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Health care coverage has been tied to employment, should this continue


Guest Ray Berry
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Guest Ray Berry

Health care coverage has historically been tied to employment for most Americans. (Medicare and Medicaid are obvious exceptions.) Should this arrangement be continued? Are there better arrangements? Is the current arrangement too entrenched to change? Will mandates result in even less employers, particulary smaller employers, offering coverage to employees?

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Ray Berry

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Guest kchristy

Even as a person who makes his living largely from procuring health coverage for employers, it has always struck me as somewhat odd that such a vital coverage comes primarily from one's place of work. However, I can't think of a better way of providing it, for two reasons:

1) Group insurance spreads risk. Purchasing coverage on a group basis provides risk spreading for the carriers, removing the need for them to look at the health of individuals. Countless people who would have otherwise been unable to qualify for insurance for themselves or their family members are able to get it from their group plan, with often no questions asked.

2) The problem of selection when coverage is purchased on an individual basis. In California, where I live, some counties have as much as 50% of the drivers on the road uninsured. This is not because auto insurance is *prohibitively* expensive - it costs just a fraction of what health insurance costs - but because those people would rather spend their money on something else and just assume the risk. I can't pretend that this is a *rational* decision, but a short-sighted one. It strains credulity to imagine that people who debate with themselves about whether or not to pay $75-$100 per month for auto insurance would unhesitatingly pay $400-$500 per month for health insurance for their families.

The only other viable solution is national health care, which would obviously deal with both of these two issues. Devil's in the details, though... the *idea* of national health care is so much more promising than the ability of the government to create a system that works.

As for mandates, it's worth noting that health insurance reform here in California has made it easier for small businesses to provide coverage to their employees, and hundreds of thousands have done so in the last few years since our first major reforms in 1993. HIPAA was old hat to us by the time it hit Congress; we already knew it was a good idea based upon practical experience.

The process of employer-based health insurance, regulated by sensible acts of state and federal government, has worked pretty well so far. I say we should stay the course.

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