While critics have long attacked Wal-Mart for everything from destroying mom-and-pop stores to exploiting cheap foreign labor, the focus of the present controversy is health insurance. According to published figures, Wal-Mart insures less than half of its U.S. workforce. (Costco, considered by many to be Wal-Mart's nearest competitor, insures 96 percent.) What's more, the coverage that Wal-Mart does offer frequently includes large deductibles that leave employees exposed to heavy out-of-pocket costs. Labor activists and their allies say that such a profitable company owes its workers more than that. Last month, the Maryland state assembly signaled its agreement by passing a bill that would have required Wal-Mart either to spend more on employee health benefits or pay an equivalent amount in taxes to help underwrite the state Medicaid program, on which many Wal-Mart employees rely.Cohn mentions that Wal-Mart spokespeople point out that the health care crisis in the U.S. is broader than just one company. He agrees but says this assertion is disingenuous because Wal-Mart has consistently blocked the reforms needed to fix the system. First, he says, some context is needed:
To understand why, you need to understand how American workers came to depend on companies like Wal-Mart for health benefits in the first place. In most of the Western, developed world, governments organize health insurance-- guaranteeing coverage as a right of citizenship, mandating minimum benefits, and financing care, primarily through taxes. But efforts to bring universal health care to this country have always run up against opposition from the business community, which opposed government interference in the private sector. To corporate America, the only acceptable way to ease public access to health care was private health insurance, which it embraced starting in the 1930s.This reliance on private employers for health care, though, is not working:
But, in the last two decades or so, as medical costs have skyrocketed, unions have atrophied, and the pressure to squeeze labor costs has intensified, employers have been rethinking the commitment to employee benefits. Many companies engineered (or reengineered) their workforces so that fewer employees were eligible for coverage; others ratcheted back coverage, transferring more costs to employees. All of this has made Wal-Mart a model other companies emulate--if not out of admiration, then out of perceived necessity.For Cohn, while the efforts to legislatively force Wal-Mart and other large corporations to pay for their workers health care is commendable, it may not be the long term solution:
But this notion also assumes that the employer system is really worth keeping--which may not be the case. The system made a lot more sense back in the 1950s, when a breadwinner might spend decades or a whole lifetime at one full-time job. That's not true anymore.He then describes the need for a complete gutting of this system – a task, he admits, that will be far from simple – and how companies like Wal-Mart and their Republican allies have inexorably fought these reforms, including the possibility of universal health care:
And they're still fighting. In the last election cycle, 80 percent of the donations from Wal-Mart's political action committee and individuals associated with the company went to Republicans, whose opposition to anything resembling universal health care is well-known. While Wal-Mart itself has not taken an official position on national health insurance, it's not hard to guess what the company would think about it. Suffice to say you won't hear Wal-Mart championing France's universal health care system. Wal-Mart is entitled to its opinion, of course. But, as long as it blocks real health care reform, then it deserves every bit of grief it's getting.