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Dec
6

Employer-based health insurance

There continues to be an ongoing discussion in this country regarding who or what entity should be responsible for providing health insurance. The ends of the spectrum are the strong conservatives/libertarians who are in favor of total individual responsibility for paying health care costs; at the other end are the strong liberals who favor single payer, universal coverage funded and mandated by the government.
In reality we have a “hybrid” system, or perhaps more accurately a mish-mash of individual coverage, employer-based insurance, governmental programs and tax-payer and employer-subsidized care for the uninsured (although this takes the form of a hidden tax).
The reality is we have universal coverage funded by individuals, employers, tax-payers, and providers. Everyone has access to care, although some do not have access to the same level of care or the same providers.
For working age Americans, most insurance coverage is provided through their employers. Although there has been a trend towards fewer employers offering coverage (60% in 2005, down from 69% in 2000), in general larger employers and those with average annual employee earnings above $21,000 tend to offer health insurance.
And the latest information is that this is not likely to change anytime soon. While national health insurance provided by the government would certainly help manufacturing companies such as GM and Ford, there does not appear to by any traction for other funding mechanisms.
An article in the New York Times on employer-based health insurance focused on this issue, and is well worth reading. One passage reads:
“What is also clear, though, is that there are no clear alternatives. Corporate executives and many others are leery of a government solution, but no one has come up with a private-sector option that has gained significant support. Because individuals who buy private insurance on their own pay much higher prices than the group rates employers get, many people could probably not afford health insurance if their employers were not buying it for them.”
The present political climate makes it unlikely that any nationalized system will emerge in the near term. Until and unless large employers, and the middle class, feels pain, there will be no change. That said, my sense is we are approaching that point. With the percentage of employers offering health insurance declining by nine points in five years, more and more soccer moms will soon be directly impacted by this trend. This is a powerful and vocal demographic that will make its presence felt.
What does this mean for you?
Change is coming; the next Congressional election will indicate how soon and provide some hints as to the direction of the health care debate.


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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