Healthcare Expenses in the U.S.

With all the troubles surrounding health care expenses in the U.S., one aspect that doesn't get specifically discussed all that often is the effect on hiring. A recent article in the New York Times regarding this phenomenon cites government data, industry surveys and interviews with employers.

It seems to me that this ties into the whole outsourcing debate as well. Not only are the employees cheaper abroad, but the healthcare in these other countries is either not as good and/or is provided for by the government, effectively subsidizing the local companies. How do you compete with that?