Sean Safford confronts Greg Mankiw:

...a national system would likely impose a burden on many larger employers while improving the lot of smaller ones.  To the extent that one sees America’s competitive advantage as having to do with the relative ease with which this country produces small, entrepreneurial companies that might grow to become tomorrow’s Google or Microsoft, a national health care system should be a net positive.
A second dimension: impact among large companies is not equal either. Older industries and older companies with older workers are currently our least ‘competitive’. Think: legacy airlines.  Because the current system charges employers based on the risk pool of their employees, and also because the longer employees’ tenure, the better their benefits are likely to be, national health care would end up improving the competitiveness of some of our least competitive industries.

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