My talk at the New America Foundation panel yesterday apparently became most noteworthy for an exchange I had with a representative of Safeway, focusing on their “personal responsibility” plan they have implemented for their managers, which my colleague Hanh discussed several days ago on this blog.
Daniel Weintraub started a debate from that panel at the Sacramento Bee Crossroads blog, where he thought the big takeaway from both the Safeway and San Francisco plans was that insurance should have a bigger co-payment for going to the emergency room than for going to a doctor. I was surprised that he found that newsworthy. (I even asked the room if anybody had insurance that didn’t include a co-payment for an ER visit. No hands went up.)
The real news, I thought, was when the Safeway representative made the case for an employer mandate. Of course, he didn’t make an endorsement of any proposal, but he criticized the system where the employer-based system is “voluntary,” which leads them to be undercut by other competitors who offer scaled-back health plans.
Several years ago, Safeway was the positive example in the health care wars. Presidential candidates cited them as the union employer who provided good benefits, and yet who were threatened by seeing Wal-Mart come in with their supermarkets, undercutting them with less costs because they provided less coverage.
At the time, there was a potential solution: SB2 and later Prop 72, the proposal to set a minimum standard for on-the-job benefits. Yet even though they complained about Wal-Mart’s competition on an unlevel playing field, Safeway never took a position on the bill or the initiative, and instead tried to force down benefits themselves, which led to a bitter and long labor strike in Southern California. Many Californians respected and observed those picket lines, given their own insecurity about their own health benefits.
Safeway’s image, especially around health issues, has deservedly soured. Those striking workers kept many of their benefits, but new employees in Southern California now have to wait for many months for health benefits–up to 30 months (!) for family coverage with a $1050 deductible, and have to pay 20% of the premium.
It was a surprise to see both Safeway and Wal-Mart represented at the Governor’s Summit on health care earlier this year, the two most infamous corporations with regard to health benefits. The Governor would have sent a very different signal if the businesses around the table included those that provide benefits *above* their competitors, like Starbucks and Costco, which actually faces Wall Street pressure to scale back their health benefits.
So I was surprised that the Safeway representative, after that history, still acknowledged the problem of the unlevel playing field, of the problems of not having an employer mandate. In other states and cities, grocery chains have actually taken a lead of supporting laws to set basic standards for employers’ contributions to health benefits, including Giant Food in Maryland, and Gristede’s in New York City. Maybe Safeway could look at those chains as models.
Just to be clear, the representative of Safeway spent most of his time on their “consumer-directed” health plan that includes high deductibles, that they have been actively advocating to the Governor… We disagreed enough that after the panel, when following up on our conversation, our panel moderator Daniel Weintraub felt compelled to step in between us. It wasn’t necessary, though.