There are lots of reasons to adopt single payer (and personally in my dreams I’d have an NHS- just take the VA and use it as a base and expand), but one I rarely ever hear about is the impact it would have on innovation. I firmly believe that NOTHING could foster more innovation than people not having to worry about health insurance. I personally know at least a dozen people who are stuck in their jobs because they can’t afford to go without health care. People who would probably be better suited to different kinds of work, people who have ideas they would like to bring to fruition, and so on. With our current system of employer provided insurance, we have an artificially inefficient utilization of our greatest strength- people and their individual talents and skills.
It sucks.
Bailey
Yes. This. We are captive to our jobs in a way that is disgraceful just so we and our families can be covered. Ridiculous.
Frankly, this should ALWAYS be part of the democratic pitch for better coverage. The “healthcare as a moral right” argument only gets you so far. The “opening up innovation in business” would probably get even further.
Ed
Another Argument – it would make almost all insurance cheaper – Homeowner’s, Auto, Workmen’s comp – because none of them would have to cover medical expenses. This is a no-brainer.
Major Major Major Major
This was supposed to be one of the conservative/business friendly/all ‘murican arguments in favor of the ACA (insurance for sole proprietorships was a nightmare for example) but it never really got off the ground because we had to fight a rearguard PR action against death panels.
cgordon
For all the bad PR you hear about the VA, people I know who use it love it. Even my GF’s former employer, a quite wealthy business owner, who has used the VA for heart problems AND cancer, and can’t say enough about them.
bystander
Not to mention the effect on the bottom lines of organizations that will no longer provide insurance to employees.
hilzoy
I’ve been pushing this for years, and it actually makes some conservatives do a double-take and really think about it.
Patricia Kayden
It seems as if “businesses are people” politicians feel that insurance companies’ profits are all that matters when it comes to healthcare. Single payer would eliminate that. In a Congress where insurance companies lobby and buy politicians, it will be a hard fight to get to a patient-focused healthcare system but good on Senator Sanders and the Democratic Senators who are supporting a single payer policy.
Starfish
I live in a place where a lot of people start their own companies, and we have exactly this problem. There were a lot of entrepreneurs trying to get healthcare on the exchanges.
O. Felix Culpa
It could also open up jobs for younger people, since boomers who aren’t quite old enough for Medicare could retire (or become entrepreneurs) without fear of crippling healthcare costs.
Walker
Relevant recent post:
How Being an Author Changed After the Affordable Care Act
Villago Delenda Est
But then employers would have one less bludgeon to hold over people’s heads, John. What are you, some sort of commie?
So much of this is about power, and assholes who desperately want to hold on to it when they’re unfit to wield it.
Jim
@Major Major Major Major: Exactly. Well-put.
Rand Careaga
“people who are stuck in their jobs” — you say that like it’s a bad thing. I’m sure I could find a plutocrat or two who would disagree.
The Moar You Know
You know two more; my wife and I.
zhena gogolia
Slightly OT but not really: I’m getting an ad for “Exclusive Christian jewelry from Russia.” It’s rather pretty, actually, if you disregard the slogan.
Villago Delenda Est
@hilzoy: Some ACTUAL conservatives. The GOP is made up of “conservatives” who are greedy assholes first, and have actual principles later.
Sourmash
Have their been any studies about the effect of the ACA on this so far? Even anecdotal ones would be helpful. Any academics know of anything?
Lyrebird
@Bailey: AGREED, and I do try when anyone will listen to remind them: Way more new businesses, entrepreneurial leaps, etc if people know that they can still take the kid or their great-grandma or whoever to the doctor in times of need!
OT but I don’t know if anyone here has favorite links for helping hurricane-stranded pets. This one (RawStory) article about a shelter was pretty compelling, I hope they got their heartworm meds…
Rob Lll
Thanks for this post. My formerly Republican, still fiscally conservative dad has been making a similar argument for years. It really does make some people think twice.
arrieve
This is so rarely mentioned. I know from my own experience — around 15 years ago, two co-workers and I talked about starting our own company. We were really excited about it, and our plans fell apart for exactly this reason. Two of the three of us had (minor) pre-existing conditions that would have made getting health insurance prohibitively expensive, assuming we could get it at all. And so we all remained, unhappily, in corporate jobs where we had coverage, and at least in my case, in a job that does not exactly tax my brains or my talents. And thanks to Obamacare, I can, and actually am, now making other plans because I don’t have to worry about health insurance. (I know, I know, assuming R’s don’t manage to kill it.)
