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Idea#4230

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Remove health insurance from the pervue of the employer

Why Is This Idea Important?: The answer is NOT government managed care (aka socialized medicine). Unfortunately, history has proven that national governments are not good at providing this type of service. If you have but one provider (be it government or private), you remove one of the primary legs of economics (competition). You also end up with a system where one size does not 'fit all'. The stories from Europe and Canada of people literally dying while on a wait list for relatively routine procedures are many and well known. The solution - create not for profit, state and national level plans. Not for profits have done a good job in many other areas (Credit Unions, Charities and many others), there is no reason this model cannot be used for health insurance. Companies/individuals still have the option to negotiate their own plan. However if no plan is available to you, or you choose not to participate in a company provided plan, you would be required to participate in the state not for profit plan. If you lose your job and are not eligible for Cobra or choose not to use Cobra, you can transfer to your state plan with no pre-existing exclusions. The amount any indivdiual pays is based upon a number of factors, including your ability to pay. Those that choose to engage in behaviors that have an adverse effect on your health, have a modifier that increases their premium (smoking for example). While those that take care of their health have lower premiums. No one would be penalized for conditions over which they have no influence or control. When you join the plan, you are given a physical and many of these factors can be readily identified objectively. There would be a minimum coverage that everyone must have and pay for, with the option to add to your plan at additional cost based upon your lifestyle modifiers and personal desires. Want better insurance at a lower price, take care of your health. If you are unemployed / have no assets or income, then you are covered by the minimum plan. However, once you do become employed/have the ability to pay you not only start paying for your existing insurance but are also required to pay back at least a part of the insurance provided for you while you were unable. People do what you incent them to do. We need to encourage personal responsibility and healthy choices while providing choice and a minimum level of acceptable care for those unable to care for themselves.

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Employers being responsible for providing health insurance dates back to WW2. At that time, insurance was relatively inexpensive and quickly became a common benefit/perk. With annual average increases in the double digits, the health care costs are crippling and bankrupting many of our companies.

The premium quoted by insurance companies licensed in your state is determined by several factors, the two that have the greatest impact are:

1) The mandated requirements by your state (mental health care, birth control, pregnancy coverage etc).

2) The demographics of your 'group' (the employees in your company)

If you work for a small company (and approximately 50% of Americans do), you are at a decided disadvantage to an identical individual working for Microsoft, IBM or any Fortune 500 company. The larger the number of employees, the more people to spread the cost of catastrophic care. Insurance companies use fairly complex mathematical formulas developed over years to determine the likely costs they will incur over the plan period based upon the demographics of the people in the group. The more people, the lower the average risk, and the lower the average policy cost.

This is why the large companies can provide better plans for less cost to their employees. As insurance costs continue to escalate, the small companies are limited in the plans and coverage they can afford to provide and the amount they can afford to pay. This often puts the employer and employee on different sides of the 'table' when it comes to health care selection.

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Submitted by topry 2 years ago

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Comments (2)

  1. ls072456 said:

    are there really all those folks literally dying in europe and canada??? how about the 16,00 plus that die each year in the Us because they cannot afford health coverage or are denied coverage or have their coverage rescinded?

    health care is a human right and no one should be able to profit from the sale of a human right. we all need to pay for health care, but we should not be subject to profiteering. it is time we treat health care as the public good it is, not as a market commodity.

    an emphasis on personal responsibility is important and as a society we need to help each other and encourage each other to take care of our health because it benefits us all. consumable items detrimental to health (cigarettes, liquor, fast food, soda etc. ) should be taxed and those taxes should be applied to health care funding. as these behaviors decrease the revenue will decrease from these sources, but also hopefully will the diseases associated with these products.

    everyone must be afforded the same coverage because health care is a human right. as a society we can make this happen, but first we must tell those who wish to take advantage to get the hell out of the way.

    2 years ago
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  2. jackmcg said:

    The whole thing is a scam and they have people believing it. Insurance companies are not insuring small groups they are insuring everyone who has a policy with them in one huge pool. To think that they are taking a risk is silly. If the risk gets too great they either raise rates or move out of the state. Insurance companies are very profitable and they are getting away with murder. They need to be regulated the same as any large utility. They are the poblem not the sulution. Owned by people who make nothing but money.

    2 years ago
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