Healthcare costs pinch employers

"That," he said, helps "explain why so many employers are hyper-focused on health reform this time around compared to 1992-93."

Nichols said his study was prompted by a question from a manufacturer in the Midwest who was shifting his jobs overseas. "My question for you is this," Nichols recalled, "who is going to buy my stuff? If we move jobs overseas, who is going to be able to buy our middle-class stuff."

Foreign manufacturers' healthcare costs are lower because they are the beneficiaries of government-run programs that are not primarily employer-financed, Nichols said. Additionally, he noted, many competitor nations enjoyed greater healthcare efficiency, spending less for better outcomes.

But at least one policy expert said healthcare costs were not U.S. manufacturers' biggest problem in the new global marketplace. "What really drives international competitiveness is whether the U.S. company has a better product to sell at a better price," said Joseph Antos, a healthcare and retirement policy analyst at the American Enterprise Institute.

Pointing to the automotive industry, he added: "If you are not competitive in the business, you are in, then having somebody bail you out in health insurance is not going to help."

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lisa.girion@latimes.com