If Congress Fails to Pass a Health Plan ...
It's already happening. Employer provided health insurance is just too expensive. Small businesses haven't been able to afford it for a long time. They pay high rates--double, we discovered when we were in business--what you can buy as an individual. And the rates have been going up dramatically every year. If you think large corporations are going to be able to continue providing coverage, think again. Chrysler and General Motors went into bankruptcy, largely because of huge legacy costs generated by their commitments to worker/retiree pensions and health care.
Even when companies continue to offer health insurance, workers and would-be workers are at risk, especially older workers too young for medicare. If you're 50 to 65, watch out. You'll be first in line to be laid off and last in line to be hired--precisely because you are too expensive to be covered.
While this is painful, it may not be entirely bad in the long run. Our reliance on "benefits" has had some unfortunate consequences.
- Workers are insulated from medical costs: With health insurance provided for them, workers have no incentive to pay attention to medical costs and every reason to demand the latest and the best medicine has to offer.
- Medical providers are insulated from price pressure: With workers not paying attention, medical providers are free to ratchet up charges, pad invoices, order unnecessary tests, by expensive equipment duplicated in nearby facilities, and so on.
- Insurance companies are insulated from price pressure (sort of): To some extent, insurance companies benefit from the same absence of price pressure as providers. However, insurers are really middle men who pass on the costs in the form of insurance to companies and individuals.
Employer provided health insurance has other consequences.
- People think employers must provide health insurance. Why? Do employers provide auto insurance? Or home insurance? Or long-term care insurance? Why is it their business? Why is a good thing? Does it make a business a better business? Does it help a company serve its mission? Does it make a company more competitive, especially in the global market where health insurance is either not provided at all or provided by the government?
- People think they must work for a company that provides health insurance. In setting this as a priority, they often wind up working for a company they don't like in other respects doing work they hate, and generally limiting their options.
In another post, we'll talk about what we might do instead. Wile E.