Greenville Business Magazine 2009 December issue : Page 11

Should Health Care Be Considered A Public Service? BY WILLIAM B. GARTNER | PHOTOGRAPH BY ASHLEY RUFF - IMAGE TO IMPACT “ T he column is not an argument for any one particu- lar health care solution. My view is that everyone should have access to affordable health care. Yet, a critical part of the solution involves who should pay. What is apparent to those who study entrepreneurship and small business, is that providing health care is an ever rising expense that prevents many entrepreneurs from starting businesses and keeps many small businesses from creat- ing more jobs. As I follow the development of legislation mandating universal health care, what concerns me most is the focus on requiring employers to pay for this mandate. For any employer, the cost of paying for health care is one of the many costs that are a part of paying an employee. So, as health care costs to employers have increased, employees are actually receiving a boost in their overall earnings. It should be no wonder that most employees are not receiv- ing increases in their wages. Employers are using possible wage increases to pay for health insurance premiums. This, over the long run, is unsustainable. Requiring employers to pay for increasing health care costs for their employees will insure that employers have fewer employees. Requiring employers to pay for ever increasing health care costs for their employees will insure that employers have fewer employees. ” I believe that one of the criteria for developing a health care solution has to be that employers cannot shoulder the entire burden of paying for mandated coverage for all employees. If such a health care payment mandate is required of employers, I predict that current rates of unem- ployment will continue to stay high, if not increase, for a number of years. For many jobs with low wages, the cost of an employee will become less about wages and more about having to pay for health care benefits. So, who should pay? I suggest that health care, if it is thought of as a public good, that is, something that we believe everyone should have access to, will need to be paid by the public (which is another way of saying that you are going to pay for it). If we think of health care as a public service, just as we think of universal education as a public service, and police and fire, and water and sewer, and highways and roads, and all of the other public services that we all benefit from, then, we are going to have to pay for it. We don’t require that businesses pay for our public schools, or our roads, or for the police and fire services we receive. So, why should we assume that businesses can shoulder the burden of paying for universal health care? ■ William B. Gartner is the Spiro Professor of Entrepreneurial Leadership at Clemson University. DECEMBER 2009 | GREENVILLE BUSINESS MAGAZINE 11

>>columns - Should Health Care Be Considered A Public Service?

William B. Gartner

The column is not an argument for any one particular health care solution. My view is that everyone should have access to affordable health care. Yet, a critical part of the solution involves who should pay. What is apparent to those who study entrepreneurship and small business, is that providing health care is an ever rising expense that prevents many entrepreneurs from starting businesses and keeps many small businesses from creating more jobs. As I follow the development of legislation mandating universal health care, what concerns me most is the focus on requiring employers to pay for this mandate. For any employer, the cost of paying for health care is one of the many costs that are a part of paying an employee. So, as health care costs to employers have increased, employees are actually receiving a boost in their overall earnings. It should be no wonder that most employees are not receiving increases in their wages. Employers are using possible wage increases to pay for health insurance premiums. This, over the long run, is unsustainable. Requiring employers to pay for increasing health care costs for their employees will insure that employers have fewer employees.

I believe that one of the criteria for developing a health care solution has to be that employers cannot shoulder the entire burden of paying for mandated coverage for all employees. If such a health care payment mandate is required of employers, I predict that current rates of unemployment will continue to stay high, if not increase, for a number of years. For many jobs with low wages, the cost of an employee will become less about wages and more about having to pay for health care benefits.

So, who should pay? I suggest that health care, if it is thought of as a public good, that is, something that we believe everyone should have access to, will need to be paid by the public (which is another way of saying that you are going to pay for it). If we think of health care as a public service, just as we think of universal education as a public service, and police and fire, and water and sewer, and highways and roads, and all of the other public services that we all benefit from, then, we are going to have to pay for it. We don’t require that businesses pay for our public schools, or our roads, or for the police and fire services we receive. So, why should we assume that businesses can shoulder the burden of paying for universal health care?

William B. Gartner is the Spiro Professor of Entrepreneurial Leadership at Clemson University.

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