THE TREATMENT FEBRUARY 14, 2009
Anthony Wright is executive director of Health Access California, the statewide health care consumer advocacy coalition. He blogs daily at the Health Access WeBlog
and is a regular contributor to the Treatment.
I think President Obama found his new spokesperson for health reform: Julio Oseguida. The enthusiastic Mr. Oseguida became a mini-media celebrity after he asked the last question of the President at the town hall earlier this week in Fort Myers. In all the attention focused on his “man-on-the-street” character, most of the media missed what he actually said: that even after over four and a half years of working at McDonald’s, he still doesn’t get benefits. President Obama picked up on his plight, and highlighted not just the help that Julio would get from the economic recovery package, but also the need for health reform.
McDonald’s posted record profits last quarter, but the focus of an economic recovery should not be McJobs, literally or figuratively. President Obama was right to guess that as a McDonald’s employee, Julio wasn’t getting health coverage.
On top of its questionable nutritional impact on the health of the nation, McDonald’s benefits to its workers aren’t much of a contribution either. In fact, the fast food giant could emerge as a big, if not the biggest, opponent of health coverage reform efforts this year—even more than the usual suspects of insurers, drug companies, and the like.
Central to any reform is the notion that we all need to pay our fair share into the health system. Most of us do so at work, with our employers helping us buy coverage. And most employers do provide health coverage to their workers. But financing any reform will have to require asking something of those employers that do not contribute already.
In 2003, a bill in California that would have required large employers to provide coverage to their workers was put up for a referendum. Fast-food and chain restaurants provided nearly 70 percent of the funds to defeat the requirement, with McDonald’s and its franchisees as the largest financial contributors, as my organization, Health Access California, reported at the time. Their opposition mattered, helping them eek out a bare majority against the proposals.
This isn’t an isolated example. In San Francisco, the Golden Gate
Restaurant Association has filed a lawsuit against that city’s
universal health care proposal, which would also ask all businesses to
contribute towards health insurance costs. (I’ll have more to say about
that proposal soon soon).Restaurants and retail chains tend to
oppose employer requirements because, as low-wage employers, they can
save money by providing skimpy coverage or no coverage at all. But not
all companies act that way. Starbucks, for example, offers much better
coverage than McDonald’s, while Costco provides much better coverage
than Sam’s Club. Of course, without a requirement that all employers
contribute to health care, those that do provide coverage will face
increasing pressure to scale back their benefits. Many health reforms provide employers a bargain: In exchange for
requiring businesses to contribute money for health insurance, they
make available the kind of affordable coverage now available to larger
companies and offer subsidies for businesses that might need them. In
addition, reform promises to hold down the cost of health care, over
the long run, which should help employers, too. The question is whether the purveyor of the Value Meal sees the value in such a bargain. Perhaps Julio Oseguida could make the case.