is it funded? Let's say it's like Germany... 15% payroll tax half funded by employee

and half by business. It would be really shitty for small business because you have to pay both sides of the payroll tax. If you had a small business that made 200k/yr, you'd end up paying 30k/yr for health insurance.

The current system also highly favors large employers who are self funding their insurance. They pay way lower premiums than small business.

[Cicada]

10. We spend twice as much per capital as Germany

So if the tax is 15% in Germany it might be 30% here

[Cuthbert Allgood]

14. We spend more because our system needs to change.

We don't need to be spending that much.

[Cicada]

22. Good luck lowering income of medical providers

We can be more efficient but that means somebody gets less money. They will fight to keep the money.

In other countries there are limits on medical charges. A doctor in Japan has a book with maximum prices for different tasks. Treating a cut up to five inches ling X yen, etc. A medical scan which costs $1000 here might be limited to $112 in Japan. That is an accurate measure of relative cost for many scan images. Yet the govt in Japan carefully studies costs to make sure their medical providers are paid a fair amount.

We could and should impose similar cost controls but good luck trying to pass a law cutting doctor incomes forty percent.

[Not Ruth]

29. I would pass that law

[Cuthbert Allgood]

45. Well, then, let's give up.

But, what about insurance companies that you leave out? They would be gone in single payer. That's money that wouldn't have to be paid. And when I get a scan for $1000, my insurance has a contract to brings that down to $200. And I don't remember my doctor screaming about my insurance company. So we get rid of insurance companies and have people pay what the scan is ACTUALLY worth and not the bullshit system we have now.

[Cicada]

46. I agree with you BUT

We can save some money from a single payer system, but more people will get more services. Some people think we can spend a lot less. But I doubt we can pass what we most need - price controls - to save a lot.

So we will need new taxes big time. A school spends $20,000 for a teacher's health insurance, say. The teachers wages should go up $20,000 if single payer passes. But the govt must collect $20,000 roughly in new taxes. Politically that is going to be a hard sell even though it is a good idea.

[Voltaire2]

25. The proposed funding is 7.5 not 15.

And it is employer only, there aren't "both sides".

So in you example, this small business with 200k in pre-tax profits would pay a 15k payroll tax, more or less what a private insurance plan would cost.

[Demsrule86]

38. Small business would fight this...not all of them offer health insurance.

[Voltaire2]

39. Yes they are free riders on the existing system.

That has to stop. The ACA with its penalties was and is ineffective. An all in system with everyone sharing the cost and everyone sharing the benefits is the best way to provide healthcare for all.

[Demsrule86]

41. Or some provide extra money for people to buy their own...but either way...another opponent for

single payer...much easier to build off of the ACA and offer universal health care.

[Voltaire2]

42. to be clear the opponents in this case would be "small businesses that cannot be bothered to provide

healthcare benefits".

I weep for them.

[Demsrule86]

31. They don't have single payer in Germany. They have a plan more similar to the ACA

with one important change...the "sickness funds" are a non-profit. The rich can opt out too...We could get to this sort of coverage quite easily assuming we save the ACA, but I fear the new repeal, while we play with a plan that is not achievable-could doom our efforts.It has been reported that the GOP has the votes to repeal the ACA which means we get nothing for at least a decade maybe longer. Interestingly, few countries actually have a pure single payer system similar to Sen.Sanders' bill. I think universal coverage is achievable if we save the ACA...but not single payer.

https://www.theatlantic.com/health/archive/2014/04/what-american-healthcare-can-learn-from-germany/360133/

[Bleacher Creature]

8. Why don't police unions call for gun control?

For some reason people tend to support policies that aren't in their best interest when it comes to Republican policies.

[Xolodno]

9. Company I work for wants it.

Every once in awhile an exec promotes it.

But....

Small and mid sized companies who don't have it or provide crummy coverage rail against it.

Some people in large companies don't want it as they think its just a way for the company to "get out of" paying for better insurance (honestly don't see the logic here on that one)

Remember, Repubs always say they are for the main street business owner and want to stop pesky regulations, burdensome taxes, etc. Of course they do that for the big companies as well.

