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Boston Globe, August 06, 2004
We have a list of deadbeat dads. We have a registry of sex offenders,
which we now post on the Internet. Coming soon: a list of Massachusetts'
corporate freeloaders. This could be good reading.
With no fanfare and over the veto of Governor Mitt Romney, the Massachusetts
Legislature last month became the first in the nation to require the
Commonwealth to compile an annual list of which companies' employees
and their dependents use state health benefits the most, and what
it costs taxpayers. The requirement, included in the state budget,
applies to employers with more than 50 workers.
American medicine is the best in the world, but paying for it is a
constant game of pass the buck. Increasingly, the private sector is
passing the buck to the public sector. In 2001, about 67 percent of
Americans under age 65 got their healthcare coverage through their
employer, according to the Center for Studying Health Care System
Change. By 2003, that number had fallen dramatically to 63 percent.
Meanwhile, those under 65 getting government coverage increased to
12 percent from 9 percent. People still went to the doctor; the difference
was who paid.
In Massachusetts, healthcare is the biggest, fastest-growing piece
of the $24 billion state budget. So the Legislature is dead right
to ask which companies aren't providing coverage to their employees,
and at what cost. "Having clear information on the extent to
which healthy, financially robust employers have significant parts
of their workforce using publicly sponsored health insurance programs
is important," says John McDonough, executive director of Health
Care for All.
Romney vetoed the plan, saying the Office of Health and Human Services
does not have the information on employers to complete the required
report. But Amy Lischko, the agency's assistant commissioner, said
that while there are problems ahead, the state already requires those
who use both MassHealth and the uncompensated care pool to list their
employers. She said the agency is still working out how to respond
to the new disclosure rules.
This shouldn't be allowed to slip. In Georgia, an internal audit of
who was using the state's healthcare program for kids was revealing,
if embarrassing for some brand-name companies. Wal-Mart, Georgia's
largest employer, had about one child in the state program for every
four employees, by far the highest ratio of children covered by the
state. Others on the list included McDonald's and Home Depot.
When firms don't offer workers health insurance, or pay workers too
little to afford the premiums, somebody else must pay. Wal-Mart has
become Exhibit A: In California alone, Wal-Mart workers seek $86 million
a year in state aid because of inadequate wages and benefits, according
to a study by the University of California at Berkeley Labor Center.
"In effect, Wal-Mart is shifting part of its labor costs onto
the public," the researchers said.
Deydamia Soto is an immigrant single mom in Roslindale. Soto, 48,
cleans the offices at 225 Franklin St. five nights a week for Unicco
Service Co., a Newton giant with 20,000 employees and sales of $690
million. She works part time, is paid $11.20 an hour, and isn't eligible
for company insurance, so she and her daughter are covered under MassHealth.
Ultimately, Soto says, what matters is that she and her 8-year-old
can see a doctor. Who pays -- her employer or the state -- matters
less, she says.
In fact, Soto and Unicco are all too typical, in Massachusetts and
elsewhere. In all, 41 percent of those who are employed and uninsured
in Massachusetts work at large firms, a state study found. It is not
just about small companies not insuring their workers.
Bottom line: If Soto can't pay, and her employer won't, that leaves
the rest of us. And if we're going to pick up the tab, we have every
right to know which employers are freeloading—and just what
they are costing us.
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