EdTheRed
I’ve been an attorney for 16 years…and the last 12 of them have been almost entirely because of the need to provide health care for my family (my wife is self-employed). So, yeah, I think Cole is on to something.
boatboy_srq
@Patricia Kayden: This.
Every single Conservatist I’ve talked health insurance with doesn’t want to upset the insurer applecart, fearing “uncertainty” and “disruption” in the marketplace – yet those very things are business virtues every time Conservatists discuss technology or retail enterprises. It’s as if the health insurance model is carved in stone while the entire rest of the business sphere is fluid, and in this one instance they pretend to care about the workers in the market sector by trying to “protect jobs” and keep insurers profitable and growing. I suspect a part of that is that it’s Big Gummint that’s rendering the health insurer obsolete instead of Walmart or Amazon crushing small brick and mortar retailers, but it’s a strange dichotomy nonetheless.
boatboy_srq
@zhena gogolia: Windfall for Orthodox oligarchs at the expense of Gud Xtian Ahmurrrcans.
Jim, Foolish Literalist
I know so many people who make or have made major life decisons– when and whether to have a/nother kid, where to live, when to retire– based on health insurance. It’s baffling to me that this is a hard sell.
NCSteve
That was always the most powerful argument in favor of the ACA. One that was real, one that Obama alluded to from time to time, but one that Democrats never had the sense to put front and center, make the heart of their pitch to voters.
And it was just infuriating. But I think it had a lot of causes. Partly it was just pure Democrat ineptitude when it comes to marketing. They think policy and marketing are the same thing, that good policy sells itself and that the way you market policy, if at all, is to take the “features and benefits” approach, dig into the details of how the policy works rather than talking about the societal change aspect. Partly, it was just due to the fact that, frankly, a significant number of the people who are Democrats are explicitly and vociferously anti-private sector. They are. Just face it. They’re the ones who hated the very idea of having to buy insurance, no matter how good and how low the price, from a private company. And those people would have seized upon talking about the fact that the ACA would free the millions of people working jobs they hated just for the insurance to take jobs they loved or, start a new business without worrying that the price of failure could be death for them or a loved one as “Clintonian triangulation” a “bailout” of rich people somehow or other.
And I am convinced that that very thing is what was truly behind the Koch-aligned oligarchy’s vociferous hatred, and constant insidious attacks, on the ACA. The ACA risked creating competition for them, of creating innovation that they didn’t own and of breaking the chains of the neofeudal serfdom that is their real core ideology.
Major Major Major Major
@boatboy_srq: modern conservatism is 50% cleek’s law, 40% IGMFY, and 10% special pleading to justify it all
Major Major Major Major
@NCSteve:
They’re certainly vociferous but I don’t know if I’d call them that significant.
sublime33
We should be screaming this from the rooftops. My wife and I are 61. One of us has to remain employed full time by at least a medium sized employer so we can be assured of being covered by health insurance. I can’t even consider retiring until Medicare kicks in because I could get financially wiped out if I lose my job, COBRA runs out (and at least I can afford the premiums) and one of us gets seriously ill. And as a bonus, has anyone noticed the “sticker price” of hospital bills? Take your typical bill and multiply by at least 3.5 because if you aren’t in the Blue Cross or UHC buyers club, your bill is astronomically higher. Freedom? How about freedom to retire before aged 65 and not worry about losing everything I have saved.
PaulB
@O. Felix Culpa:
This…. I’m prepared to retire as early as next year, five years before Medicare kicks in. As long as Republicans keep trying to destroy the ACA, I can’t. There is no way I can afford the premiums on their respective plans.
Trabb's Boy
Ex-pat now Canadian weighing in here with a couple of issues. I love, love, love the Canadian health care system — the freedom from job dependence is absolutely a huge thing, as is the absence of millions of dollars lost in unnecessary paperwork and in-fighting about who pays what. But.
1. It only works because everybody gets the exact same care. If it were for the poor it would be dissolved with the political winds. Everybody getting the same is not the American way of doing things. It is a nation in which the rich don’t have to tolerate ordinary service. There will be a lot of fights about what is covered and what can be bought privately. I honestly think that the best bet here is solid, 100% public sector coverage for routine primary care and catastrophic treatment, with an opportunity for private sector variation of everything else.
