The Consumer Is Not the Customer

Both parties promise to preserve one of the central problems of the health care system

The other day, I was trying to figure out why the paycheck deduction for my health insurance was higher than I had expected. When I called my insurer to ask what the total premium was, the customer service representative said it was none of my business.

Three-fifths of Americans, the share with employer-provided health insurance, are in the same situation. Since someone else buys insurance for them, using money they would otherwise receive as wages, they are in no position to shop around and typically do not know the true cost of their coverage. This disconnect between payment and consumption is one of the central problems with the health care system, contributing to insecurity, rapidly escalating costs, and the general lack of choice and competition. Yet both Democrats and Republicans insist on preserving it.

Outlining his reforms in September, President Obama reassured the public that “nothing in this plan will require you or your employer to change the coverage…you have.” In fact, he said employers should be forced to provide health insurance (or contribute to a fund that subsidizes premiums). Obama presented himself as the protector of job-based medical coverage against those “on the right” who “argue that we should end employer-based systems and leave individuals to buy health insurance on their own.” That approach, he warned, represents “a radical shift that would disrupt the health care most people currently have.”

Yet the Republicans, whose last president and last presidential candidate both proposed eliminating the tax incentives that encourage employers to offer insurance in lieu of higher pay, seem to have abandoned that idea. In fact, one of their main complaints about Obama’s plan was that it would reduce the number of Americans covered through their jobs.

Senate Minority Leader Mitch McConnell (R-Ky.) warned that one Democratic health care bill “would cause 10 million people with employer-based insurance to lose the coverage they have.” The Republican National Committee claimed “over 88 million people” who are covered through work “would lose current insurance under government-run health care.”

It’s no mystery why each party portrays the other as bent on destroying employment-based medical coverage. A large majority of people who have such insurance are happy with it. According to a recent Zogby poll, 77 percent of Americans oppose “taxing employer-provided health care benefits.”

Yet it’s the tax-free status of those benefits that favors them over cash compensation, maintaining a bizarre system in which most Americans get their health insurance—unlike their car, life, or homeowner’s insurance—through their employers. As a result, they are insulated from the actual price of their insurance and are more likely to have plans with low deductibles that cover routine medical expenses as well as large, unpredictable costs. In choosing among providers, drugs, and treatments, they have little incentive to economize and usually do not even know the relative costs of their options.

The artificial dominance of job-based plans, along with misguided restrictions on where insurers can sell policies and what types of coverage they can offer, has stunted the development of alternatives. Even so, the price difference between the job-based and individual insurance markets suggests the savings that are possible when people decide how to spend their own money. In 2007 the average annual premium for nongroup health insurance was about $2,600 for single-person coverage and $5,800 for family coverage, compared to $4,500 and $12,100, respectively, for job-based plans.

In addition to enhancing competition and controlling costs, cutting the link between employment and insurance would relieve the insecurity many Americans feel about going without coverage when they lose or leave their jobs. Obama is right that such reform would be “a radical shift”—radical in the sense that it goes to the root of the health care mess.

Senior Editor Jacob Sullum (jsullum@reason.com) is a syndicated columnist. © Copyright 2009 by Creators Syndicate Inc.

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • ||

    Wow, is anyone actually surprised by this?

    Jimmy
    www.web-anonymity.de.tc

  • ||

    Like Ezra Klein's oral gonorrhea, this situation has run its course. Just ban the stupid anonymity bot already.

  • Rimfax||

    Jimmy just wants to help you engarle your pines.

  • ||

    Great article and some nice points.

    What our benighted trolls can't understand is that criticizing ObamaCare is not a defense of the status quo, but an objection to trading one failed government program for one that is worse.

  • Alice Bowie||

    I would love 2 c employer-based healthcare go away.

    I either want to buy my own private coverage or a public option.

    Health Insurance should be separate from employment.

    And, of course 77% of people like their plan...they've never really used it for anything other than maternity, routine checkups, etc. Ask the people with serious illnesses or injuries that required them to stop working.

  • Chad||

    Why do you want it to go away? So you can buy on the individual market, and pay far more? Or pay the same but get much crappier insurance? Or opt out entirely, and then come begging to me when you are desparate?

