Making health care work

Money and a stethoscope.

Jeremy Hobson: The nation's second largest health insurance company, WellPoint, will report earnings this morning.

But LA Times consumer columnist David Lazarus says if you really want to see what's happening in the world of health care, should you look at what's happening at the nation's largest private employer: Wal-Mart. David, good morning.

David Lazarus: Good morning.

Hobson: So, first tell us what Wal-Mart is up to here.

Lazarus: Wal-Mart is basically scaling back its health coverage. Employees who work 24 hours a week or less -- no coverage for you! For everybody else, an increase in premiums in some cases as much as 36 percent. Wal-Mart is our largest private employer. They've got 1.4 million U.S. workers. If these guys can't make health care work, who can?

Hobson: So you're saying we're going to start seeing this at other companies. Other employers are going to start dropping or cutting back their health coverage.

Lazarus: Well, we're already seeing that. In fact, health coverage up 9 percent this year, according to the Kaiser Family Foundation, for family coverage. Clearly the trend is going that way with workers having to pay more and more of the load. Now, clearly our employer-based system is not working for us. And it's just a historical accident -- it must be said.

We got this system during World War II when congress imposed wage caps and companies in turn said, "How about if we offer health benefits as a perk?" And the system never went away. But right now with health care costs soaring, companies are finding it an unsustainable phenomenon.

Hobson: Well, if that's unsustainable and there's so much political opposition to going to a European-style single-payer model, then what are we supposed to do?

Lazarus: That's a good question. For reasons passing strange, a Medicare-for-all system is seen as socialism in the United States. So if not that, then how about we build on what's already coming down the pike. In 2014 under our reform law, we're going to see these 50 different state exchanges established where people can buy insurance there.

How about we create a national exchange that would allow people to buy insurance and have that insurance follow them no matter where they go in the country for a job. And most importantly if you lose your job, you don't lose your coverage.

Hobson: L.A. Times consumer columnist David Lazarus. Thanks David

Lazarus: Thank you.

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