[Cicada]

11. Who will pay the additional 2 trillion tax?

The fed govt spends about a trillion a year for Medicare plus Medicaid. Other spending is almost two trillion. If the Fed Govt pays it all who will pay the extra two trillion? Businesses may worry that the funding will somehow cost them more in extra tax or reduced sales than they now spend on health insurance.

Taxpayers might balk at a huge tax hike, say 10,000 per year, or more, so business might face huge additional tax. The uncertainty must worry business.

[Voltaire2]

26. there are several options.

An employer 7.5% payroll tax is one.

[former9thward]

34. You just made Cicada's point.

They are going to have to pay for it (and I really doubt a 7.5% payroll tax would do it).

[zipplewrath]

12. They are worried they'll have to pay for it either way

Actually, they worry it will be more expensive than what they are doing right now. Especially since they've been pushing the risk and costs off onto their employees for a few decades now.

[JCanete]

20. that definitely sounds likely, along with the "trap" value others have mentioned of the status quo.

[zipplewrath]

21. They'll ultimately bring it to us

Alternately, I've been predicting for a while that ultimately the multinationals will bring it to us. They will grow tired of carrying this as a direct cost while they compete against foreign companies that fund this as a shared cost.

And I suspect the GOP will be the ones to pass it, much as they did Medicare Part D.

[JI7]

13. It's a way to keep employees

And they will still pay

[Sen. Walter Sobchak]

17. Because the debate is irrational and their expression constrained by responsibility

Most companies don't want to get in a shit flinging contest.

[exboyfil]

18. If a near single payer gets going

with an opt in for employers, would they eventually chose to opt in? In general their demographics will probably be healthier than the current pool.

The money needs to come from system efficiencies and monopsony buying power.

At the end of the day it always seems some are willing to stay out of the social insurance pool (see California state workers who do not participate in Social Security).

[Demsrule86]

32. We have a near single payer with the ACA...we won't have a better chance...Germany's universal

coverage is similar. You have sickness groups (non-profit insurance), you pick one and you pay for it... there are rules about what must be covered...very similar to the ACA. It is universal coverage and would save insurance jobs which people never think about.

[exboyfil]

36. Germany is mandatory opt in for those below a certain income

Along with that comes the roughly 7.5%/7.5% split in payroll withholding.

You do make an excellent point about the German system. From what I know about it, I think it is the best model for our system (a large relatively diverse country). I admit I don't enough about the system. I would love a recommendation for a book in English that explains the system and its advantages/disadvantages.

[Demsrule86]

37. We have a mandatory opt in too...just need to make the consequences stronger.

I have been reading about it...and I think we could end up with this if we save the ACA...it has quite a few similarities.

[Voltaire2]

43. I've got a great idea how to do that!

Tax employers a standard percentage of wages paid to employees to fund health insurance.

[Demsrule86]

44. It would work for me.

[berni_mccoy]

19. Companies that provide healthcare and pay some or all of the premium

Have a way to trap their employees, especially if the ACA were repealed.

I was self-employed for 10 years until I could no longer afford to self-insure my family and was forced to take a job at a company with health care. That was before the ACA of course.

[octoberlib]

24. Taxes. They absolutely can not pay one percent more than 0. (which is what they currently pay due to

tax loopholes). Seriously, I wonder if they get tax breaks for providing benefits. You'd think they'd be jumping on it.

[Dem2]

27. I wonder this myself

It's a huge expense in our small company

[Not Ruth]

28. Employee health insurance is a wage slavery trigger

[GreenEyedLefty]

30. Because benefits, like salaries, are competitive.

My company has excellent benefits with low employee contribution (the company picks up 90% of the premium). I strongly believe it is what keeps our turnover very low.

[Demsrule86]

33. Not these days...the anyone is replaceable is the meme...and the older you get the worse it is.

[tanyev]

35. Good question. It would also solve the problem for those churches

that get the vapors at the very idea that their employees using birth control. Of course, then they wouldn't be able to congratulate themselves that they are controlling their employees' morality via their health coverage.