  • ||

    Chad,

    Is there something magical about employee provided insurance that would keep the cost of insurance lower, yet provide higher quality coverage? Is having a choice of only about twenty plans, with low deductibles and no choice of a plan with an HSA, somehow better than allowing me to choose from plans offered from the over 1300 insurance companies in the US? And if we were allowed to buy insurance from ANY company in the world (getting competition from over 1300 companies), you really think the costs would be higher AND the quality be lower? Do you really think giving a tax deductions to employers to provide health insurance, rather than giving tax deductions to individuals to buy their own health insurance will result in better outcomes? Do you really believe the government or employer can make a better decision about what type of insurance you need better than you?

    Do you even know what you are talking about?

    And just because you would go to the government with your hand out when you make bad decisions, don't make the assumption that everyone else is such a low life that he would lobby the government to take from you to give to themselves.

    Regards,
    Ken

  • Sean W. Malone||

    Ok, here's the thing... There's no reason to tax employer provided health care benefits! It's far better to just make all health care purchases tax-free, for employers and individuals alike. All that is needed here is for the playing field to be even again, and let the market sort itself out. If you increased taxes on employer provided while lowering taxes on individually paid insurance, OF COURSE that would disrupt the whole system. It would provide incentives to shift that have nothing to do with the best arrangements obtained voluntarily... Exactly as the system is today, only... "reversed".

    So I'm saying - make it all tax-free...

    (While we're at it, make everything else tax-free too, and fire the government.)

  • ||

    And make it really tax-free as well. Medical monies should be completely untaxed by fed, state, or local income, payroll, or at the register.

    If healthcare is so important, why continue to tax it?

  • Alice Bowie||

    What's wrong with simply having the government collect the premiums in a form of taxes (we already pay 6% in medicare) and firing the insurance companies?

    I do agree with you on the other points.

  • ||

    Because of the capture rate.

    Which is better, I pay you the $5 I owe you, or I give the $5 dollars to Episiarch, who takes a cut to keep his collection business a float, and then he gives it to Fluffy, who decides if you really do get the money after all and takes a cut to keep his evaluation company afloat, and then he passes it to Warty who cuts you a check and takes a cut to keep his check cutting business afloat and you get $3.50. And that's assuming Tony and Chad didn't intervene to give a dollar of it away to some "deserving" poor person.

    Capture rate. You throw a wad of money through any system, and less comes out the other end.

    Governments have the highest capture rate of any money transfer system. Everyone should stop pretending it's zero.

  • Alice Bowie||

    You just explained the Insurance Industry. It takes the so called 3% profit and charges a 25-30% adminstrative fee (with no transparency) for offer ABSOLUTELY NO SERVICE other. I'd rather just eliminate insurance all-together and just pay when I need to go to Dr. or Hospital.

    If something catastrophic happens and I can't pay...They can go after my estate.

  • Sean W. Malone||

    I think you may want to review the actual facts instead of the paranoid, anecdotal propaganda that's racing around your mind, Alice.

    90% of Americans still have health insurance, and the vast majority of us are relatively happy with the service provided... The whole point of (real) insurance is that you should be paying for all your normal health maintenance expenses. You pay the $50 to go see the doctor, the occasional $500-1000 for the ER visit, anything short of something that would be financially ruinous, you pay out of pocket.

    When something really catastrophic happens, THAT'S why you carry insurance!!

    This way, the insurance actually acts as a risk pool, and not as a sugar-daddy to pay for whatever you want, regardless of whether or not you can easily afford it. Doing away with insurance would royally fuck up a LOT of people's health care needs. And by a lot, I mean, somewhere in the realm of 200 million people.

    So... Anyway, what you need to recognize is that the problem with insurance is that what we do with health care is explicitly NOT insurance! It's the fact that we have a highly controlled market, where major insurance companies essentially operate within a cartel structure (everyone is legally required to offer the same services with relatively minimal variation between plans), and there is no real competition. That combined with the reality that people now expect insurance to simply pay for everything, and the other incentives that are in place just results in skyrocketing costs and coverage that cannot possibly meet demand.

