Race you to the bottom!

The Massachusetts Taxpayers Association reports that health care costs are eating up municipal budgets like beetles through bark. Apparently, it's partly because contracts are negotiated somewhat differently for those unions than those with state employees. Still, it's not good news that cities and towns are in the same position as, say, GM, in paying ever-exploding health care costs.

On one hand, there's a place for groups like the Group Insurance Commission, which as the Globe suggests, acts as an honest broker for reasonable benefits for state employees. It's good that there's something like that for those state workers -- and us taxpayers.

But for companies like GM who are facing similar problems, I don't necessarily share some folks' optimism that they have to choose between 1. skyrocketing health costs, or 2. higher taxes and an increased government role in health coverage. There's a third choice: neither. If business interests completely reject the idea that they have any responsibility for health care at all, either in the form of benefits or tax support, that's bad news for all of us. Sure, we all want low low prices, but we may only get that at the expense of our own health.

Luckily, the labor marketplace doesn't seem to necessarily want to race to the bottom quite so fast: Toyota just opened a plant in Canada, famously choosing it over the states because of our rising health care costs.

Massachusetts seems to be having competitiveness problems of its own: New England just recently dropped to a spot to number three on the list of areas getting the most venture capital. Now, there are reasons to think this was just a blip. But it's foolish to think that job growth and economic expansion are just a matter of having Wal-Mart wages and benefits: we need to think about what kind of jobs we want, and have the government take an active role in attracting them.

For instance, decent public education, investing in a smart and capable workforce: Toyota cited the, er, difficulties in training workers in Alabama as a reason to move to Canada. We do reasonably well at that in Massachusetts compared to the rest of the country. Creating -- and just as importantly, allowing the creation of -- more affordable housing is one thing government could do. What if we were able to bring down the cost of health care in MA, through re-insurance, increased pooling, or using the buying power of the government to bring down the cost of pharmaceuticals?

As Paul Krugman pointed out recently, providing decent, affordable health care could be our competitive advantage, if we decide to take up the challenge.