According a form from my employer, my family health insurance coverage costs over $14,000 per year and I pay about half of that. In addition, I pay co-payments, deductibles and out-of-pocket for a doctor who isn't in-network. My insurance doesn't cover dental or optical. In short, my share of my family's healthcare expenses is right up there with food on the top of our monthly expense list (our house is paid for). Nevertheless, because of the laws it is better for my firm to "give" (my firm doesn't give me anything, I earn it) me health insurance than it is to pay me the cost of that insurance. Because of that large contribution, I can't get near the coverage for near the price anywhere else. Because of the laws, the managing partners of my firm get to decide how I am going to spend a large sum of money every month. They pick the company, the deductibles, the network of doctors, the coverage and the premium. Why?
Because my firm chooses not to pay me as much as they pay my boss, my housing choices are limited, and there are a lot of places he could afford to live that I can't. Still, within the parameters of what I can afford, I get to pick whether I buy a smaller house in better neighborhood or a bigger house in a lesser neighborhood. I get to decide whether I want all the house I can afford, or whether I'd rather spend less on housing and more on something else. It's my money and my choice. I don't have to live in the neighborhood selected by the managing partners.
If we removed health insurance from the workplace, if it became something that people had to buy just like we have to buy food, housing, transportation or clothing, then the market would adjust and provide products that meet the needs of the consumers. My guess is that we would see a lot more high-deductible plans that didn't cover routine expenses like birth control simply because it is dumb to run routine expenses through an insurance company. You'd have a lot less lobbying of Congress to make insurance companies cover this or that because if they do cover it, whatever "it" is, then the price has to increase to cover "it".
While I think the Supreme Court made the right decision in the Hobby Lobby case, I don't think they should have been in to position of having to decide it. I don't think Hobby Lobby should be buying its employees health insurance. I think Hobby Lobby and every other company should pay their employees with money and let the employees decide how to spend that money, and that our laws should encourage that rather than the paternalism of the company or the government deciding what employees need.
Very good! Very well said! And I agree.ReplyDelete
But then there would be one fewer issue to polarize people over! We can't have that! ;)ReplyDelete
Seriously, I admit this incredibly obvious solution had never occurred to me. It's good for me to read your blog.
I agree with you (and Ginsburg, after the Wheaton College verdict) that the Supreme Court ought not be involved in such case-by-case decisions. But I cannot imagine a world where insurance is not tied to employment. Let's not forget the advantages of group insurance; it is a win-win.ReplyDelete
I worked in the private sector for about ten years (more than ten years ago) and my recollection of insurance was my employer allotted employees an allowance to be spent on medical insurance as well as buying extra vacation days, etc. Life insurance at one times salary was always included free of charge, but any payout above that came out of my pocket in the form of a payroll deduction. Same with accidental death and dismemberment (AD&D).
I guess I'm saying that the sky was never the limit. There are advantages to employers providing health insurance to their employees but at a time when they seem less willing to do so, it's ironic that some are demanding more coverage. The demand may be the swan song of this model. The straw that breaks the whole system.
There are advantages because that's the way the laws were written. If my employer pays me another $7000/year then that's another $7000/year they have to pay Social Security, unemployment, and other payroll-based taxes on. If I earn another $7000 per year that's another $7000 I have to pay taxes on. Yes, group insurance isn't priced by the health of the individual but on the price of the group, but the result is groups buying overly expensive plans and people getting into the mindset that insurance should pay for all medical care. Your employer may have offered options, but mine does not, it is take it or leave it. I'm not saying the plan we have is bad, or that I could find a better one for the money; just that I think the whole system is broken.Delete