| The high healthcare costs are systems issues and the reasons they are so high are because of politics which can be fixed at the state and sometimes city level. The high health care costs are externalities created by state and city policy (and sometimes federal policy) that create an additional burden for employers such as Walmart which creates an additional burden for customers and employees. The higher health care costs result in lower wages for employees while resulting in higher prices for customers than in Wal-Marts case, many can ill-afford. For example, most of health care costs are from those with serious chronic disease (the highest category is the 9 million "dual eligibles" -- people with disability that are on both Medicaid and Medicare). These chronic diseases are from smoking, obesity, lack of exercise, air pollution for starters. The fixes are raising the cost of tobacco through taxes, banning smoking in public places, hard hitting anti-smoking TV ads, ....), taxing sugar added beverages as Philadelphia has just done, lowering air pollution by getting the highest polluting coal-powered electric plants shut down, and in the Northeast and Midwest, converting buildings burning #6 and #4 fuel oils to less polluting #2 or natural gas. The more of the healthcare cost externalities that are borne by private firms that are a result of government policy that government must pay for, the better for all of us. Only when the costs to government are high enough, will they implement policies that will reduce the high costs of health care. |