Freedom Line Blog

A revealing commentary this week in The Wall Street Journal on reduced competition and insurance industry consolidation under ObamaCare coincides in an interesting manner with a new Gallup poll showing very low public confidence in big business.

In “How the Affordable Care Act Is Reducing Competition,” physician and American Enterprise Institute (AEI) resident fellow Scott Gottlieb lays out how ObamaCare by design requires industry consolidation to accommodate its massive regulatory burdens and higher operating costs:

To sustain themselves, insurers must spread fixed costs over a larger base of members.  The bigger they are, the easier it is to meet the government-imposed cap on their operating costs while cutting their way to profitability.  This pressure discourages new health plans from launching.  Startups often must channel more money into initial operating expenses.  But the caps largely prevent this, so the market stagnates…  ObamaCare’s architects saw these trends coming – and welcomed them.  They mistakenly believed that consolidation would be good for patients, on the theory that larger companies would have more capital to invest in innovations that are thought to improve coordination of medical care, such as electronic health records, integrated teams of medical providers and telemedicine.

This was a profound miscalculation.  The truth is that the greatest innovations in healthcare delivery haven’t come from federally contrived oligopolies or enormous hospital chains.  Novel concepts – whether practice-management companies, home healthcare or the first for-profit HMO – almost always have come from entrepreneurial firms, often backed by venture capital.  That venture capital has been drying up since ObamaCare was passed.”

Meanwhile, a new Gallup survey reveals that is precisely the sort of big-business favoritism that Americans distrust:

Americans are more than three times as likely to express confidence in small business as they are in big business.  Sixty-seven percent of U.S. adults report having a ‘great deal’ or ‘quite a lot’ of confidence in small business, far eclipsing the 21% who are similarly confident in big business.  Confidence in small business is up slightly from last year’s 62%, while confidence in big business is unchanged.”

This helps explain why, despite Barack Obama’s ongoing protestations and false assurances, the healthcare law bearing his name remains widely unpopular with Americans it affects.  Each week brings a fresh wave of bad news about ObamaCare, such as this week’s news of skyrocketing costs unanticipated only by those who supported the law.  Its unpopularity, along with the unpopularity of big government and big business more generally, provide optimism that Americans remain open to conservative and libertarian efforts toward replacement and reform.

An interesting critique is starting to surface: Big Government and Big Business are conspiring to enrich themselves at the expense of job and wealth creation for the middle and lower classes.  Demographer Joel Kotkin is noticing it.  So too, is potential GOP presidential candidate Sarah Palin.

As Kotkin notes, grassroots Democrats are noticing that President Barack Obama’s neglect of job creation is costing their members dearly.  (Just ask California Democrat Maxine Waters.)  Republican presidential frontrunner Rick Perry is weakest on the issue of crony capitalism.  Palin’s critique of the Big Business-Big Government axis could expand a core Tea Party theme into a viable national campaign.

Of course, this argument may fizzle, but it’s interesting to see quite different commentators coming out with the same idea.

California Democratic Governor Jerry Brown appointed Michael Rossi, former Bank of America executive and GMAC subprime mortgage guru, to be his unpaid “jobs czar.” Brown hopes that Rossi will be able to tell Brown how to revive the state’s sagging economy.

It’s telling that Brown chose a career Big Business executive instead of a successful entrepreneur.  The two types of people – and their skill sets – couldn’t be more different.

Rossi’s path to success involved managing large corporate structures that focus heavily on exploiting government-created revenue streams, such as subprime mortgages that but for government-owned Fannie Mae and Freddie Mac’s guarantee would never have been made.  It also doesn’t help that today BofA is announcing its second straight year of layoffs (3,500 employees this year alone).

It would be far better for Brown to enlist the help of an entrepreneur with success starting and growing businesses.  As the Kauffman Foundation showed in a study released last summer, “new firms add an average of 3 million jobs in their first year, while older companies lose 1 million jobs annually.”

Here’s the Kauffman Foundation’s explanation:

Most notably, during recessionary years, job creation at startups remains stable, while net job losses at existing firms are highly sensitive to the business cycle.

“These findings imply that America should be thinking differently about the standard employment policy paradigm,” said Robert E. Litan, vice president of Research and Policy at the Kauffman Foundation. “Policymakers tend to focus on changes in the national or state unemployment rate, or on layoffs by existing companies. But the data from this report suggest that growth would be best boosted by supporting startup firms.”

If Governor Brown wants to create jobs he should consult the people creating jobs – not those managing a declining workforce.