2. While it is cheaper overall, it makes national health care costs very visible. In general, I’d say that U.S. taxes are comparable to other countries because the U.S. has a huge military and other countries have a health care system. Taxes would increase very substantially in a single-payer system as the government takes over the role played by most businesses. It might be dealt with less visibly through corporate taxes, but still, America really doesn’t play this way. Again, a public system for the very basics and the catastrophic only would result in a much healthier and less tragically bankrupt population, without creating a constant nightmare struggle with the Republican party over every fucking detail of expenditure and entitlement.
Barbara
The expression for it is “job lock.” It is so part of our landscape that we don’t even see it as a thing anymore. So by all means, keep bringing it up.
Barbara
@sublime33: Yep. My father retired at the age of 61 and took the risk he could get by until Medicare eligibility. He was diagnosed with pancreatic cancer basically one year before he would have become eligible, and died four months later. The only “good news” for us was that there was no point in throwing thousands of dollars at treatment because it was inoperable and terminal without a doubt.
RAM
When Obama announced he was going to push for the ACA, fostering economic growth and innovation through universal health insurance was one of his major points. But it got completely lost in the death panel nonsense, the typically terrible press coverage of creating the ACA, and Democrats’ cowardly decision to run against both Obama and the ACA, in which they lost so much political ground.
Chet
Couldn’t agree more. I know a guy who, many years ago, left his company to start his own business, but had to go back because he couldn’t insure himself. Taking insurance out of the job decision makes people more flexible, more mobile, and should be better for the economy.
gene108
@NCSteve:
I think one issue with the ACA is that it was such a bold step that people were not sure exactly how it would impact things. No one could say definitively that in four years,when it went fully into effect, this would be the benefit. There were expectations, but even minor misstatements, like Obama’s “you can keep your insurance”, was met with hell and fury, when insurance companies decided to cancel non-ACA compliant plans.
There’s a risk to over promising and under delivering that is very real.
gvg
I think part of the problem is it has taken too long to get here. For decades, people have been makng this job healthcare calculation and gradually there is less of a tradition of starting their own companies/business. This is also caused by not enough taxes and not enough of a slant to finance laws to make wages below the top more equitable but as the lower and middle class have been squeezed they have become more conservative in the true definition of not taking risks. this means that the number of new businesses started has been dropping and because they never start, some of them never become bigger and compete with the already established businesses to force them to be better at serving us. the squeezed aren’t all that good at figuring out WHY things aren’t so good anymore and are reacting by blaming the others. Healthcare being tied to only big company jobs is a problem.
It’s taken a long time to get to this point.
25 years ago I noticed college students calculating that if they were married, one had to have a big company or government job for the other to start a business. At the time i just thought it showed they were smart. Now I see it as a missed warning sign. It was influencing a lot of choices and they were so young, they had to have been picking it up from parental experiences.
Matt McIrvin
Anyone who really cares about small-business entrepreneurs, as conservatives and liberals always claim to, should want health insurance ultimately taken out of the hands of employers.
Gretchen
I would retire now and take care of my grandson but I don’t get Medicare until March. We’ve decided I can retire in January and pay 2 months of COBRA to get there, but 6 months of COBRA with no paycheck is a lot.
MaryL
Absolutely. It should also put upward pressure on wages, since people will have less incentives to stay or take jobs they don’t love, so employers will have to find alternative ways to sweeten the deal.
James Powell
@EdTheRed:
So, not Lovin’ the Law?
Mike J
Republicans looooove to talk about tort reform. They hate the idea that somebody might be awarded money for the bad actions of another person.
I have a friend in London who was hit by a car while riding his bike. Expensive medical care followed, but fortunately he wasn’t permanently disabled. In the first hour after the accident he probably received more than $50,000 worth of care. Then for months afterwards there were follow on costs.
He never considered suing the driver (who stopped after the accident and got the ambulance.) He didn’t have to worry that the bailiffs were going to come to his house and evict him because he couldn’t pay for his medical care and his rent. You would have far fewer multi million dollar lawsuits if people knew their multi million dollar medical treatment was covered.
Butch
Literally the only reason I’ve continued to work where I work is because my partner is self-employed and, being in a rural area, private insurance is unaffordable. The new owners of the company are jerks, and I would love to leave.
