Burdened by healthcare costs, US businesses seek a shift

The company has come under fire for what critics say are skimpy health benefits. Wal-Mart, for its part, says that 9 in 10 of its blue-garbed "associates" have coverage, either through the company or another source.

In last week's push for universal coverage, Wal-Mart was joined by other major companies: Intel, AT&T, and Kelly Services.

"We feel a huge sense of urgency," says Maria Ghazal, public-policy director for a healthcare task force at the Business Roundtable, a group of large employers based in Washington.

The Roundtable itself, last month, joined with the Service Employees International Union (SEIU) to push for action on healthcare.

"Mostly it's a sense that the way the system is now, if you can call it a system, is not sustainable," Ms. Ghazal says.

She says the desire for discussion is very different from the atmosphere in 1993, when President Clinton's push for healthcare reforms foundered amid dissent, including from business.

"That's one of the fundamental differences between 2007 and 1993," says Sara Howard, a health policy expert at the SEIU. "What is remarkable about what's happened in the last few weeks is that, for the first time, major corporations are stepping up and saying that the time for change is now."

But all the calls for change don't create any clear mandate on policy.

"Right now the momentum is there. I just don't know where we can find common agreement," says Katie Strong, director of congressional and public affairs at the US Chamber of Commerce, a business group in Washington.

For one thing, the business world push doesn't settle a basic conservative-liberal divide over whether the key fix is a stronger role for government, or the introduction of more free-market competition in an industry where government has become the major purchaser.

"The status quo guarantees government dominance of the system," says Robert Moffitt, an expert at the conservative Heritage Foundation.

That's because government programs such as Medicare and Medicaid continue to grow, and some proposals envision government insuring workers who don't get coverage through their employer.

Many employers support at least the concept behind President Bush's recent proposal to let individuals have the same tax deduction for healthcare that business enjoys. Such a move might inspire greater competition in the health-insurance marketplace, something businesses generally support.

Employers also hope to see cost-control achieved through policies that improve the use of information technology in healthcare.

Many others are open to discussing requirements that they provide health insurance for workers, or pay into a government fund to provide such coverage. Such a system, often dubbed "play or pay," is under consideration in California.

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