Last week I did a quick hit on NPR’s excellent series of reports, “The Rise of the Contract Workers”, and I’ve been thinking a lot about this paragraph from that post:
America as it is right now isn’t equipped to have a large independent workforce. The government has relied on corporations to provide safety nets like retirement income, health insurance, and disability pay. What happens when those go away? It doesn’t seem likely that the government will force companies to provide benefits for their contract workers – corporate lobbyists would kill any such measure in a heartbeat. But people without health care, and without retirement savings, will create a huge strain on the country’s resources if things keep going the way they are.
This week, three of those companies – Amazon, Berkshire Hathaway, and JPMorgan – announced a somewhat vaguely-defined joint venture to provide healthcare for their employees at a lower cost than the traditional system. For as long as there have been employee benefits there have been efforts by employers to reduce the cost of those benefits, which is why we now have 401(k) plans instead of pensions and high-deductible health plans instead of full coverage. Despite the high-minded rhetoric it remains to be seen if the employees or the shareholders of these corporations will get the better outcome.
From a self-employed perspective, it may be discouraging to see another service that the government could be providing to all of its citizens instead be taken up by private enterprise for the benefit of a select few (i.e. employees and/or shareholders of Amazon, Berkshire Hathaway, and JPMorgan). Let’s not absolve the healthcare industry either: the ability of drug and device makers to charge essentially whatever they want for their products is a big reason we’re where we are right now. However, if this new venture – in whatever form it winds up taking – by three companies previously foreign to the healthcare industry ends up working, it wouldn’t be surprising to see someone emulate the model to bring it to the open market – very possibly Amazon itself.
This would be a huge development for cutting healthcare costs. I won’t try to guess the exact amount, but think of everyone right now who, after coming down with a minor ailment, will book an appointment at the clinic, sit and wait in the office, be looked at by a nurse practitioner, spend three minutes with the doctor, get a prescription, wait for it to be filled, and then go and pick it up. Now imagine going to your computer, checking off a list of symptoms, having a short videoconference (or even just a chat session) with a doctor, and getting your prescription delivered to you that day. Just that change would mean a boatload of time and cost savings for those patients and their providers, not to mention better outcomes for people whose time and budget constraints prevent them from booking an appointment in the first place.
Don’t get me wrong, I’m not wild about the prospect of relying on one corporation for my news, reading material, groceries, and health care. At the same time, the government, with its shifting political winds, may not be the most reliable partner either. The individual insurance market, improved as it is since the pre-ACA days, has its own flaws and is likely to have its own cost increases stemming from the Republican tax law (among other things). Like it or not, the solution for healthcare eating up more and more of our earnings is likely to come not from government nor the healthcare industry itself but from a company currently outside the industry. Until then, self-employers will continue to be left to their own devices to find a solution that works for them.