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<text id=93TT2180>
<title>
Sep. 06, 1993: Prognosis:Fewer Jobs
</title>
<history>
TIME--The Weekly Newsmagazine--1993
Sep. 06, 1993 Boom Time In The Rockies
</history>
<article>
<source>Time Magazine</source>
<hdr>
HEALTH CARE, Page 32
Prognosis: Fewer Jobs
</hdr>
<body>
<p>Clinton may not know it yet, but his advisers predict job losses
from health-care reform
</p>
<p>By DICK THOMPSON/WASHINGTON--With reporting by Dan Goodgame/Washington
</p>
<p> While Bill Clinton relaxed on Martha's Vineyard last week,
staff members were sweating and fretting back in Washington,
studying computer models for answers to one of the most explosive
questions facing his health-care-reform proposal. That question--the subject of a showdown meeting scheduled with the President
this week--is, How many jobs will be lost during the long
transition to reform?
</p>
<p> Clinton has publicly stated that health-care reform will "boost
job creation," a claim that unnerves many of his advisers. What
they know--and what some of them fear Clinton has not been
told--is that the Administration's own preliminary computer-aided
studies of the "employment effects" of health reform predict
"significant" job losses.
</p>
<p> TIME has learned that according to one computer run, the plan
would slow net employment growth by as many as 1 million jobs
over the next five years. Other Administration forecasts--based on computer simulations of the U.S. economy at various
government departments and the Urban Institute, a Washington
think tank on contract to the White House--have produced lower
estimates of job losses, sources said. But they do not support
Clinton's claims of job gains.
</p>
<p> Sources caution that these forecasts resulted from a draft of
the health-reform plan that is still being refined, and was
tested on an econometric model that included "faulty assumptions"
about the ways in which employers, workers and health-care providers
are likely to respond to health-care reform. Still, these estimates--and others by independent economists who predict job losses
in the 200,000-to-600,000 range--galvanized Clinton's health-reform
advisers last week into a crash program to refine both their
computer models and the health-care plan in order to minimize
their forecast of unemployment. Says a worried official: "The
jobs issue is probably the most sensitive one we face in health-care
reform."
</p>
<p> Privately, several of the President's advisers contend that
the current runaway spending on public and private health care
is a growing burden on the economy, which, like a surgical patient
who must feel worse before he can get better, might need to
endure modestly higher unemployment for several years as the
price of reform. Trouble is, Clinton has not prepared the public
for any sacrifice. He and his top health-care strategist, Ira
Magaziner, have been selling health-care reform as a four-course
free lunch. Everyone will be covered. It won't require new taxes.
It will immediately boost job creation. And it will immediately
reduce the federal deficit. "Several of us," says a political
adviser to Clinton, "are worried that we're creating expectations
for health care that can't be met.''
</p>
<p> No business will be required to pay more than 7.6% of its total
payroll for health insurance. For big companies, such as automakers,
which now pay about 19%, the potential savings would provide
an incentive to hire new workers. But for small firms that now
provide no health insurance, the requirement will add to the
cost of labor. Some of these firms will cover the cost by cutting
profits, raising prices, withholding raises or extending overtime
hours. But many firms will not have these options. Most vulnerable
are enterprises like restaurants and farms, which employ many
of the nation's 4.8 million minimum-wage workers and often operate
with slim profit margins. For them, cutting jobs may be the
only option. The National Federation of Independent Business
has estimated that 1.6 million jobs will be lost over five years.
A new study, financed by restaurant owners, forecasts losses
of 3.1 million.
</p>
<p> The White House rejects these figures as flawed because they
don't sufficiently account for jobs created in firms that save
money through lower insurance costs and because they are based
on false assumptions about the tightly guarded reform plan.
The next computer runs, to be conducted on the Urban Institute's
microsimulator (called TRIM, for Transfer Income Simulator),
will include various "transition subsidies" designed to minimize
job losses for small businesses and low-income employees. His
advisers plan to present Clinton with four options this week
for easing the transition, but one official said they were having
trouble designing subsidies that were not "a nightmare to administer."
</p>
<p> Hillary Clinton, who heads the health-care-reform effort, is
committed to a rapid phase-in, by January 1996, for universal
coverage and a generous basic-benefits package--though few
others believe this schedule is realistic. She has waved off
warnings of job losses as the propaganda of greedy business
interests. Her strong views and assiduous hunting of suspected
leakers have exerted what one official describes as a "chilling
effect" in sessions she attends. Nevertheless, at a recent meeting,
her colleagues report that Laura Tyson, chair of the President's
Council of Economic Advisers, cautioned that once the plan is
released, respected outside economists will run it through standard
econometric models, which will probably show job losses, "and
some of those numbers might be big."
</p>
<p> Clinton health-care planners have tried to address the concerns
raised by small business, which enjoys great influence in Congress.
They emphasize that under the proposal, the smallest businesses
will pay as little as 3.5% of their payroll for insurance, rather
than the 7.6% top rate, with taxpayers subsidizing the rest.
And the smallest businesses will be allowed a slower phase-in
of the new expense. Insists Magaziner: "We think we can do this
without having a negative employment effect." Magaziner, backed
by Hillary Clinton, has so far insulated the President from
internal assessments that might challenge his rosy scenario.
But that, officials say, will change in the meeting scheduled
this week.
</p>
<p> Many small-business owners who want to provide health coverage
for their workers will back reform because the current situation
inflicts large and growing burdens on them. Audrey Rinker, owner
of a graphics shop in New Port Richey, Florida, has been denied
coverage by three insurance companies because her workers have
pre-existing illnesses. Says Rinker: "We need something done
right now." Even when they can get insurance, small companies
pay some of the highest rates. Barbara Silver Miller, co-owner
of a vending-machine firm in Phoenix, Arizona, has seen premiums
for her employees rise 20% to 30% a year.
</p>
<p> To reform this festering mess, some Clinton officials argue
privately, the transitional loss of a few hundred thousand jobs
is not a high price to pay. Certainly not in an economy that
employs 120 million workers and creates 2 million jobs a year.
Yet for the individuals involved, a single job lost on a Nebraska
farm isn't really "a net wash" when a new job--requiring relocation
and training--is created in a Detroit auto plant.
</p>
</body>
</article>
</text>