Employer-Linked Health Insurance--Time to Go?
It seems we’re into a new type of thematic blogging here at the Agent Blog. Last week’s posts dealt primarily with e-mail and this week’s with health care. This post will explore the concept of employer-linked health insurance.
Whenever I get to thinking about it, the less sense it makes. Why should people get health insurance through the workplace? They don’t get their car or homeowner’s insurance from their employer, and as far as I know, there is no one lobbying for this to change. It would be weird to get a new auto insurance policy every time you switched jobs. Yet there are passionate advocates out there for keeping the link between your health care and your paycheck. Why?
One argument is based on the high cost of care and the fact that group insurance is a better deal than individual insurance. Ok, I get that part. And there’s also the claim that companies, with their numbers and bargaining power, empower health care consumers and help them navigate the messy system. Makes sense.
But there are as many good arguments for breaking up the relationship. Young workers today are expected to have some ridiculous number of careers by the time they turn 40. It’s conceivable, then, that a lucky young worker today will enroll in separate health care policies for each of his successive jobs. Now consider that insurers’ administration costs play a large part in escalating health care costs. That administrative burden is exacerbated by an increasingly mobile workforce.
Many businesses, particularly the very small and the very large, have the most to gain from being released from their insurance obligations. Without having to pay health care costs for aging workers, they would have more cash on hand to compete with overseas companies, which have never had to provide coverage for their workers.
Proponents of keeping the link say that health insurance is an important way for companies to attract and retain their workforce. (In fact, that’s how it all started—in WWII, companies faced a labor shortage, and since there were wage controls in place, they started offering health insurance to lure workers.) This creates a winner-take-all situation in which small business get the shaft. They cannot afford to pay for insurance, and loose a lot of good workers as a result. And the large companies that could once afford to lure workers with health benefits now find themselves bogged down with aging workers who are draining the company funds. It’s a pyrrhic victory.
Additionally, employer-linked health insurance is a drag on upward mobility and personal growth. Consider the would-be Beethovens or Einsteins who are afraid to leave their jobs pushing paper clips or changing ink toner because they are scared to go without insurance.
By taking employers out of the equation, consumers would be forced to be better stewards of their health and more conservative in their health care spending. When your company is footing the bill, there is no such thing as care that is too expensive or perhaps unnecessary. The result? A country that spends way more on health care than most of the developed world.
Sever the connection, and you can also get rid of the employer tax deduction, which costs $200 billion a year. Why not give those billions directly to people and tell them to go buy insurance? Why give it to a middle man, the employer?
Ready, set, tear apart my argument.








Comments
Great blog and arguments.
What about the argument posed in megan's blog/video? That people are irresponsible, and expect someone else to pay their health expenses, and consequently we all end up paying more. Employer-provided insurance sort of forces or encourages strongly employees to have health insurance.
I also am known to space out payments etc... and just like I never want to run out of oil in my car, I don't want to be caught sick when I've forgotten to pay my insurance (just like I don't want to get caught dead, and not have paid my life insurance). On the other hand.... It seems the same argument would hold true for auto insurance...But it's against the law not to have auto insurance...
Posted by: lori | September 21, 2007 03:49 PM
"What about the argument posed in megan's blog/video? That people are irresponsible, and expect someone else to pay their health expenses, and consequently we all end up paying more."
In some ways, he's right. People are quite irresponsible when it comes to their health and their health care spending. They don't eat well or exercise, and that's how you get a situation where people get more health care than anywhere else but don't have healthier bodies to show for it. That's also why any overhaul of the system ought to emphasize routine, preventive care.
Although he'd probably hate to admit it, Browning's anti-Sicko amounts to a great argument for an individual mandate. If people who can afford to pay are in fact mooching off the system, as he suggests, they should be forced to buy insurance to prevent penalizing everyone else with higher costs.
Browning's argument is tough follow. On the one hand, he says the media hypes the health care crisis in order to generate support for socialized medicine. It seems, then, that Browning thinks our current system is pretty good. On the other hand, he speaks of an epidemic of unfair gaming of the system. He says people have no incentive to pay for insurance because they can always get free care. He points his finger at the wealthy uninsured, young adults who'd rather get take-out every night than pay for a policy, and immigrants--all of whom, he says, get care and don't worry about paying for it. If he's right, then isn't that in itself a crisis? Browning seems more of a clever sophist (much like Michael Moore) than a coherent thinker when it comes to this issue.
As for the employer-health insurance link, I think that when your employer pays for most or all of your premium, you have no incentive to be conservative in your spending. While you may opt for more routine care, which is good thing, you may also opt for less essential care—because, hey, why not?
Posted by: Jeb | September 25, 2007 07:57 AM