If you want to read more about this, I really like Matt Stoller's blog. The problem started with Michael Isner who took over Disney in the late 80's. He asked that his compensation be in stock options because he was promising that as the company was more profitable, the more money he would make in dividends. This eventually gave rise to some very questionable business practices and funny accounting because CEOs got their "bonus" pay every three months in the form of quarterly dividends. Once they realized that leveraging the accounting to create positive dividends each quarter means a lot more money for them, businesses got into the business of making a company look profitable by any means necessary, that included laying off work force and closing down branches that weren't as profitable as they could be. This business model works fine as long as the company is profitable but the minute they start losing money, they look to "trim the fat" and become "six sigma lean" because their dividends are at stake here. This started the trend that persists today. CEOs make business decisions not based on the long term profitability of their company, but instead for short term gains only realized by stock holders. Thus if worker healthcare becomes an impact to the profits, they reduce them and push the cost to either the consumer or the worker.