  • Kroneborge||

    +1

  • Chad||

    The vast majority of Americans have never had treatment outside the US as a comparison. They have no idea how much they are getting ripped off.

    We overpay by 50% and suffer far greater risk than anyone else, for care that is good but not great.

  • Tim||

    Your point that Americans may pay more for health insurance doesn't do anything to reject the libertarian reform proposals.

    At best you can merely prove that other nations outright socialism or mixed system performs better than our current cronyism and corporatism. While to do that you have to account for costs hidden in technology rationing, taxation and the dead weight cost and waiting lists and the host of factors that affect health outcomes that have nothing to do with the health system.

    But then you aren't here to have an honest debate about what to do, you want to build up the straw man that we currently have free market health insurance and it isn't working. Failing that you will make a bunch of nonsensical statements about how markets can't provide health insurance; largely because people wouldn't buy the kind of insurance you want them to that will transfer away their wealth while covering things they don't want or are unwilling to pay for. While failing that you will just argue that our plan would never get enacted so we should just join you in your big government schemes, just like MLK should have given up on his dream of racial equality because the Chads of the civil rights era where skeptical that it could ever be achieved regardless of its merit.

    While of course pretending that your support for big government is based only on "the facts" that consist of poor logic, false comparisons between poor mixed systems, and your views of how the horse race politics of free markets would play out. The standard M.O. of a progressive who needs to hide his big government ideology behind half truths masquerading as objective facts in order to maintain the appearance of being smarter and more virtuous than the rest of us that entitles him to micromanage our lives with coercive force.

  • Sean W. Malone||

    What you mean to say, is that we "over pay", in order for our friends in Europe & Canada to underpay, right?

    It's just another one of the joys of the EU's price controls shoving costs onto us dumbass Americans. Of course, if we imposed price controls here, we would merely cause world-wide shortages of medicines, drugs and crush what's left of our ability to innovate technology (which... umm... is still by far greater than anywhere else in the world).

    So yeah... We overpay, I don't disagree - we're subsidizing our socialist brethren, and the alternative is basically a disaster.

    I mean, we also overpay due to ridiculous cartels, government-create oligopolies, god-awful incentive structures for "insurance" (as noted above), and a litany of mandates eliminating any and all competition and destroying prices - thus removing any and all information on relative scarcity that might have existed... But there's only so much ground I can cover here and it's just depressing.

    But as Tim says (below?), all of that strengthens, rather than weakens, the libertarian position.

  • ||

    We overpay by 50% and suffer far greater risk than anyone else, for care that is good but not great.

    We have the best outcomes in the world by a large margin. There's no place else you want to be sick. There's a reason why people form all those places you laud come here for health care if they can afford it.

    Also it's one of the few industries we have a trade surplus. All the money spent on health care in the US isn't Americans.

  • JohnD||

    Be careful what you wish for Alice.

    Actually if you don't hasve insurance you probably won't be admitted to the hospital in the first place

  • ||

    "I'd rather just eliminate insurance all-together and just pay when I need to go to Dr. or Hospital. "

    And you have that choice.

  • Frank||

    The problem with jacobs analysis is that he compares an individual policy for a younger, healthy person with a company health plan that covers the entire spectrum of the population. Any pre-existing condition blows those individual numbers sky high.

  • Mary STACK||

    Pre-existing condition = changing age brackets

  • ||

    Buy a policy that is guarenteed renewable at the same rates (maybe plus inflation) and stick with the same insurance company.

  • Mary STACK||

    Hazel, thanks you for the advice but we have a hsa plan and our insurer (Unicare) is leaving the state of Texas. We will be starting from scratch and my husband had the nerve to age into a new bracket.

  • ||

    If you were allowed to buy insurance across state lines, you could keep your Unicare insurance.

    Too bad the Democrats want to make sure that every stae remains a separate insurance cartel.

  • ||

    Governments have the highest capture rate of any money transfer system. Everyone should stop pretending it's zero.

    Government action is frictionless!
    And then there's the multiplier to consider.