Jeff
I’ve gone without health insurance in the past. Had it when I needed it the most. Very lucky to be covered when I needed it. Now I’m on Medicare with a supplement via my husband. When he dies I’ll have Medicare and maybe a supplement.
Kelly
When my first wife was dying of breast cancer we’d have traveled when she was feeling OK if I hadn’t needed to hang on to our Big Tech Corp insurance. We had the money to live and travel but for health insurance.
Hal
If and when Medicare for All becomes a thing, I hope President Obama gets some much deserved credit of having taken the first steps with Obamacare. This was one of my great annoyances for years after the ACA passed; people claiming the ACA was just a handout to the insurance industry and should have been scrapped in favor of universal healthcare, which had no chance of passing at the time. This is one of those incremental changes that has a long term payoff that Sanders supporters and other progressives need to take heed of when trying to pass legislation that’s less than perfect.
Miss Bianca
Is it rarely mentioned? This is an argument I’ve been making for years, and I know I’m not the only one. Or is it just that we rarely hear politicians and media talking heads making the argument?
Insane Clown POTUS
I find it odd that Americans are seemingly okay with what we pay for healthcare. We spend about 50% more than the French for objectively worse coverage and more hassle. It’s perplexing. We get all riled up about tiny taxes, but roll over for paying huge amounts to insurance companies.
PST
During the ACA debate not only was relief from “job lock” argued too infrequently as a virtue, it was painted as a vice by opponents. The CBO statistics used to pin the label “job killing” on Obamacare were actually about the number of people who would leave their jobs if they didn’t need to hang onto them to maintain coverage. These were people who could have been doing jobs they liked or retiring and giving up jobs to younger workers during a time of high unemployment. I made the point every chance I got, but I think proponents were inhibited by the way opponents had turned the argument around. Also ignored, in my opinion at least, was “marriage lock” — couples trapped in relationships both wanted out of but couldn’t afford to dissolve because the non-corporate spouse had a preexisting condition.
Blake
This is 100% correct, and we already saw it with the implementation of Obamacare, though arguably not in an altogether positive way. I was at a large employer pre-Obamacare, and not very happy, but it was expensive to move because I had gold-plated insurance – no deductibles, very small copays and only for odd things, all premiums paid by the company. With the implementation of OCare and the “cadillac tax” looming, they switched to a HDHP with HSA. It was still very generous, but not really tons better than anyone else. So I bolted, because it finally made sense, and I’m much much MUCH happier at a medium-sized company doing more interesting work. Single-payer would be this kind of thing times a bunch.
Elizabelle
Yes, innovation and not being tied to a job. Exactly the case.
I don’t understand why we didn’t hear more of this argument. Maybe because it’s effective?
Villago Delenda Est
@RAM:
Yet another reason for my nym.
Wipe them out. All of them.
Double for Chuckles the Toddler and Cokie Roberts.
MManoInSewickley
I could not agree more with Mr. Cole on this. It would lead to an explosion of new talent and idea.
jonas
@cgordon: Getting *into* the system can be tough for some vets, but once they’re in, almost all of them love it.
catclub
It makes me wonder, though. Are all the nations that have universal Healthcare centers of creativity and entrepreneurialsim?
Do people in those nations more often start businesses since they have no healthcare worries related to the present job?
I have not seen reports to that effect, but they should be there if it is true.
Another Scott
I’m so old that I [remember when] GM said health care costs were a huge burden (from 2006):
There’s that last sentence, but there was no serious effort to address the issue at the federal level until Obamacare.
Our choices have consequences. Our economy is a human construct and we can make different choices. Yes, freedom to change jobs is a huge benefit of national guaranteed benefits. But there are lots of other benefits, also too.
Cheers,
Scott.
Brachiator
Hmmm. More innovation in the US than the home of the NHS, the United Kingdom. Much of this may be due to the fact that a lot of this bunch is mainly healthy anyway. Some may be on college health plans or their parents’ insurance.
However, a universal plan might spur small business growth. Larger business growth, too.
Yep. Peace of mind is probably a big factor as well. But yeah, possibly a significant impact on job mobility.
On the go, and have not been able to read all the comments here. Has an economist looked at these factors?
