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Why business gets it wrong on health care

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Matt Miller

When you ask business leaders why this is the case - why Americans in the twenty-first century should still look to their employers, not their country, for such support - you bump up against uncharacteristically muddled thinking or nonsequiturs, sure signs that something beyond reason is at work. "If I've got a good health care program that you can go home and tell Muriel about, I've got a better chance of recruiting you than the guy down the street who doesn't have one," says Tom Donahue, the president of the U.S. Chamber of Commerce, by way of explanation. But if government assured a basic benefit, surely companies could still lure talent with supplemental offerings. "We'll end up paying for it anyway, and we won't have control over the costs this time," says John Castellani, the president of the Business Roundtable. But our employer-based system already delivers the costliest health care on the planet. That hardly makes a case that it's the answer. Business won't pay, or won't pay as much as today, if the powerful business lobby makes permanently lowering business's contribution to health costs its reform aim, rather than mindlessly fighting off government altogether. Steve Burd, Safeway's CEO, says that if government picked up the tab we'd lose the innovation and efficiency that companies like his bring to bear. But that's not clear either. The Veterans Administration health care system, for example, has been hailed as the leader in using technology and evidence-based medicine to improve health while lowering costs.

American business has been ill-served by its misleadership, which has consistently chosen class warfare over profits.

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