  • Slutmonkey||

    Keynes was half right. Government programs DO have a multiplier. Unfortunately it's value is 0 < x < 1

  • DJP||

    The serious distortion of where incentives ought to be is the biggest problem with our health care system.

  • ||

    This article is radical in the truest sense of the word; it gets right to the root of the problem, while the Elephants and Jackasses argue over the stems and leaves. Most of the protests over "ObamaCare" don't even have a clue about this.

    We need health care reform. That is something we have come to realize. The question is how.

  • Alice Bowie||

    I can answer the HOW:

    -Eliminate Insurance

    Insurance is what truly brings up the costs as mentioned by others earlier: no one knows (or cares) how much the healthcare costs.

    Trust me, the laws of dimishing returns will kick in real quick and Doctors/Hospitals/Drug Companies will ONLY be able to charge what people can pay.

  • ||

    That's a good proposal, although I wouldn't argue eliminating insurance. Let me explain my position.

    Insurance was never meant to be a primary way to pay for anything, but as an emergency fund. Insurance is meant to cover costs when you find yourself unable to. When insurance companies were not directly involved with health care, they served this purpose.

    Insurance is for contigencies, not day to day expenses. That's what insurance is supposed to do.

  • Alice Bowie||

    I agree with that.

    And, I would be OK if insurance was for catastrophic situations like stroke, heart attack, cancer, aids, etc. I'm sure the premiums would be much much lower.

  • ||

    Within an hour you have changed your mind about banning insurance. I don't believe you've really thought this issue through very thoroughly.

    Do you still want to ban insurance for non-catastrophic incidents and why? Why shouldn't I be allowed to sell you an insurance plan that covers hangnails and why shouldn't you be allowed to buy it?

  • ||

    It's neither needful nor desired to eliminate insurance.

    1) Replace the employer based tax subsidy with a personal tax subsidy. Gradually devolve the subsidy.

    2) Invoke the commerce clause to remove insurance mandates and regulations and break up state insurance cartels.

    3) Tort reform. Loser pays.

    4) Remove police powers from the AMA/FSMB/LCME cartels.

    4a) While you are at it remove police powers from the ABA cartel.

    5) Devolve all public health programs. Medicare, medicaid, SCHIP, everything.

    6) Dual Option Safety Net. Only available to people at poverty level. Citizens may choose freely between the two but you may not leave the public option for two years if you join it. Funding may be changed but funding follows participation. Neither option may be funded independent of participation.

    6a) Direct subsidies to people at poverty level to help them afford health insurance. If they do not use the subsidies after a few years they keep the subsidy.

    6b) National Health Service. This is your basic euro style health bureaucracy.

  • ||

    Yet the Republicans, whose last president and last presidential candidate both proposed eliminating the tax incentives that encourage employers to offer insurance in lieu of higher pay, seem to have abandoned that idea. In fact, one of their main complaints about Obama’s plan was that it would reduce the number of Americans covered through their jobs.

    I wonder what sort of policies they might come up with if they went somewhere other than the cafeteria in the Capitol to find their "focus groups"?

  • Slutmonkey||

    I find it amusing that politicians on both sides are saying healthcare reform will “let you keep the plan you have”. Isn’t the whole point of reforming healthcare insurance, no matter how you want to reform it, to get people into NEW healthcare plans that are cheaper or provide more/better benefits? No one should care about healthcare insurance reform if it doesn’t DO anything.

  • Alice Bowie||

    I agree

  • Sean W. Malone||

    Or perhaps, more to the point... If both sides are so focused on letting people keep things as they are, isn't that kind of a de facto admission that a lot of their constituents are happy with the status quo?

    If nothing needs to change, then why change it?

    (Disclaimer: I do think things need to change...)

  • ||

    Personally, I'm mystified as to why the Democrats are obsessed with the number of "uninsured".

    Shouldn't the key factor be the nubmer of people who aren't getting health care, period? Why does it matter if they have insurance or not? The insurance just means that they have fewer bills. But if that's the problem, then a fund to help people who can't pay their medical bills would make more sense.