James Powell
@Trabb’s Boy:
It may be impossible or maybe just real hard and we need to keep working at it, but we have to convince the great majority of Americans that health care is not one of those products or services that we in the consumer culture use to construct our identities.
Ian G.
Other than preferring the German or French model to the British one, I agree with everything Cole said, and have long thought our health system destroys entrepreneurship.
boatboy_srq
@Major Major Major Major: You would still think that the 40% IGMFY quotient would be persuadable in terms of the bigger house, nicer car, fancier wardrobe, plusher vacations and other perks that not having to spend significant sums paying health insurers and deductibles could enable. It’s surprising how effective “do you REALLY want to pay Big Electric high-three-figures every month just for those incandescent bulbs?” is on the We Can’t Keep Installing Incandescent Bulbs Because Fat Al Gore crowd: this isn’t any different.
dnfree
@Gretchen: I think you don’t have to actually “pay” the COBRA if the time period you are talking about is two months. I’ve read that there is a 60-day grace period, so if within the two months you need expensive medical care, you can go back and pay for the months retroactively. But of course I’m not an expert–just something to check into. Quickly Googling finds me this, but it’s from 2012 so you could check it out.
http://www.mymoneyblog.com/cobra-and-retroactive-health-insurance-coverage.html
dnfree
For those of us who live in farm country, most smaller farms have one spouse who works at a full-time job to get health coverage for the family, while the other spouse runs the farm. Often both spouses would prefer to be running the farm but they have to have insurance. And I’ve known a couple in their early sixties with significant medical issues requiring surgery (from a life spent farming) who were waiting until Medicare kicked in and living with the pain for a few years. Surely even Republicans think such hard-working people should have the medical care they need?
the Conster, la Citoyenne
@NCSteve:
Democrats got sideswiped by “death panels”, which was beyond stupid, but a shiny object that the media couldn’t refrain from being distracted by because of Stupid Sparkle Pony Palin, and the idiots in the Tea Party. The same thing will happen again, because any government paid for health care program has to have rationing. To say nothing about the Hyde Amendment being baked in, granting permanent second class citizenship to women.
eemom
Hey, somebody tell trump! He’s an entrepreneur — he’ll totally GET this. ?
Raven Onthill
It’s called “job lock” and has been fairly widely discussed, but not (metaphorically) “front-paged.” I think this argument isn’t made more often because it runs the risk of offending the big money that funds the campaign system. I’ll give links in the next post, which will almost certainly go into moderation because of the number of links.
Raven Onthill
Job Lock Links:
http://www.huffingtonpost.com/wade-buchanan/aca-breaks-job-lock-obamacare_b_4832463.html
http://theincidentaleconomist.com/wordpress/job-lock-what-the-aca-does/
http://familiesusa.org/blog/2014/02/reducing-job-lock-how-affordable-care-act-empowers-working-families
http://www.msnbc.com/rachel-maddow-show/when-the-aca-ends-job-lock-its-feature-not-bug
https://www.healthinsurance.org/obamacare/how-obamacares-breaking-the-bonds-of-job-lock/ (insurance company marketing, forsooth)
http://www.latimes.com/opinion/op-ed/la-oe-0411-baker-obamacare-job-lock-20160411-story.html
http://www.modernhealthcare.com/article/20161228/NEWS/161229966
http://fortune.com/2017/02/13/job-lock-aca-repeal/
There’s some fairly heavyweight figures commenting on this, as well as insurance marketing, and more conservative sources.
Fair Economist
You don’t need single-payer, just universal coverage. This is an important point with the current insanity of “single-payer or bust”. We’ve seen the outcome of that choice in the US, and the outcome is “bust”.
IdahoFlaneuse
It was having access to healthcare insurance outside of work that allowed me to retire early.
TenguPhule
@Major Major Major Major:
This should be part of the BJ Lexicon.
MomSense
Are people not aware that portability is one of the current benefits of the ACA? I know David has done posts about this on several occasions.
Jim, Foolish Literalist
@eemom: you snark, but Roseann DeMoro believes this
Raven Onthill
And Sanders just (just, minutes ago) said it, in his “Medicare for All” bill introduction.
catclub
@Another Scott: This how you know that tribal is what matters. GM would be MUCH better off offloading their medical insurance costs onto a federal single payer system, but they never spoke up in favor of it. Even after the 2008-9 bailout.
