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Life, Liberty and Employer-Provided Health Insurance

by: Dean Baker, t r u t h o u t | Perspective

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(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.

  

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Dean Baker is the Co-director of the Center for Economic and Policy Research. CEPR's Jobs Byte is published each month upon release of the Bureau of Labor Statistics' employment report.

Comments

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At first I thought reform

At first I thought reform would be simple: in the name of competition, just give us a public plan and allow us to buy in if we choose, with premiums set to cover actual costs. How could those big-business-bought Republicans possibly argue against such a perfect free-enterprise solution? HA! The joke is on me. Even the blue dogs have joined the insurance industry gravy train. The contortions in logic required to sell this plan would be laughable if the consequences were not so dire. I fear we will end up with a mandate that forces us to buy insurance in an even less competitive market. I'm not laughing anymore.

Senator Baucus thinks he

Senator Baucus thinks he will go down in history as the greatest senator in Montana history right up there with Mike Mansfield. He will be known as something else if his health plan is passed. Look at who fills his campaign war chest. He works for the pharmaceutical and health insurance industry. I voted for him and feel used. And I fear Senator Tester may be hitching is wagon to Baucus' team. He is strangely silent on health care. From a disappointed voter in Montana.

Thank you. I sympathize

Thank you. I sympathize with your having to deal with your own health care insurance issues. My spouse is a health benefits trustee for the state's public employees. These trustees several of whom are actually state employees (others are accountants, lawyers, etc) have their regular day jobs to do, often are shop stewards or union officials with that side work to do, and have to read an enormous amount of non-job related materials every week along with many days of training to do this unpaid, yet, essential work. It is exhausting and thankless work. We'd love a single-payer system. It is astonishing to see the huge differences in charges the different major health providers (hospitals, doctors) have in our small area for the same procedures! Preferred provider? We have to drive 100 miles round trip to the hospital that is our POP even though there's a brand new hospital just 10 minutes away that refuses to give POP status! And you ought to see what these robbers charge compared to the hospitals in the city!! Of course, this is just little Palmer, Alaska (next door to Palin's Wasilla) and our new hospital that used to be a non-profit Presbyterian institution is now owned by a huge Texan corp.! Keep up the good work Mr. Baker!! Thanks again.

I viewed Charles Schumer on

I viewed Charles Schumer on DailyKos TV saying that a public option is going through; there's no question about that at this point. The President wants it, and that's the direction we're going to head in. Now there is the deadline of twenty-odd days to meet, and, what shape or form the public option is going to take. As ever, I imagine, the devil is in the details, and I am hoping we will hear more discussion about this, and quickly. The most sensible thing would be a single payer system, as under HR 676. But we all know that they are not sensible because they are all being bribed by the health and pharmaceutical industries. The public plan should have dental, particularly periodontal care and maintenance covered, as well orthodontic treatment for periodontal-related (vs purely cosmetic) conditions. Without proper cleaning (which is extremely costly for individuals), people can develop infections that go straight into the brain and kill you. And periodontal conditions afflict an extraordinarily high percentage of Americans. I read an article whereupon a dental professional stated that our dental care is now at the Third World level -- forget about even 37th internationally. We have elderly people sitting in the boonies with all their teeth out, and they can't even get an appointment in the major cities with clinics serving the underserved. Think about that the next time you watch a Washington D.C. politician smile, and remember that their health plans paid for by Americans, for themselves and their families, and even after they leave their temporary employment, include great dental (and vision, too, btw, which is a whole other post).

Charles Schumer says that

Charles Schumer says that the public option (whatever it turns out to be) is going through. Why isn't the only decent option, single payer, going through? Politicians, never long on backbone, are overwhelmed by profiteers' lobbyists, with money hanging out of their pockets, so single payer is off the table and officially suppressed. What is shaping up now is a tremendously expensive bailout of insurers, with no effective cost control mechanism and an endless flow of money into private profiteers' bottom lines. People need to get really angry. They are not getting accurate information on what's going on, or are being badly misled. The corruption in the health insurance system is much worse than we've been told, and the stage is being set to lock us into a system that could well be worse than the mess we're in now. It's time to stand up for what we want and need - and not whine later, once it's too late. Joining the rally in Washington D.C. on July 30th would be a good start - it's Medicare's anniversary. And this time, we must insist - healthcare is a human right, and everyone deserves access to good health care, regardless of income. (Rally info is available on PNHP or Healthcare Now web sites).

