US bill to keep SMEs healthy

Peter Delmar: The US health secretary predicted the other day that her government's healthcare bill would be supported by the public once it understood it.

Now, if the average American doesn't understand what the great brouhaha is about, what chance do common or garden foreigners like us have of figuring it out?

All I know about the issue is that the Democrats want poorer Americans (30 million or so of them) to be able to have open-heart surgery when they need it and not be sent home to die because they can't afford insurance. The Republicans are up in arms because, they say, the country can't afford the Obama administration's law and because the federal government shouldn't be poking its nose into such matters anyway.

Most of us non-Americans still think President Barack Obama is Christmas, but a lot of Americans, particularly on the conservative side of the spectrum, are now more convinced than ever that he's a wacko Communist Beelzebub.

At the heart of the whole healthcare reform process - and all of the confusion - is small business.

One of the things I particularly like about that black man in the White House is the fact that he is very good at finding the time to engage with small business, something our political betters never seem to have the time for. After his bill passed into law, Obama popped into an Iowa bookstore called Prairie Lights to buy books for his daughters and the son of his press secretary. He paid $37.44, in cash, from his own wallet.

Obama has a reason for liking Iowa (a state which is somewhere between California and Florida and about which the research team who work on this column have been unable to find any salient and pertinent points of interest). It was where his election campaign first acquired traction and it was where he stuck his neck on the chopping block by promising the healthcare overhaul which had eluded US administrations for a century.

Among the provisions of the legislation which has just squeaked through Congress is the stipulation that (unless Republican state attorneys who are all to the right of Genghis Khan get their way) states must set up organisations that will enable smaller businesses to buy health insurance as a collective.

On the face of it, you could argue - as many Republicans have been doing so very vociferously - that this is anti-capitalist. But then you could also argue that healing sick people and keeping healthy people healthy is the last thing that should be earning investors and executives mega dividends and bonuses.

Of course, the president doesn't have to go walking the streets of Iowa City to buy books (he has an Amazon account, I'm sure). It was a photo opportunity that had more to do with winning votes than the acquisition of literary learning. But good for him!

Obama had mentioned Prairie Lights in a pro-healthcare reform speech, saying how this typical small business would benefit from his programme. The independent bookshop, he said, had offered its full-time staff healthcare cover for the past 20 years, but last year, the cost of this cover shot up 35%. Reform, the president was telling the electorate, would help small businesses like the Iowa bookshop keep its staff healthy and, in so doing, its business strong.

They're not like us, the rich. Americans should count themselves lucky that they can even have this debate, as partisan and divisive as it may be, about government intervention in the provision of healthcare. Our state spends billions of rands on state hospitals and primary healthcare facilities and is now asking retired doctors, nurses and pharmacists to volunteer for a big voluntary HIV-testing project. In spite of the sterling efforts of thousands of dedicated healthcare professionals, our public healthcare system is not one you would want to expose yourself, your family or your valued employees to.

I'm sorry, but I'm with the Democrats on this one. Any entrepreneur wanting to look after the health of his two or three workers has as much clout with the medical aids as he does in his own private capacity. It's another instance of how the odds are stacked against SMEs and another reason, as the firebrands at Cosatu keep reminding us, why business increasingly wants to "casualise" its labour requirements.

It's one thing to provide employment; it's another, much more expensive thing, to provide quality employment, including such things as decent healthcare.