They happily have it in their Canadian operations. So those operations are lower cost than US operations.
catclub
@Ian G.:
do you know of any evidence showing single payer helps entrepreneurship in countries that have it? Lots of nations have it, so there should be evidence.
boatboy_srq
@catclub: One would think Richard Branson and Virgin Everything would be proof enough all by itself.
/s
Seriously, this is data we desperately need. The presumption among the Reichwing that Ahmurrrrca is the home of all entrepreneurship will be tough to crack.
sublime33
@catclub:
” do you know of any evidence showing single payer helps entrepreneurship in countries that have it? Lots of nations have it, so there should be evidence.””
It’s not single payer. It’s access to insurance regardless of full time employment status for yourself and family is what locks many people into not leaving their current job.
Elizabelle
@Raven Onthill: Thank you. Those are some good links.
JustRuss
@Mike J:
Yep. And how many fun activities get the kibosh because getting insurance in case someone gets hurt is too expensive? Happens all the time. Heck, we might even get to have lawn darts again!
NCSteve
@gene108: That was part of the beauty of the squandered “unleash entrepreneurship and free people staying in jobs they hated” pitch. It was anecdotally demonstrable and incapable of being definitely empirically disproven. And it’s the inability of Democrats to grasp that kind of thing that kills us.
Raven Onthill
There’s actually some economic literature on this, see Blumberg, Corlette, and Lucia at Blumberg, Sabrina Corlette, and Kevin Lucia at http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf406367. That was from 2013. There may be more by now; follow their cites and look for work that cites them and their cites for more.
@Elizabelle: You’re welcome!
Greenergood
Sorry, have not had time to read through all the comments, but can I just say how amazing it is to see so many comments even contemplating the idea of single-payer health care. I live in Scotland, which is desperately trying to hang on to a national health service – Scotland’s health service is ‘devolved’ to the Scottish Parliament, but the funding comes from the UK (English, really) Parliament. So we get health-service money from down south and we can sort of do what we want with it, but every year the amount of money we get is less and less, because the English ‘National ‘ health service is privatising and selling off everything. The less public money there is in England, the less there is in Scotland – because the ruling is that the percentage of public money avallable in England should be the same in Scotland, even though we in Scotland haven’t sold off (yet) our health services to private companies, as the Tories are gleefully doing so south of the border. What’s going on here is rampant globalised capitalism in action. I read newpaper business reports here in the UK that mention companies that were on the letterheads of the companies that were demanding money when my dad was dying of head/neck cancer in NY 10 years ago – Capital, United, etc. – they are sharks around the struggling whale of the British National Health Service, as the Tories salivate at the amount of money they and their donors will make as they privatise this precious health service. There are politicians and many, many people beginning to see the light in the US – stand your ground, change your health system, use ours as it ideally functions as an example – it might be the only way we can preserve ours as well if your rapacious health insurance companies can be deterred…
Loneoak
Don’t tell Anne Laurie about this post, she might call you a Bernie Bro because you are actively undermining something Hillary once said.
StringOnAStick
@Greenergood: Let’s see, what does the UK and US have in common that has such an impact on health care policy plus oligarchy? Rupert Murdock, Mr Propaganda himself.
Rusty SpikeFist
It’s already hilarious watching the nonplussed flailing and backtracking from Clinton-cult zealots and Obama-Industrial Complex neolibs — some of them front-pagers and regular commenters on this blog — who spent the last 8 years explaining why it was unpossible that we should ever have single-payer or truly universal healthcare of any kind in this country because “we can’t do that because that’s not the way we do things in America” / Won’t Someone Think Of The Poor Insurance Company Parasites! / “BernieBros Only Want Single Payer Because They’re Racist, Which Makes Sense For Some Reason”
not John of course, but some of the other BJ people spent the better part of a decade making complete clowns of themselves spreading talking points from self-interested politicians on the take from the insurance industry. Then all of a sudden the party goes and pulls the rug out from under them by making it clear those rationalizations had all been bullshit from day 1.
LOL
andy
It does suck, but bosses love having that gun to your head, which they deployed with glee in the last recession. And I think the innovation angle is why Chamber of Commerce types hate the idea of Universal Health (they can Google “health care expenditures as a percentage of GDP” as well as anyone). Once you take the fear of losing everything away, people would feel free to strike out on their own and very likely end up competing agains former employers. Can’t have that.