Healthcare Cost Externalization by private corporate entities

 One of the frequently overlooked dimensions of the United States healthcare system is the externalization of the costs associated with poor quality and high-stress working conditions those working in private corporate entities face daily. 

It has become generally accepted that the lower the wage a job pays in the US, the worse the working conditions. In substance, this includes exposure to carcinogens, routine immersion in toxic environments,  long work hours and draconian policies that places stress on mind, and use of manual labor over automation, placing stress on the body. Individuals working these jobs often are provided meager health benefits, often far less than the long term damage being done to them, and often do not have enough money to live a basic life much less save for the future. This leaves them in a position where they are unable to care for themselves. To whit, the most common cause of bankruptcy in the United states is the occurence of a healthcare emergency. 

Corporations such as Tyson, Walmart, and Amazon are notorious for their poor treatment of workers. Historically, companies such as Ford and Dow chemical were famed for churning entire populations of workers to the point where they relocated entire communities across the country to work in their factories when all the locals were no longer able to work due to the abominable working conditions they were exposed to.  These included routine exposure to dangerous levels of airborne particulate matter such as crystalline silica, working with heavy duty lubricants containing potent carcinogens, routine inhalation of solvents used for paints and coatings, and encourage smoke breaks as a means of stimulating continued performance. This is to name only a few. 

Though these exposures are manageable in and of themselves through the presence of a universal healthcare system focused on prevention, the absence of healthcare for these individuals inevitably causes their care to fall onto their community, family, and healthcare services such as medicare and medicaid. Those individuals on both medicare and medicaid consume ~60% (Michigan Health Network) of state resources despite comprising less 5% of the population. The refusal of the corporations that employed them such that the state and federal government is compelled to take up the burden after the damage is already done is what is called 'cost externalization'. That is to say, the companies know what they are doing to their workers, and have already baked into their business model the assumption (and fact) that they can forgo healthy treatment of their workforce and instead rely on the communities in which they are based to do so. This amounts to the government and communities paying the corporations bills. 

This practice is wide spread but poorly documented for obvious reasons. Corporate lobbies ensure that policies which would require compensation of works equivalent to the wear and tear on their bodies associated with there work never come to fruition. Rather, a continued shifting of corporate responsibility away from the c-suite making these decisions and onto individuals and their community is increasing rather than decreasing. An interesting example of this is the approval of Proposition 22, which enabled several companies such as uber and lyft to not even classify their workforce as employees, which would entitle them to benefits mandated by state and federal governments, and instead classify them as contractors. Contractors are entitled to no benefits, and relive corporate actors of substantially all responsibility for their well being. 

It is noteworthy that as corporate profits have bloomed, the general healthcare status of average American has decreased. This trajectory can be reversed, albeit modern strike-fighting and union-busting techniques have made it incredibly challenging for works to engage in collective bargaining. Some of the last vestiges of such groups are the United Auto Workers union, originally formed in response to the abominable working conditions forced on them by early automotive. No large scale union has formed in the United States since the 1980's due to Reagan era anti-union policies. 

Through causing corporate actors to provide workers compensation commensurate with the health toll associated with their work, funding for existing healthcare issues may be attained and an era of preventative healthcare through a universal system could be achieved.