  • Colon Bowell||

    "In 2007 the average annual premium for nongroup health insurance was about $2,600 for single-person coverage and $5,800 for family coverage, compared to $4,500 and $12,100, respectively, for job-based plans."

    This has less to do with a lack of consumerism than it does with the fact that insurance carriers must insure all members in an employer group. This includes the sickies. This will naturally cause premiums to rise. In the individual market, sick people can not get coverage. This will explain the disparity in average premium.

  • Alice Bowie||

    But as Tristan Band explained above, if insurance only covered high-cost catastrophic illnesses and injuries...it wouldn't be the case. However, if insurance drops you once you get sick...what's the point?

    Look at homeowners insurance. I pay about $1,000 per year. I would only use it if the cost of repair was greater than $15,000. Anything less, I'd pay for it myself because I'd know that once i file a claim, I'll never get a $1,000 per year policy again as long as i live. And, it's not a life/death situation. I'll just simply have to go back to renting.

    Imagine what a mess homeowners insurance would be if they covered light bulbs. This is what we are doing with health insurance.

  • NAL||

    Amen.

    Even if we wanted to keep the current employment-based system, a better solution would be for the employer to pay for catastrophic coverage, and then put a pot of pre-tax money in a health savings account (HSA) to cover checkups, prescriptions, etc. If a person doesn't use his/her HSA, it keeps rolling over till death, at which point it can be taxed and put into his/her estate to be inherited.

  • NAL||

    Should say, "...then put a pot of pre-tax money in a health savings account (HSA) each year..."

  • Big Negro||

    "This is what we are doing with health insurance."

    Due to the incorrect belief by progressives that regular check-ups some how prevent death, which will ruduce over all costs.

    Stupid progressives.

  • Alice Bowie||

    Yes, the incorrect belief that regular check-ups somehow prevent death. Like pap smears, mamaograms, psa tests, blood work. How do u think people realize that they are sick?

    Stupid conservatives.

  • ||

    Preventive care is good for you, but it's not like you don't have an incentive to get it unless you have a $10 co-pay. If you don't want to get sick, you get regular checkups, that's just as true, if not more, when you only have a high-deductible plan.

  • ||

    It's the progressives that are trying to sell the idea that mammograms and self exam cause more harm than good. It's the progressives that are trying to sell the idea that PSA tests cause more harm than good.

    This will be used to decide for you what testing will be funded once you get your rationed health care you think you want.

    You need to check your premises.

    Also I doubt you were addressing a conservative.

  • ||

    Don't think for a minute anything a progressive does is to forestall death. To them death is the preferrable outcome for everyone except mass murderers.

  • ThinkOregon||

    ThinkOregon represents fiercely independent types who believe that the nation needs to return to some semblance of fiscal restraint. We hope you'll find that our position on such matters to be fairly clear and intellectually consistent. But with that said, the need for healthcare reform has never been more acute.

    But rather than buying into just the headline of Healthcare Reform, we must define what we really want Washington to deliver:

    1. COVERAGE: Some sort of universal, non-revokable, reasonable level of care that covers 100% of the citizens in the United States. It need not be the end-all, be-all of care, just good enough to deliver competent care in an efficacious manner during the times when American's really need it.

    2. COST: Something that costs far less than the exploding healthcare insurance premiums currently being paid by average taxpayers across the country. Full disclosure of my personal interests on this point: my family's premiums went up from $600/mo in a group plan ... which was cancelled by Regence BCBS. They converted us to a personal plan at over $800/mo, which just increased to nearly $1000/mo after the State of Oregon approved insurance rate increases.

    3. DO NO HARM: I am concerned that the reform that is likely to come out of Washington will not address either points 1 or 2 effectively ... and may actually increase healthcare costs -- or worse yet -- damage this fragile economy by hampering our return to full employment.

    Comments?

    http://thinkoregon.squarespace.....-want.html

  • NoSpillBlood||

    Where to start with this...I guess start in Disneyland:

    "100% Coverage"

    100% of what? A broke country with 20 Million illegals in it?

  • ||

    I prefer not to think of Oregon.