I find it singularly ironic

I find it singularly ironic that federal lawmakers, who enjoy the VERY BEST of care (for life, if I'm not mistaken) under a "government run" plan should object to such a plan for ALL Americans! Employer-paid health care is fine, so long as one is continually employed. What about the unemployed, and retired senior citizens living on severely limited fixed incomes? Perhaps our elected officials should remember who is paying their salaries, and be more strictly monitored where "perks" from lobbyists are concerned, we might have a government that cares about the well-being of the people who elect it!

As a small employer who gets

As a small employer who gets TOTALLY CONFUSED when comparing plans and who knows that the current plan is neither the cheapest nor close to being the best, I would welcome a public plan that is simple and consistent. Understanding my options under Social Security is complicated enough for most of us -- Let simplify things. And I have a great deal of confidence that the public sector will give me a much better product than the private sector. I need health insurance, not insurance for catastrophic illness (which is kinda what mine really is) for over $1000 a month.

I am a physician. Why

I am a physician. Why should a stockholder or CEO of an insurance company earn money each time a patient visits my office? Larry

Baucus is a Streetwalker

Baucus is a Streetwalker rubbing his private business all over the greedy execs of his best paying John:big,corrupt insurance. Yes these "clients" are his feeding tube into organized crime, always trying to clean itself from its roots by installing paid for lawmakers who don't want us to know that they are lawbreakers. That is they hide behind laws they paid to be written,complex and passed under the table, in the middle of the night in order to obstruct any open debate. The tragic irony behind the lies that are needed to float this crap is that these "traitors for a buck" try to convince the victims that it is good for them to have their paychecks stolen by these billionaire thieves serving up an old recipe: extortion. Baucus has his own greed interests at stake. Who needs foreign enemies when we have such good ones at home like Baucus?

How much money does it cost

How much money does it cost to buy a Senator? Just ask Aetna or Gigna. Health care should be non-profit, plain and simple. But of course, they are now in the process of privatizing the prisons. What's next, a private police force? Run on a "for profit" model. I can hear the 911 call now, "I'm sorry ma'am, we cannot respond to your call at this time as it has been determined that visiting your neighborhood is not financially viable."

What is the benefit of

What is the benefit of employer-provided health care??? - LOL... You gotta be kidding! - It may have got started by accident but the capitalist control freaks that run this excuse-0f-a-country have since discovered that employer provided health care keeps the working class in line - Can't afford to loose that health care... Better keep my mouth shut... docility earns benefits. When is the AmeriaCOW population gonna get mad? When are they going to clean up Washington of all its whores and corridor walkers? Never....can't loose what corn feed we got.

I wish Baker had named names

I wish Baker had named names when he told us that some representatives are vowing not to let a public option go through. These guys need to have their noses rubbed in a dose of public opinion. Their constituents should know what their reps are up to. Even the big bucks the lobbyists bring along won't offset a tidal wave of votes against them come 2010. The more they expose their own venality the more certain they will be dumped by the electorate.

If the majority are not

If the majority are not allowed a non-profit public option, then it is only proper that nobody should be so allowed. I will accept this if Congress will. In other words, Congress and all other governmental employees, federal, state and local, must give up their public supplied health insurance plans. I mean truly give them up; no increase in salaries to compensate nor tax deductions nor rebates for increased health insurance payments they will have to pay. I am sure that they will see the fairness in this. I know that my congressman and senators do not think they are more deserving than the rest of us. Just do the right thing.

Max Baucus is the political

Max Baucus is the political arm of the insurance companies. He has received millions in contributions for the "healthcare industry". Everyone knows that and nobody is doing anything about it. Hopefully Montanan's will vote him the hell out of Washington for being such a fraud. Unfortunately he will have already done as much damage as possible before that happens. Ultimately though, it is President Obama who is letting down the millions of voters who catapulted him into office on the promise of change, yes we can and all the other sound bites we so desperately hoped were true.

