"Microsoft would be glad to hire locally if they could find people with the skills required."

Not true. Corps like Microsoft used to train people locally. Now they open mass campuses in foreign countries like India where labor is cheap and train there then whine about lack of talent here. Who in their right mind would get a comp sci degree these days when you can see the hand writing on the wall....those jobs aren't coming back until the pay is so crappy it ain't worth it.

BTW, I would never consider health care a reward. It should be a basic right which is good for society as a whole in the long run. Healthy kids mean healthy adults. Better workers and less of a drain on society. If every child and adult were allowed an annual physical think of the long term benefits. "You blood sugar is getting low so we need to regulate that". Right there could mean that twenty years down the road we don't have someone suffering from severe diabetes, can't function and drawing welfare or disability. In this example a $100, or whatever, physical saved $100K or more.
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"You learn more from losing than you do from winning." Lou Pinella