Why is healthcare tied to the workplace?

[MountainLaurel]

LIKE MOST HEALTH policy researchers, Bob Moffit and Susan Sered have long been obsessed by the vexing question: Why is America the only industrialized country to link health insurance so closely to employment?

Moffit, who directs the Center for Health Policy Studies at the conservative Heritage Foundation in Washington, says ''it's nuts" that nine out of 10 Americans with private health insurance get coverage through their employers. ''Imagine if auto insurance worked the same way," says Moffit. ''So, if you lost your job, you could no longer drive. That would be profoundly absurd."

Sered, a researcher at the Center for Women's Health and Human Rights at Suffolk University, stands at the other end of the political spectrum from Moffit, yet on this particular point she sees eye-to-eye with him. ''Employer-sponsored care is the main reason for the crisis of the uninsured," she said in an interview.

In ''Uninsured in America: Life and Death in the Land of Opportunity" (University of California Press), Sered and coauthor Rushika Fernandopulle, a primary-care physician and clinical instructor at Harvard Medical School, argue that precisely because healthcare and employment in America are linked, job loss can often have dire consequences-namely, what they call the ''death spiral." Without reliable medical care, unemployed individuals, who often have too many assets to qualify for Medicaid, become more prone to developing serious illnesses and hence less employable. Eventually, many are forced to leave the workforce permanently, and some become a statistic-18,000 Americans, according to a report by the Institute of Medicine, die every year because of the lack of health insurance.

http://www.boston.com/business/healthcare/articles/2005/10/16/why_is_healthcare_tied_to_the_workplace/

[Nite Owl]

1. Tying healthcare to work

makes people take and keep jobs that they otherwise would leave. It gives the employer leverage because people need what they have for themselves and their families. Don't like the $.25 hr raise? But if you want to move to another corporation you lose the benefits you have and you will have to wait for any new benefits to kick in. Want to start a business of your own? What will happen for healthcare then? It makes people dependent on lower paying jobs because there is no flexibility.

[dflprincess]

5. It began during or immediately after WWII

when there were wage freezes. Employers couldn't use salary as a way to attract workers so they started offering benefits like health insurance.

[sui generis]

2. Actually actuary is the reason

The insurance industry has one goal only:

PROFIT

So the insurance industry creates "risk pools" based on arcane statistics and demographics and sets premium rates based on what their expected losses and profits need to be to build and maintain regulatory cash reserve requirements and keep their investors happy, NOT because they give a flipping shit about anyone's wellbeing.

After the system is in place, and particularly in health insurance, the industry does everything in its power to adjust individual risk profiles based on new information and to remove risk (and decrease "loss") from the risk pool.

They have a lobbyist hand in setting "reasonable and customary" service charges artificially low, and doctors have a hand in submitting claims that far exceed these thresholds so that they get paid no matter what is "reasonable and customary". Big Pharma has their arm up the collective ass of congress to guarantee their right to profit the most from the least insured who can least afford it, including making reimportation illegal, and in a nutshell, you exist to be harvested of your cash either directly to the doctor, or to your insurer, sooner or later, until you die, in which case they still don't give a damn about you.

The single most disgusting aspect of our medical system right now is that ordinary life saving medications for seniors and children and even proven preventative regimens are priced sometimes 300% to 1000% higher for Americans than other countries because here in America Big Pharma has a greater right to profit than you have a right to live.

Real universal healthcare for everyone is a fundamental requirement of a civilized society. There is still room for a free market in medicine, just not in its current form. There is no reason in the universe that American seniors should be splitting pills or foregoing medicine for food or shelter, that children should find themselves without access to healthcare, that people with treatable life threatening disease or injury should find themselves unable to afford to stay alive.

[RaleighNCDUer]

4. I've always maintained that we don't have a healthcare crisis

in this country -- we have an insurance crisis.

The only way we will ever get national healthcare is if the insurance companies are made the administrators of it. Otherwise, the insurance industry and the pharmaceuticals industry stand to lose billions of dollars. In effect, we'd see them setting the prices with the government guaranteeing payment. Kind of like the Medicaid (or was it Medicare) perscription deal that went through last year. In the long run it will only exacerbate the problem.

No politician that tries to stand up the big pharma and the insurance companies will ever last more than a single term in congress.

[mokawanis]

3. Haves vs. Have-Nots

I am simply amazed that we put up with this. Anyone who thinks we shouldn't provide health care for everyone needs to have his/her head examined, which of course means a lot of people should visit a shrink, especially the one who are in the best position to do something - our elected "leaders."

Right after the presidential election, Ed Gillespie, chair of the RNC, said "Americans have made it clear we don't want universal health coverage." He wasn't speaking for me when he said that and he damn sure wasn't speaking for the uninsured. What he was really saying was that the Republicans don't want those damn lazy poor people to have insurance they can't pay for. Disgusting.