It's simple what ever the

It's simple what ever the congress passes they will have to live with. This should be a first principle. So if the Senators think insurance provided by employers is so great. I say give them the same coverage and cost structure that 85% of the companies plans offered in there states. i bet they change their tune in a hurry.

If you really want congress

If you really want congress to consider a single payer health plan, take their insurance away. After they have to pay exorbitant prices for reduced care, they will understand the public concerns

The plain, blunt truth is

The plain, blunt truth is that the 'health' insurance industry and their corporate allies are guilty of murder, maiming, infliction of physical and mental pain and suffering, for a start. Those who aid and abet them, like Sen. Baucus, and the 'blue dogs' are equally guilty. They should all be greeted every morning on their way into the halls of Congress with signs to that effect. They should be greeted with those same signs in stockholders' meetings. They should be shunned on the streets when encountered. They can laugh all the way to the bank, but decent people do not have to treat them like they deserve respect when what they really deserve is prison!

So the house and senate gets

So the house and senate gets government run health care, but its not good enough for everyone else? Obama promised that U.S. Citizens would get the same health care options as our elected officials in Congress. If those fat cats on The Hill with their big paychecks accept government run insurance paid for by tax dollars, either: 1) give it up as substandard rationing of service (I don't recall Hilary Clinton complaining of substandard, rationed care when she just had surgery for a broken elbow) and pay for their own insurance policies or 2) open it to all americans, paid for with tax dollars.

Re: Sallyport "I wish Baker

Re: Sallyport "I wish Baker had named names..." Anyone should be able to go to their Representative's and Senator's web pages and find out where they stand on _real_ Health Care versus Greedy Insurance. If they don't tell you on their web site, look for their "Contact" link and write to them, DEMANDING that they state where they stand on ALL issues.

For heavens sake...write and

For heavens sake...write and call your Representatives and Senators. Obama needs your help or he will crash. Tom

How many congress members

How many congress members have opted out of the Government Health Insurance that is provided to them. If this type of Insurance is soooo bad then I would suggest that they should opt out and buy some of that good private Insurance. If they don't opt out they should shut up and vote for insurance for everyone.

My understanding is that

My understanding is that members of congress get the same menu of choices of PRIVATE, FOR PROFIT health "INSURANCE" companies that most workers get. The difference may be that the govt pays for their premiums and the co-pays and deductibles that most of us pay out of pocket. Another perk is that the members of congress get those benefits for themselves AND their family members FOR LIFE, and for free. Can a member of congress who reads Truthout confirm this?

I am a strong advocate of

I am a strong advocate of Single Payer (Medicare for ALL ( ages). I'm glad someone wrote about the July 30th Single Payer rally at 1 p.m., Upper Senate Park, in Washington, D.C. Come and agitate with us, and let your voice be heard. If we miss this opportunity to get what is long overdue, we will be the laughing stock of the rest of the world who enjoy universal, publicly-funded, free of employer attachments, health CARE, not funny money health "insurance". This is OUR time. let's get it done!

Yes free healthcare for

Yes free healthcare for those who sell out the people that voted them into office. Free healthcare for those that supports trillions spent on unpopular for the sake of corporate greed. Free healthcare for liars in office who say one thing while taking money from big pharma. I will never vote for anyone who votes against a public healthcare option and as its been said, if its good enough for the government I should at least get something that good.

Between the insurance wonks

Between the insurance wonks practicing medicine and other B-school grads practicing pharmacology, the USA is the laughing stock of the so-called civilized world. The horror stories we get about Canadians waiting months for medical attention to symptoms getting progressively worse can be matched by the horror stories of Americans being told that they will not get their treatment paid for because of "pre-existing conditions." It's time to call the Congressional mules' bluff -- stand up (TO your paymasters and FOR your constituents), put up, and shut up!