  • Medic001||

    Only thing going for it now is Goonies and 36 plant limit.

  • Chad||

    Jacob, you seem to be confused. In most states, there is plenty of competition by health insurers, both for corporate and individual clients. In the individual market, prices are FAR higher than the corporate one...much more than could ever be justified by any efficiency gains due to economy of scale (which really are neglible for this market anyway). Prices are only modestly different in high and low-competition states. The latter is a real problem, but a very small one.

    The reason corporate plans are so much cheaper than individual plans is that the corporate plans largely eliminate a serious market failure - adverse selection - which completely fubars the individual market. Throwing more people into the broken individual market won't address this failure in any way.

    The reason the employer-based scheme has persisted for so long is that it actually solves a serious problem for those that fall under its scope. However, that still leaves tens of millions at the mercy of a completely broken system. Every other nation has figured out how to beat this problem - insure everyone all the time at roughly the same level. It works.

  • Tim||

    I can buy a plan in Illinois for $30/month. In New York it will cost $150+/month. Check the quotes out for various states, in some it is quite affordable.

    The problem of adverse selection comes in when coverage mandates, community rating and other underwriting rules make health insurance so expensive as a means to transfer wealth and force people to pay for things the politicians and their lobbyists want them to get that only sick people will find it worthwhile.

    Yet insurers still do turn down people with pre exisiting conditions enough that it seems that insurers are preventing people from gaming the system.

    On the one hand people like Chad complain about adverse selection, and then turn around and complain about people with pre existing conditions not being covered. It's a blatant contradiction, and another attempt by him to disguise his clear desire for socialist and paternalistic wealth transfer systems behind arguments about facts and economics.

    While ignoring the fact that the giant tax deduction leads to more people buying employer based insurance shrinking the individual market which is limited to within a certain state and the prices determined in a large part by the various state mandates. It's like the state forcing everyone who didn't have a computer at work couldn't buy anything but an Alienware gaming machine, and then claiming that workplace provided computers are cheaper because selling them that way defeats some nebulous market failure contradicted by his own other arguments.

    Chad is not worried about only sick people buying health insurance in a free market, he's worried that healthy people won't buy coverage they don't need as means to transfer wealth to sick people and politically well connected providers. That's why he wants to force people to buy insurance, because it is the only way to sustain things like community rating and guaranteed issue; and why he likes employer coverage so much because the tax deduction and the "employer contribution" which every economist admits comes out of wages make such kinds of insurance appear much cheaper to the consumer. With cheaper being relative as many younger and healthy workers would likely be better off with higher wages, a catastrophic coverage plan and an individual health savings account than some comprehensive plan designed for the average 40 yr old.

  • Chad||

    The IL and NY plans are certainly different in what they cover and what deductibles, copays, and out-of-pocket maximums they have. If my memory is correct, NY has strong consumer protection laws with respect to this industry, so your chances of getting dumped for failing to sign a check are probably lower as well. Apples to apples comparisons would probably find that IL is a bit cheaper due to cost of living differences, but that is understandable.

    What "contradiction" are you talking about? The only known solution to the adverse selection problem is to insure everyone all the time in the same manner. It works everywhere else on earth and would work just fine here.

    And do you not realize that the ENTIRE DAMNED POINT of health insurance is to "transfer wealth" from healthy people to sick people? DUH.

  • Brian Trust||

    " And do you not realize that the ENTIRE DAMNED POINT of health insurance is to "transfer wealth" from healthy people to sick people? DUH."

    No, that's the point of government mandated health insurance. DUH.

  • ||

    "If my memory is correct, NY has strong consumer protection laws with respect to this industry ..."

    Which is a big reason why the plans cost more in NY. All that "protection" creates huge administrative costs that are socked to the consumers the laws and regulations are supposedly protecting. Kind of like paying "protection money" to the mob.

  • ||

    The only known solution to the adverse selection problem is to insure everyone all the time in the same manner.

    No, the only known solution is the solution which worked before government meddled in health care and which works in every other market where government stays out.

    Your 'solution' is expanding the policies which caused cost increases in the first place.

