医療費高騰が企業経営者を追い詰める/米国医療事情

 医療費高騰が企業経営者を追い詰める
 健康保険を提供している米国のメーカーは、労働者1人1時間あたり平均 2.38ドルを負担しており、外国の競合メーカーの2倍近い。医療費コストの上昇が企業の基盤を揺るがすという今やお馴染みの企業経営者の嘆きを支持する結果である。 米国の自動車メーカーは、従業員の健康保険費用負担のために、車1台につき 1,500ドルが価格に上乗せされているため、医療費高騰に伴い多くの企業は医療費負担費用を減らすか、海外移転かの決定に迫られている。
 しかし、多くのエコノミストは、米国企業が高い医療コストで痛手を被るとは考えない。代わりに、医療費上昇を従業員の賃下げか製品値上げで負担してもらおうと考えている。しかし、最低賃金法、組合との契約、および他のファクターにより値上がりする医療費に見合う賃金の削減はできない。しかし、医療費は生産性や賃金上昇よりも速く上昇している。価格に転化しようとしても、中国やインドと競うにはそれができない。
 ガソリン高騰と医療費高騰では追いついていけない。1992-93年と違い、多くの企業経営者が今回医療改革に焦点を合わせている理由がここにある。
 外国のメーカーは、政府が管理する医療保険制度により医療コストがより低い。さらに、競合する各国は医療の効率がよく安くて良い結果を得ている
 しかし、医療費は最も大きな問題ではなく、国際的な競争力をもつには、より良い製品を持っているかどうかにかかっているとする専門家もいる。
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GM労組ストライキ突入/米国医療事情
http://kurie.at.webry.info/200709/article_61.html
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Healthcare costs pinch employers
http://www.latimes.com/features/health/la-fi-healthcost7-2008may07,0,2233033.story
Study suggests that manufacturers have limited resources to offset rising fees.
By Lisa Girion, Los Angeles Times Staff Writer
10:45 PM PDT, May 6, 2008

画像Jeff Kowalsky / Bloomberg News
U.S. automakers say health coverage for employees adds $1,500 to the cost of each car. Left, Detroit workers on the assembly line of the 2008 Dodge Viper.

U.S. manufacturers who provide health insurance spend an average of $2.38 per worker per hour on healthcare -- more than twice as much as their foreign competitors, an analysis released Tuesday found.

The study provides support for the now-familiar lament of employers -- that rising healthcare costs are eating into the corporate bottom line.

American automakers say employee health coverage adds $1,500 to the price of each car, and many U.S. manufacturers have blamed rising healthcare costs for decisions to drop health benefits for workers or shift jobs overseas.

But many economists have pooh-poohed the idea that U.S. businesses are hurt by their comparatively high healthcare costs. Instead, they have suggested that companies would pass those costs onto workers by lowering wages or onto consumers by raising prices.

But the new analysis suggests that neither lower wages nor higher prices are an option for most companies. Employers can't slash wages fast enough to keep up with rising healthcare costs because of minimum wage laws, union contracts and other factors, said economist Len Nichols, the analysis' author and a policy director for the New America Foundation.

"There's no question that if employers could push this into wages they would," Nichols said. "But every single year, healthcare costs rise faster than productivity and wages," he said. "Thus, they try to push it into prices. But with China and India competing against you, you can't do that."

George Rudes, chief executive of Not Your Daughter's Jeans, a Vernon-based manufacturer, said competition for workers prevented U.S. employers from reducing wages. He said the company paid starting wages for its 100 factory workers of 10% above minimum wage and that was not enough for them to afford healthcare coverage.

"How can you pay them less?" Rudes said.

The company wanted to extend health benefits for its factory workers two months ago, he said. But it was unable to find a plan that was affordable enough. They rejected a plan that, with the company picking up 50% of the expense, would have cost workers $80 a month each.

"We were trying to put it in and we were unable to do it," Rudes said. "They just can't afford it. How can anybody afford $4-a-gallon gasoline and insurance?"

Nichols found that healthcare costs were outpacing wages and productivity. With stiff global pricing competition, that means healthcare costs have to come out of the bottom line, he said.

"That," he said, helps "explain why so many employers are hyper-focused on health reform this time around compared to 1992-93."

Nichols said his study was prompted by a question from a manufacturer in the Midwest who was shifting his jobs overseas. "My question for you is this," Nichols recalled, "who is going to buy my stuff? If we move jobs overseas, who is going to be able to buy our middle-class stuff."

Foreign manufacturers' healthcare costs are lower because they are the beneficiaries of government-run programs that are not primarily employer-financed, Nichols said. Additionally, he noted, many competitor nations enjoyed greater healthcare efficiency, spending less for better outcomes.

But at least one policy expert said healthcare costs were not U.S. manufacturers' biggest problem in the new global marketplace. "What really drives international competitiveness is whether the U.S. company has a better product to sell at a better price," said Joseph Antos, a healthcare and retirement policy analyst at the American Enterprise Institute.

Pointing to the automotive industry, he added: "If you are not competitive in the business, you are in, then having somebody bail you out in health insurance is not going to help."

lisa.girion@latimes.com

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