What Maryland's Delegate James Hubbard, a Democrat from Prince George's County, had to say was revealing of both why he backed his state's "Wal-Mart bill" and what this fight is really about: expanding Medicaid and other taxpayer-funded health-care entitlements.Hubbard has recently introduced another bill to force all employers, regardless of size to pay at least 4.5% of their payroll on health care benefits. That means someone, like a pizza parlor, which employs part-time workers almost exclusively, would have to either spend 4.5% of his payroll on health care benefits he currently doesn't provide or pay into the state's Medicaid fund.
Let's first understand that the drive to enact anti-Wal-Mart legislation has very little to do with the retail giant except in two respects: dipping into its very deep pockets, and using the controversy surrounding the company to mask the larger agenda of expanding already-bankrupt entitlement programs. Of course, in this war legislators have a ready made ally in the AFL-CIO, which has its own reasons for going after the nonunionized company.
With that, let's turn to Mr. Hubbard. He began our conversation by pointing out that the Wal-Mart bill--which forces companies with more than 10,000 employees to spend at least 8% of their payroll on health care or pay the state the difference--was always intended to be just the first step. Four years ago, he made his intentions clear by introducing legislation to increase cigarette taxes and to use the tax code to compel employers to provide health insurance. Under his legislation the revenue from these taxes would be dumped into a new state fund that would then be used to expand Medicaid eligibility to families with incomes up to 300% of the poverty line (up from 200% now). But even in a legislature with large Democratic majorities, his bill stalled.
Over the weekend, Wal-Mart CEO Lee Scott urged governors attending the National Governors Association meeting in Washington, DC to stop playing politics with business. He urged the states' chief executives to join with Wal-Mart to set up a business-government partnership to expand health care. This proposal by Scott comes on the heels of announcements by his company that Wal-Mart will expand health coverage for employees and to open in-store clinics
Run by third parties, the clinics are open to shoppers and employees, and are staffed by doctors who can treat non-emergency illnesses such as strep throat. Costs average between $45 and $50 per visit, Wal-Mart spokeswoman Mona Williams said.Wal-Mart's effort, and its cost consciousness, make their solutions much better for the working poor in America than a government solution funded by taxpayers.
Wal-Mart said many of the patients who used the clinics in an initial nine-store pilot were uninsured, and would have gone to a hospital emergency room to be treated instead.
The national average cost for a doctor's visit is about $60, while an emergency room visit averages $383, according to insurer BlueCross BlueShield. More than 40 million Americans have no insurance, and often turn to emergency rooms for care.
Could Wal-Mart be looking to get a share of government subsidies for treating the poor? Sure, and why not. The government certainly does not do a good job regulating the delivery of care, as evidenced by the hundreds of Medicaid and Medicare fraud cases that are prosecuted each year. Wal-Mart will no doubt do it better, and cheaper, than the government. But I suspect the Wal-Mart's motive, profit, will make it a villian in this arena too, since it is a tenant of liberal faith that you cannot profit on health care.
If state legislatures want to expand Medicaid, fine. They need to do so in teh open so that every reasonable voter in the state can make sure that those legislators are voted out of office as soon as possible.
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