At over $55,000 per year, the state of Maryland enjoys one of the very highest household median incomes in the country. It is reasonably well insulated from business cycles by its geographical proximity to that well spring of spending: the federal government. Yet despite this, Maryland is running a budget deficit. Its government is so poorly run that Nathan Chapman Jr. a money manager was found guilty of defrauding the state retirement system last year. With this background of achievement, it is no wonder that the legislators of the state feel competent to tell Wal-Mart how to run its business.
This week the Maryland state legislature passed a bill directed against Wal-Mart. The bill specifically states that any private company in Maryland employing more than 10,000 people must spend at least 8% of its payroll on health care. Although there are a couple of companies as large, Wal-Mart is the only one for which the bill has any relevance.
Wal-Mart provides benefits for most its full-time employees. Wal-Mart’s strategy is to hire relatively few full-time employees with full-benefits supplemented by part-time employees including those elderly greeters at the front door who are, in many cases, covered by Medicare. This formula of efficiency and low prices has worked for Wal-Mart which has seen spectacular growth.
Many states will make foolish specific concessions to companies like Wal-Mart to entice them to enter. Maryland must be pretty well off if it not only eschews these advantages, but latches on to the anti-corporate Left-wing zeitgeist and directly penalizes Wal-Mart.
One might have been sympathetic if Wal-Mart were intruding into a small area and driving out Mom and Pop operations, while assuming monopoly control with their relentless efficiency. In the case of Maryland, however, the largest anti-Wal-Mart whiner is Giant Food Corporation that had grown fat in a grocery market oligarchy it dominated until Wal-Mart moved in. So the Maryland legislators get to have it both ways: They hobble the competitor of a politically-powerful Dutch-owned company, Ahod, the parent company of Giant, while at the same time congratulating themselves for championing the working class.
One indication of how little thought went into the legislation is the fact that it is rather poorly crafted. Should the measure of health care be the cost? Though health care has certainly improved over the last decade, costs grew faster. What if Wal-Mart was able to provide a medical plan superior in coverage to a more expensive plan at the cost of 6% rather than 8% of payroll? Maryland’s legislature again revealed the Liberal tendency to measure effectiveness as money spent rather than product or service out.
Wal-Mart’s present status with respect to provision of health care is complicated. The Maryland’s Citizen’s Health Initiative claims Wal-Mart spends 3.5% of its payroll on health care. While Wal-Mart claims that 56% of its workers are covered through its medical plan, while 86% are covered through medical plans of some sort: medical coverage through a spouse or some other alternative.
Wal-Mart with its 15,000 employees in Maryland now has several non-exclusive choices in complying with the Maryland law. They could just pass on additional costs to consumers, hurting customers that tend to be working class people for whom price is critical. Wal-Mart could partially balance increased health care costs by laying-off workers to meet the legislatively mandated 8% number. Or, they could meet the 8% legislative mandate by increasing the generosity of health care benefits for higher-paid full-time workers and still ignore part-time workers.
Most likely they will employ some combination of the above. The immediate loser may be the less-affluent Somerset County, Maryland. Wal-Mart had planned on building a distribution center in the county that would employ 1,000 people. Wal-Mart is now reconsidering these plans. Fortunately, for the Maryland legislature, those potential employees probably do not realize that they lost prospective employment. Maryland legislators can still sip wine at the cocktail parties while they congratulate themselves on their moral sensitivity in using someone else’s money to stand up for the working class. They should be so proud of themselves.
New Questions on Long-Term Care
Sunday, March 27th, 2005Conservatives and Liberals tend to have different ideas about the sphere within which individuals ought to be allowed free rein for their discretion. Liberals believe that young teenage girls have the moral insight and experience as well as the right to decide to undergo abortions without parental notification. At the same time, they hold that adults are incapable of managing a portion of their social security payments in private retirement accounts. The decisions of teenage girls on an issue of intense moral significance are sacrosanct, while adults require government supervision to manage their retirement.
On the other hand, Conservatives are eager to extend freedom by lowering tax rates and allowing taxpayers to keep more of their own money. The Conservative intuition holds that control of personal resources broadens the scope of personal discretion and thus freedom. But, woe to anyone who wishes to spend their money on recreational drugs.
Even the Libertarian position has its problems. Liberations claim to want to maximize freedom of choice and believe drug use ought to be a matter of personal choice. However, if abused, recreational drug use certainly curtails the freedom of the user. It is an open question as to which policy concerning drug use effectively maximizes freedom
The Terry Schiavo case also raises interesting and important questions about the extent and limits of personal sovereignty. There appear to be two questions that are at issue here. The issues are separate but abrade against one another. The first question is: What level of treatment would Ms. Schiavo have wanted? In the absence, of clear documentation of her preferences, who should decide on her behalf? At this point, her husband and her parents are at odds as to Ms. Schiavo’s wishes and the law gives the spouse presumptive guardians status. The second issue is the determination of the mental status of Ms. Schiavo. Is she in “permanent vegetative state” with no consciousness and no realistic prospects of consciousness returning? Is she is a semi-conscious state with some awareness of her surroundings and some ability to interact?
Let us lay aside for a moment the particulars of this case and ask more general questions about the limits of personal sovereignty and autonomy? Do we wish to grant people personal sovereignty in all cases? When we are not considering palliative care in the terminal stage of life, but long term care, do we expect others to grant all our wishes with respect to care? Christopher Reeve, the actor made famous in the Superman movies who was paralyzed in an accident, required medical care to stay alive, but lived many years before his final illness. He could not feed himself or take care of other needs, but was perfectly conscious and aware. If he asked that his medical care be stopped because he did not want to accept the quality of life afforded a quadriplegic, would we be obliged to honor and assist in this request? Ought we refuse and thereby limit his personal discretion? Can the state step in and prevent assisted suicide by someone who decided that he does not like the quality of his life? Is a person’s life and existence entirely his own, or do we all have an important interest in everyone else’s life?
If a person is in a persistent vegetative state, if he has no conscious, should that person be considered dead? While we would all concede the necessity to exercise extreme caution in coming to this diagnosis and the necessity to resolve any doubt by presumptively asserting that there is latent consciousness, it is possible to conceive of situation where all are morally certain that there is no “there” there. In such a case, is there any obligation to maintain life even if that person had earlier requested such extraordinary treatment? Are we obliged to honor the wishes of someone who would have directed us to maintain their bodily functions, even after brain death?
Much has been made as to what Terry Schiavo would have wanted. However, few are asking broader questions that have escaped noticed as people have argued about the facts of this case. Do individuals have the right to refuse long-term care because of quality of life issues? Do individuals have the right to ask that life sustaining care be continued after a careful diagnosis of brain death? With ever more capable and expensive medical care and with the Baby Boom generation entering the last third of third lives, these questions are sure to be asked more and more frequently.
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