You can call any of your

You can call any of your representatives toll free at 1-866-338-1015. Tell them you want H.R. 676, Single Payer Health Care. You can also sign Senator Saunder's petition for single payer, for the senate version of the Conyers bill (HR 676). http://sanders.senate.gov/petitions/index.cfm?uid=7fd59f2e-88e1-477a-8eaf-762a5b050809 And another single payer petition, along the Conyers bill, here, http://www.healthcare-now.org/petition

Employer-provided health

Employer-provided health care was designed as a union-busting measure. It's difficult enough for union workers to risk losing their jobs in a strike, with the establishment of employer-provided health care, striking workers must also put their families' healthcare on the line. We are being ruled, not governed.

to the gentleman from

to the gentleman from montana if you would like to know why sen. tester got so quiet go to maplight.org and take a look at whose been bribing him.it's all right there.

I urge all to have a massive

I urge all to have a massive ban withdrawal. let us all at one time -silently and cooperatively express our legal right to not cooperative with a system that eslaves us. Buy no US goods, withdraw all funds from US banks and brokerage firms, buy no US cars. The hegemonists and power brokers are supremely and arrogantly confident -that 'we' are so stooooopid- that we can't even see the way to our own salvation. Remember that Gandhi's thesi of NON_COOPERATION was quickly and hastily transformed into NON_VIOLENCE-hmm wonder WHO that benfits. NON_COOPERATION is the only answer to the betrayers of the public trust. This is what all citizens in all nations must do- and it is not illegal. We are with in are rights to express the 'choice' of not supporting a government that does not support us.

Congress need only look to

Congress need only look to the U.S. Auto industry to understand the consequences of its "protectionist" philosophy when it comes to shielding certain industries from any kind of real competition! Eventually they collapse under the weight of their own unmitigated greed and laziness. Is that what they want for the health care industry too? Health insurance should be completely independent of employment. The current system results in such huge inequities in the cost of health care for those of us who are either self-employed, unemployed or small businesses, with employees of large corporations enjoying ridiculously lower health care costs at the expense of those who don't enjoy the same economies of scale. Patently unfair and highly anti-competitive! Those so-called "free market" politicians are a bunch of liars and scammers.

I work for the USDA. The

I work for the USDA. The tax payers pay 70% of my premium. I pay 30%, a $12.00 copay at each visit, and a $250.00 deductable each year. My insurer is Blue Cross & Blue Shield. I am totally for universal single-payer as the ONLY option that will reduce costs and provide coverage for everyone. However, efforts must be made to reduce abuses by lazy, foolish Americans who make no effort to protect their health or pay any taxes. I have called all five Democratic committee heads who have a say in whether or not we have single-payer or make more people give their hard-earned money to for-profit insurance companies. What have you done besides read this essay or make a comment? Oh, and whenever anyone says universal single-payer health care is "socialism" you can point out that national defense is also. How many ships, airplanes, tanks, and missiles would our defense contractors sell if only rich people bought them? Instead, they are kept in business by our collective tax dollars. And how many Americans benefit from the defense provided by our military who pay little or no taxes, including some of our largest corporations? Both are examples of SOCIALISM! Furthermore, if our socialized national defense is to protect our lives and way of life, then isn't health care foe everyone just as important? Which is more likely, an attack by Russia, China, North Korea, or Iran, or a family member getting cancer, heart disease, diabetes, or injury in an accident? Start calling your congressmen and the committee heads, now!

Dear Anonymous on 07/06 at

Dear Anonymous on 07/06 at 20:56 - Your snark about Privatized Police Forces is quite apropos; what does anyone think Blackwater is? Besides, there are wealthy communities in Calif. already that have their own fire fighters . . . I'm not a Christian by anyones standard but I find myself paraphrasing his words a lot: "If they do this when the wood is green, what else will they do when it is dry?"

Dear Anonymous on 07/07 at

Dear Anonymous on 07/07 at 3:10: No congressperson with an adequate sense of self-preservation (tho' I believe Dennis Kucinich has posted to T/O in the past!) would be caught dead on these pages! Look at what Rahm Emmanuel did to anti-war Democrats!