Road to Serfdom: 10 Items or Less

In the debate over health care reform, Republicans seem to be casting about for some successful example of a free market system that holds down costs and improves outcomes. Currently, the Safeway grocery store chain is filling that roll. Senate Majority leader Mitch McConnell mentioned Safeway during his appearance on Face the Nation over the weekend and Safeway CEO Steven Burd had a recent Op-Ed in the Wall Street Journal. Mr. Burd describes the key mechanism used by Safeway to control costs:

Safeway's Healthy Measures program is completely voluntary and currently covers 74% of the insured nonunion work force. Employees are tested for the four measures cited above [tobacco usage, healthy weight, blood pressure and cholesterol levels] and receive premium discounts off a "base level" premium for each test they pass. Data is collected by outside parties and not shared with company management. If they pass all four tests, annual premiums are reduced $780 for individuals and $1,560 for families. Should they fail any or all tests, they can be tested again in 12 months. If they pass or have made appropriate progress on something like obesity, the company provides a refund equal to the premium differences established at the beginning of the plan year.

So in this case an employer, Safeway, uses a financial inducement to force employees to submit to invasive health screening and then coerce them into modifying behaviors. Behaviors that no doubt have an impact on the bottom line, but seem to have little or no direct bearing on daily work performance.

I can't for the life of me understand how this type of system can be touted by the Republican party, which bills itself as the party of individual freedom and personal responsibility. Is a workplace nanny state enforced by an employer qualitatively different from a nationwide nanny state enforced by the federal government? One could argue that an employer does not have the power to impose a death sentence or the power to tax. While this is true, I am sure that during the midst of a global economic downturn and unemployment levels not seen for decades, these differences are somewhat diminished. In fact, I would argue that for the average law-abiding non-self employed person, employers have a greater influence over the rhythm and shape of people's daily lives than does the federal government.

While I don't think we all ought to start smoking two packs a day, it might be a good idea for us all to stop and think about just what it is that we are so eager to jettison in pursuit of health care reform. After all, the 'cost' of the Safeway plan isn't entirely reflected in the premium.
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For more on health care reform from the RWC blog, click here and here.