Life, Liberty and Employer-Provided Health Insurance
Monday 06 July 2009
by: Dean Baker, t r u t h o u t | Perspective

(Photo: mynameisharsha)
Independence Day is a time to reflect on the United States and to ask what it is that we really value about our country. Most people would probably list the freedoms that it has usually guaranteed to most members of society. The opportunities for economic success, while not as great as often touted, are nonetheless impressive.
However, some members of Congress were apparently celebrating our system of employer-provided health insurance last weekend. Or, at least that is what they want us to believe.
As Congress starts to delve into the dirt of a health care reform package, the clearest point of conflict is over the existence and structure of a public health care plan. Some members of Congress have thrown down the gauntlet, insisting that they could never allow the public to have the option of buying into a government-run plan.
These members tell us that a government-run plan will be like having the post office manage our health care. While the post office actually does a pretty good job where I live, if the point is that a government-run plan is going to be bureaucratic and inefficient, then why are opponents of a public plan so worried about giving people the choice to buy into it? If the public plan is bad, then people will just stay with the options currently available in the private sector. As those of who believe in the free markets like to say: "what's wrong with giving people a choice?"
In addition to the members who just say "no" when it comes to a public plan, there are also members who are willing to allow a public plan, but only if they can be sure that it will not provide real competition with existing private plans. This route involves crippling the public plan in various ways to make it less competitive.
For example, one proposal is to establish a series of health insurance cooperatives, which would be prohibited from acting jointly to maximize their bargaining power. The idea is that a newly formed Nebraska health insurance cooperative, insuring a few thousand people, will not be able to put too much pressure on Pfizer or the American Medical Associations when negotiating prices. It also will not be able to provide much competition for Aetna, Cigna, and the other major insurers.
Several members of Congress have made protecting these insurers and the current system of employer-provided health insurance into a basic principle. Max Baucus, the head of the Senate Finance Committee, who will probably have more to say in the final bill than anyone else in the Senate, falls into this camp. Senator Baucus has explicitly said that he would not support a bill that jeopardized our system of employer-provided health insurance.
This is truly bizarre. The United States has employer-provided health care insurance as an accident - it came about as a way to evade wage controls during World War II - it was not some grand principle.
It is almost impossible to imagine why someone would consider employer-provided insurance as an end in itself. I say this both as an economist and as an employer. I am going to waste several hours tomorrow discussing my center's health insurance plan with an insurance broker.
It is very difficult to compare the merits of the different insurance plans that we are considering. There is an endless list of conditions that are or are not covered (which can change after the fact). There are also issues about how quickly and consistently the insurer will pay bills. We can ask people with other insurers about their experience, but there is no guarantee that our experience will be comparable.
Of course, our broker is of little use. She will only get paid if she persuades us to change insurers. How much can we trust her?
I am trying to do research and run a think tank. Senator Baucus might think that it is a good idea that I have to waste my time dealing with insurance brokers, but I don't, and I suspect that millions of other small employers feel the same way.
So, why not give us a choice of a good, simple, public plan? Employers that want to read through insurance contracts will still have that option. The rest of us can get back to our work.


Comments
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At first I thought reform
Mon, 07/06/2009 - 16:55 β Joan (not verified)Senator Baucus thinks he
Mon, 07/06/2009 - 17:02 β Anonymous (not verified)Thank you. I sympathize
Mon, 07/06/2009 - 17:29 β Brooke Heppinstall (not verified)I viewed Charles Schumer on
Mon, 07/06/2009 - 18:55 β Anonymous (not verified)Charles Schumer says that
Mon, 07/06/2009 - 20:13 β Svejk (not verified)I find it singularly ironic
Mon, 07/06/2009 - 20:22 β Anonymous (not verified)As a small employer who gets
Mon, 07/06/2009 - 20:43 β Anonymous (not verified)I am a physician. Why
Mon, 07/06/2009 - 20:48 β Anonymous (not verified)Baucus is a Streetwalker
Mon, 07/06/2009 - 20:50 β Anonymous (not verified)How much money does it cost
Mon, 07/06/2009 - 20:56 β Anonymous (not verified)What is the benefit of
Mon, 07/06/2009 - 20:56 β Anonymous (not verified)I wish Baker had named names
Mon, 07/06/2009 - 20:59 β Sallyport (not verified)If the majority are not
Mon, 07/06/2009 - 21:32 β Charles Eggen (not verified)Max Baucus is the political
Mon, 07/06/2009 - 21:42 β ucantmakeitup (not verified)It's simple what ever the
Mon, 07/06/2009 - 21:46 β Anonymous (not verified)If you really want congress
Mon, 07/06/2009 - 22:34 β Anonymous (not verified)The plain, blunt truth is
Mon, 07/06/2009 - 23:12 β Anonymous (not verified)So the house and senate gets
Mon, 07/06/2009 - 23:13 β Anonymous (not verified)Re: Sallyport "I wish Baker
Mon, 07/06/2009 - 23:38 β Progressive Patriot (not verified)For heavens sake...write and
Tue, 07/07/2009 - 00:56 β Anonymous (not verified)How many congress members
Tue, 07/07/2009 - 02:12 β Merle (not verified)My understanding is that
Tue, 07/07/2009 - 03:10 β Anonymous (not verified)I am a strong advocate of
Tue, 07/07/2009 - 03:17 β Anonymous (not verified)Yes free healthcare for
Tue, 07/07/2009 - 04:06 β Anonymous (not verified)Between the insurance wonks
Tue, 07/07/2009 - 04:44 β Regina (not verified)You can call any of your
Tue, 07/07/2009 - 06:03 β Anonymous (not verified)Employer-provided health
Tue, 07/07/2009 - 06:10 β Orley Allen (not verified)to the gentleman from
Tue, 07/07/2009 - 08:02 β tell the truth (not verified)I urge all to have a massive
Tue, 07/07/2009 - 16:54 β Anonymous (not verified)Congress need only look to
Tue, 07/07/2009 - 19:13 β Anonymous (not verified)I work for the USDA. The
Wed, 07/08/2009 - 03:22 β Michael Bugg (not verified)Dear Anonymous on 07/06 at
Wed, 07/15/2009 - 17:58 β Frances in California (not verified)Dear Anonymous on 07/07 at
Wed, 07/15/2009 - 18:01 β Frances in California (not verified)