All developed countries have universal national health insurance except the United States. A standard opposition response in our country to this is: “I don’t want the government to take over my health insurance.”
But we are the government in our democracy, more than we are business or the employer who controls our health insurance, if we are lucky enough to have it.
We get to vote in elections.
Employees rarely get to vote for anything about their jobs.
It’s authoritarian control by the boss.
Unless we have a worker organization that bargains our health coverage and costs, and other work conditions, or government rules, we don’t get real input. Business controls our health insurance. Government rules (our rules) force certain coverages, including in the Affordable Care Act’s (ACA) coverage for pre-existing conditions.
Employer sponsored health insurance covers about half the population. Economists generally regard this as coming out of what would other-
wise be wage-earner pay ($20,600 for average family insurance).
We spend about twice as much per person as comparable countries do – and yet they cover everyone – a total of 18% of our gross national product, compared with 10.5% in those countries.
Employer-paid insurance is also subsidized by our government at $250 billion.
Government does directly oversee our Medicare, paid through deductions from worker pay. Thus, we control it. Medicare has a lower overhead, about 2% (despite Medicare being stuck with the older, sicker patients) than company insurance which average about 20% overhead.
Medicare is single-payer, and most seniors think it is a good deal.
Of course, we the voters, don’t get total control. Elections are controlled by money, too, usually big money. Business money has more control of the operations of government than voters and citizens do, unless the latter are organized. Business power – capitalism – controls our work conditions and how things are run in America, except when there is off-setting power, such as unions, cooperatively
worker-run businesses, or parts of government favoring the public, such as regulations (which the Trump administration have seriously weakened). Regulations protect consumers, workers, the environment, the sick, among others. Public pressure has put these into effect for the general good. This is one way the public offsets capital and corporate control.
In Germany, workers are mandated to have 50% representation on corporate supervisory boards. In our country, Senator Elizabeth Warren has proposed giving American workers 40% representation on corporate boards. Germany relies on a consensus style of labor relations and worker participation in the supervision of company management.
In many other countries, particularly in Europe, there are forms of employee participation in the management of private companies. Being part of corporate governance makes workers feel more part of their company and probably thus furthers the business.
In our country, some citizen funded organizations, such as Common Cause and Public Citizen also protect the public interest.
Voting is one important part of public power, but having some control in your work is important.
The U.S. had 35% unionization of its work force 50 years ago, but it is now down to 12%. Business has curtailed unions through laws (Taft-Hartley, e.g.), unfavorable court rulings, and anti-union tactics, including simply firing union organizers (supposedly illegal). Heavy unionization helps all workers by setting wage standards and promoting laws and other protections for even non-union labor.
Suppression of unions in the American South keeps wages and protections there low. In the European Union, 23% of workers are organized, with Sweden and Norway in the 70 percentile. This gives workers, and the public too, real control to offset big wealth and capital (the owners of corporations). The decline in unions in the United States is one reason why a greater share of U.S. national income is going to corporate profit and a lesser share to wages.
In other countries, Canada, Europe, some Asian countries, the average person has more guaranteed benefits than in the U.S. These countries have had strong social Democratic parties that offset big business power. They all have universal health care, which is rated better, according to the Commonwealth Fund, than American health care.
They also have guaranteed paid vacations of up to five weeks, paid sick leave, paid family leave protection, free or low cost higher education, and they work up to five fewer weeks per year, among other benefits.
Every American daily newspaper has a business section, but no labor section, despite the fact that labor comprises many times the owner class.
Business dominance of public information is one reason Americans are trained to blame government as a standard response, and ignore the social welfare benefits that are available in many comparable countries.
When the people are organized to have some countervailing power against the corporate class (capital), government can favor them.