Just back from the UK where government austerity programs akin to what the Republicans want to do here are not exactly bearing fruit what with a negative GDP registering last quarter. Pay to play operates there as well as the Prime Minister’s right hand man gets caught on camera offering suppers at 10 Downing Street in return for big campaign contributions. The Chancellor of the Exchequer carves out tax breaks for a big food chain with government access at the expense of Mom and Pops, and the PM gets caught up in damage control talking about the last meet pie he bought in a local shopping district bangers and mash store that hasn’t had a “pasty” place in more than five years.

Sound familiar? Most college educated young people struggle to find work, and in real estate—the big gateway city London does better than anywhere else. The London-based financial institutions warn about regulations and reserve requirements that can make them uncompetitive against New York, just like the Wall Street bankers warn against regulations and reserve requirements that could make New York uncompetitive versus London. It conveniently works to ensure that regulations and reserve requirements get watered down in both markets.

Everywhere you go people know how to take pictures with an I-phone—just click the camera icon—“I know, I know.” Meanwhile, the post office raises first class rates by nearly 40% to try and offset recent losses--all the more reason to pay more bills over the internet. And the calendar reads early spring, but the temperatures headed into the 70s, balmy for July without a drop of rain for the eight days I toured around. This is not the merry old England I used to know—all the waterproof hiking gear stayed at the bottom of my duffle.

So you come back to news that the Supreme Court might very well overturn the health care law and wonder what would happen if we revert to the totally busted “you’re-on-your-own system” where big business—drug companies, health insurers, hospitals, doctors, and lawyers all go back into a free-for-all at trying to boost their profits at the individual’s expense. I guess not having to pay a penalty for not buying health insurance is a “liberty” more valuable than either “health” or “happiness” when you cannot get coverage for a pre-existing condition or pay considerably more each year in deductibles and premiums.

I don’t understand why the average American company doesn’t want to go to a single payer government system and take the healthcare coverage line-item entirely out of their budgets or is it the tax deduction they don’t want to give up? They compete against companies in other parts of the world that don’t have to provide or administer medical benefits programs to their workers. And their workers may pay higher taxes for socialized health care, but the overall health care costs in the system are two-thirds to less than half of here in the U.S. with typically better life expectancies. It’s just another reason why American companies are less competitive…

And so no wonder why multinationals have another reason to shunt their work forces overseas to lower cost places. And why our office markets are so lackluster and will continue to suffer.

Technology is a big reason, but labor costs are even bigger and healthcare is a big part of that equation.

And yes the Brits were one of the first to adopt a national health plan. And it’s far from perfect. But at least everyone has a basic standard of care, and if you want to pay more and can for private care you can go right ahead. The pay-to-play politicos with their austerity budget aren’t about to abrogate their socialized medicine program anytime soon.

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Jonathan D. Miller

A marketing communication strategist who turned to real estate analysis, Jonathan D. Miller is a foremost interpreter of 21st citistate futures – cities and suburbs alike – seen through the lens of lifestyles and market realities. For more than 20 years (1992-2013), Miller authored Emerging Trends in Real Estate, the leading commercial real estate industry outlook report, published annually by PricewaterhouseCoopers and the Urban Land Institute (ULI). He has lectures frequently on trends in real estate, including the future of America's major 24-hour urban centers and sprawling suburbs. He also has been author of ULI’s annual forecasts on infrastructure and its What’s Next? series of forecasts. On a weekly basis, he writes the Trendczar blog for GlobeStreet.com, the real estate news website. Outside his published forecasting work, Miller is a prominent communications/institutional investor-marketing strategist and partner in Miller Ryan LLC, helping corporate clients develop and execute branding and communications programs. He led the re-branding of GMAC Commercial Mortgage to Capmark Financial Group Inc. and he was part of the management team that helped build Equitable Real Estate Investment Management, Inc. (subsequently Lend Lease Real Estate Investments, Inc.) into the leading real estate advisor to pension funds and other real institutional investors. He joined the Equitable Life Assurance Society of the U.S. in 1981, moving to Equitable Real Estate in 1984 as head of Corporate/Marketing Communications. In the 1980's he managed relations for several of the country's most prominent real estate developments including New York's Trump Tower and the Equitable Center. Earlier in his career, Miller was a reporter for Gannett Newspapers. He is a member of the Citistates Group and a board member of NYC Outward Bound Schools and the Center for Employment Opportunities.