    You cannot subsidize something without increasing demand. You cannot increase demand without increasing price.

    You cannot reduce competition without increasing price.

    You cannot protect monopolies without increasing price.

    You cannot create cartels without increasing price.

    Yet these are everything you want expanded.

    But you know all this. You know this will increase price.

    If you didn't know it you'd be willing to try it, assured the system would get worse and you'd get what you really want.

  • Medic001||

    In order for me to get rid of my "employee" insurance, I have to sign a TEN page wavier and show proof of other coverage before my work would allow me to discontinue the insurance they "provide" Even though I pay 75% of My naturopath Dr visits since the insurance only covers 75$ of "alternative med."

    I've even been approached by my HR of all people as to why, I don't use the "Our" providers, and why I insist on going to a ND.

    I smiled and replied.

    "Well that information is patient -Doctor Privilege, and for which; you are nether."

    I’m sorry I don’t want to be seen by the Giant Hospital and Company clinics where my coworkers and government can access my medical history via the EMR system we have in place. My ND has staunchly REFUSED to go to paper charts.

    When I do leave this company, she has already worked out an Insurance free plan with our family. One that is FAR cheaper then what the company pays.

    Maybe we should just go to consumer choice. If Blue Cross and First choice had to fight as hard for my business as any other consumable (medicine is consumable) then we probably wouldn’t be dealing with the final rape and pillage of our rights.

    But hey that’s just my two pesos.

  • ||

    Private health care is just that. It is in the hands of private business. You wouldn't think of asking AT&T about rate increases. What makes the consumer think they have the right to question American Business practices?
    The government will make sure we all get trickled down on equally.

  • Beezard||

    Yup. As in Golden Showers.

  • Sean W. Malone||

    "You wouldn't think of asking AT&T about rate increases."

    Really? Cause it seems every single time I've ever had a cable or phone bill larger than expected, the first thing I've done is call companies like AT&T to figure out what the deal was. As a consumer, I'm free to question business practices all the time, and if I so choose (as I did in the case of Time Warner, not more than 3 weeks ago), I can reject their terms and find another option.

    When you're forced to pay taxes upon penalty of jail, you don't exactly get to do that. You "buy" their product not matter what... Whether or not you want to use it is irrelevant - you still have to pay for it. As an added bonus, that destroys any chance of acquiring feedback on whether or not what the government is doing is actually working... Monopolies with the power to collect revenue by force and beat up and imprison anyone who would like to keep what they've earned are fun like that.

    Normally we call this theft, but of course, since they call it "taxes", we're supposed to forget about that.

  • G Mc||

    There's nothing surprising about this at all. Policy wonks on both the left and right generally seek an eventual transition away from the current employer based system (in fact, it's been eroding for years, and will continue to do so in all probability).

    The reason both the two major political parties are not yet advocating such a policy is because... they're the two major political parties! Because of their relative positions of power, they have deemed such a policy politically inexpedient.

    You can sit on the sidelines and bitch all you want, but see how far you get proposing such a massive overhaul to "the people" or, better yet, to a Congressman. It's just the reality of governance in this country.

  • ||

    Has anyone published a report on exactly what the costs of healthcare under the new government mandates is actually going to cost? I'm looking for a breakout on how much I will have to pay.

  • abercrombie milano||

    My only point is that if you take the Bible straight, as I'm sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won't get the full deal by just doing regular skill english reading for those books. In other words, there's more to the books of the Bible than most will ever grasp. I'm not concerned that Mr. Crumb will go to hell or anything crazy like that! It's just that he, like many types of religionists, seems to take it literally, take it straight..

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  • رش مبيدات||

    "In 2007 the average annual premium for nongroup health insurance was about $2,600 for single-person coverage and $5,800 for family coverage, compared to $4,500 and $12,100, respectively, for job-based plans."

    شركة تنظيف خزانات بالرياض شركة تنظيف منازل بالرياض
    This has less to do with a lack of consumerism than it does with the fact that insurance carriers must insure all members in an employer group. This includes the sickies. This will naturally cause premiums to rise. In the individual market, sick people can not get coverage. This will explain the disparity in average premium.

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