Back in August, when I first read Whole Foods CEO John Mackey’s WSJ article about health care reform, I did think that it was a little odd for him to be voicing so publicly an opinion that was certain to run counter to the opinions of a large percentage of his store’s clientele. His opinions aren’t radical or unusual – indeed they are shared by a good chunk of the American public. But not necessarily the chunk that shops in his stores. People who shop at Whole Foods don’t have to shop there. They aren’t shopping there because there are no other grocery stores in the area. Or because they have no car and Whole Foods is the closest store within walking distance. And given the left-of-center average demographic of Whole Foods shoppers, I found his public opposition to health care reform to be a bit strange.
I agree with several of the points Mackey made. I agree that HSAs should be available to anyone who wants one. But just having an HSA in place doesn’t mean that a person will have money to fund it; for a lot of people, HSAs won’t make health care any more accessible than it is(n’t) now.
I strongly agree that employer-provided health insurance and individual health insurance should be treated equally as far as taxes are concerned.
I agree that we need tort reform.
I agree that health care costs need to be much more transparent.
Mackey writes that we should modify the tax code so that people can make voluntary, tax-deductible contributions to help provide care for people who are uninsured. The rainbows and puppies nature of this idea is nice in theory, but I don’t think we want to rely on voluntary donations to pay for the care of 47 million currently uninsured Americans.
His other suggestions – to allow the purchase of health insurance across state lines and to eliminate government mandates from health insurance coverage – are fraught with complications and not nearly as simple as he makes them sound. The number one priority in health care reform needs to be the American people. Yes, there is a lot of special interest involvement in health care, but removing consumer protections that have been won by state insurance commissioners isn’t going to ensure that people have access to quality care. And removing mandates from coverage would result in lower premiums, but it would also mean less coverage, which isn’t necessarily a good trade-off.
As expected, Mackey’s article triggered a firestorm of anger from his base of liberal customers. Jaan Sidorov of Disease Management Care Blog wrote an article about a group that staged a pretty creative demonstration in a Whole Foods store in Oakland. Mackey believes that health care (along with food and shelter) is not a basic right. The protesters – and I think quite a few of Mackey’s customers – feel differently. Mackey is obviously doing well financially, and probably doesn’t have to worry about how he’s going to pay for his own health care. I think it’s a lot easier to say that health care isn’t a right when your own health care is well-secured. Mackey’s belief that health care is best left to the free market makes sense, given his participation – and success – in market economics over the years. But with any commodity in the marketplace, there will always be people who can’t afford it. Especially when the commodity is as expensive as health care has become. The life or death nature of access to health care makes it too important to place it on the same shelf as cars and jeans and high-end organic potato chips. It people can’t afford (and thus don’t purchase) those things, they will still be ok. The same can’t really be said for health care.
I found Jaan’s article in the Cavalcade of Risk, hosted this week by David Williams at Health Business Blog.