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At The New Republic, Jonathan Cohn has a post on Wal-Mart’s support for an employer mandate. Cohn, who has forgotten more about the U.S. healthcare sector than I’ll ever know, finds this very encouraging.
By endorsing the idea of a employer mandate, Wal-Mart has made the idea more difficult to demonize. It has also–and I can’t stress this enough–given some political cover to members of Congress who might be sympathetic to the idea of employer mandate but hesitate to take a vote that might be perceived as anti-business.
And Wal-Mart is indeed backing two promising proposals.
One, which Senator Jay Rockefeller has been championing lately, would strengthen the power of the Medicare Payment Advisory Commission (MedPAC) to guide the way Medicare pays for medical services. The other, which comes from the Bipartisan Policy Center, would create a “trigger” mechansim; basically, if health industry groups couldn’t deliver savings they’ve promised, automatic payment reductions would ensue.
But here’s the thing: Wal-Mart’s support for an employer mandate isn’t remotely surprising. Cohn rightly notes that “Wal-Mart is acting–as it always does–out of pure self-interest.”
My undestanding is that, after all of these years, Wal-Mart has suddenly found itself in the same situation its competitors once did: Dealing with unpredictable health costs and facing new competition from businesses that have found ways to spend even less on employee health benefits. Is there some justice there? You bet.
On the other hand, politics is all about channeling self-interest so that it serves the public good. And the timing of this is pretty telling.
There is another way of looking at this. As a large, powerful, deep-pocketed firm, Wal-Mart can sustain regulatory burdens that mom-and-pops and new entrants can’t. And so burdensome regulations are invariably Wal-Mart’s ally. Jonathan Rauch explained this dynamic brilliantly in his book Government’s End. It makes perfect sense for Wal-Mart to back a regulatory initiative that hurts its bottom line as long as it hurts its competitors more.
So I have to disagree with Cohn’s contention that Wal-Mart will provide much in the way of political cover. Pro-business and pro-market are, as many conservatives have argued for many years, different concepts. Collusion between big business and big government is a time-honored tradition.
To overgeneralize, conservatives and libertarians like Wal-Mart when it lowers prices for people of modest means. Liberals like Wal-Mart … when it colludes with government to squeeze its competitors? That’s obviously not right.
This isn’t to say we shouldn’t have an employer mandate. But I don’t think we should assign much weight to the views emanating from the head office in Bentonville.