6 ms·

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.",

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.", you would be laughed out of the room. I think we are running along some tracks that were laid long ago, and rather than all jumping off, some people in comfy Pullman cars are content with letting the train run off a cliff.

pnutjam 7y ago
to be fair, they think there are wings on their pullman cars. There aren't, but still...
delecti 7y ago
I happen to agree that the system is broken and getting worse, but that's not necessarily a good metric for whether you should change any given system now.
WrtCdEvrydy 7y ago
Individualism in America is the main cause... if you just got taxed and didn't have to worry about healthcare, people wouldn't care, but they all think that it could never happen to them.
- deleted 7y ago
  [deleted]
- CarriersSuck 7y ago
  Americans think the poor are slackers and they don't deserve anything. Even poor Americans think the "other" poor are slackers and don't deserve anything. Nothing will change until you change this mindset.
  - weberc2 7y ago
    This is a pretty bold statement. How many Americans do you know?
    - CarriersSuck 7y ago
      I've lived in the US all my life, so quite a few.
briffle 7y ago
I find it odd that some executive gets to pick which 401k and health insurance plans you get, and that you must pick from their few choices that allow you to have. I can see why the providers love it, they can target all their advertising, marketing, etc, at a few key people at large employers, but not sure how that benefits the average worker..
- SlowRobotAhead 7y ago
  You can get an individual 401K or IRA and make all your own choices. If you're talking about an employer matched 401K, I don't think it's unreasonable at all for them to select it.
  - jogjayr 7y ago
    > If you're talking about an employer matched 401K, I don't think it's unreasonable at all for them to select it. What's special about 401k matching that requires the employer to choose plans? My employer doesn't force me to have a checking account with a particular bank they chose if I want to receive my salary. They should be able to match contributions to any account anywhere.
    - SlowRobotAhead 7y ago
      I don’t know if you understand how 401K matching works on the backend. A lot of times the employers are capped on their own plans at a percentage rate that matches their employee’s participating. So matching is often in their best interest, esp at smaller companies. But, easier version is this is a perk, not your base salary. They are paying you with legal tender and there are freedoms associated to that. There is no such thing for perks. You aren’t entitled to make the administration choices for something they are gifting you.
      - jogjayr 7y ago
        > I don’t know if you understand how 401K matching works on the backend. A lot of times the employers are capped on their own plans at a percentage rate that matches their employee’s participating. I actually do not understand this. Could you please explain more? What does an employer being "capped on their own plans" mean? > But, easier version is this is a perk, not your base salary When I make a decision on a job offer, the 401k match, health insurance premium, free lunch and snacks etc. all factor in and they're all worth a certain amount of money. Money is money and how it's labeled, "perk" or "base", is irrelevant. If my employer ends 401k matching, I'll treat it as a pay cut mentally. My ultimate "fantasy" is to eliminate 401k altogether and instead let everyone contribute whatever the 401k annual limit is to an IRA. The employer can simply add matching funds to your IRA and you're free to have your retirement accounts anywhere you please.
justinmchase 7y ago
If you're designing a society from scratch and you end up with employers, insurance or money at all, then you probably are doing it wrong, lol
snowwrestler 7y ago
If I was designing a society from scratch, I don't think I would create "insurance" that is expected to pay for almost every routine, non-emergency, completely predictable cost just because it's a medical cost. The employer-provided system--which arose out of WWII-era wage controls, for those who don't know--has not only created the "have/have not" dichotomy in U.S. healthcare, it has also warped expectations about what "insurance" is supposed to cover--and broken normal pricing mechanisms.
clarkmoody 7y ago
Employer-provided healthcare is an aberration created by government interference in the market. > Employer-provided health insurance has its origin in a tax policy passed in 1943, which made insurance provided by employers tax free. At the time the United States was engaged in World War II and had enacted wage and price controls, preventing employers from competing for scarce labor using the normal mechanism of offering a higher salary. Instead, businesses used the availability of newly tax-subsidized healthcare as a means of differentiating themselves. > The tax advantages were made even more attractive and fully codified in the 1954 Internal Revenue Code. Over the next few decades, the government's subsidization of employer-provided health insurance lead to the dominance of that model of healthcare delivery...[1] So steps that got us here: 1. Enter into WWII 2. Enact price & wage controls 3. Create tax loophole for employer-provided plans 4. Enshrine loophole into the tax code These are not market phenomena, since government intervention got us here. [1] https://mises.org/library/whats-really-wrong-healthcare-industry https://mises.org/library/whats-really-wrong-healthcare-indu...
- heylook 7y ago
  Who cares? GP didn't say anything about "market" or "not-market". It's dumb that we're here. Full stop.
  - lordlimecat 7y ago
    It's dumb that we're here, but knowing the history suggests a possible solution. What if the government was able to pass legislation banning employer healthcare? I imagine the issue of healthcare coverage would resolve very shortly thereafter.

pnutjam 7y ago

to be fair, they think there are wings on their pullman cars. There aren't, but still...

delecti 7y ago

I happen to agree that the system is broken and getting worse, but that's not necessarily a good metric for whether you should change any given system now.

WrtCdEvrydy 7y ago

Individualism in America is the main cause... if you just got taxed and didn't have to worry about healthcare, people wouldn't care, but they all think that it could never happen to them.

deleted 7y ago
[deleted]
CarriersSuck 7y ago
Americans think the poor are slackers and they don't deserve anything. Even poor Americans think the "other" poor are slackers and don't deserve anything. Nothing will change until you change this mindset.
- weberc2 7y ago
  This is a pretty bold statement. How many Americans do you know?
  - CarriersSuck 7y ago
    I've lived in the US all my life, so quite a few.

briffle 7y ago

I find it odd that some executive gets to pick which 401k and health insurance plans you get, and that you must pick from their few choices that allow you to have. I can see why the providers love it, they can target all their advertising, marketing, etc, at a few key people at large employers, but not sure how that benefits the average worker..

SlowRobotAhead 7y ago
You can get an individual 401K or IRA and make all your own choices. If you're talking about an employer matched 401K, I don't think it's unreasonable at all for them to select it.
- jogjayr 7y ago
  > If you're talking about an employer matched 401K, I don't think it's unreasonable at all for them to select it. What's special about 401k matching that requires the employer to choose plans? My employer doesn't force me to have a checking account with a particular bank they chose if I want to receive my salary. They should be able to match contributions to any account anywhere.
  - SlowRobotAhead 7y ago
    I don’t know if you understand how 401K matching works on the backend. A lot of times the employers are capped on their own plans at a percentage rate that matches their employee’s participating. So matching is often in their best interest, esp at smaller companies. But, easier version is this is a perk, not your base salary. They are paying you with legal tender and there are freedoms associated to that. There is no such thing for perks. You aren’t entitled to make the administration choices for something they are gifting you.
    - jogjayr 7y ago
      > I don’t know if you understand how 401K matching works on the backend. A lot of times the employers are capped on their own plans at a percentage rate that matches their employee’s participating. I actually do not understand this. Could you please explain more? What does an employer being "capped on their own plans" mean? > But, easier version is this is a perk, not your base salary When I make a decision on a job offer, the 401k match, health insurance premium, free lunch and snacks etc. all factor in and they're all worth a certain amount of money. Money is money and how it's labeled, "perk" or "base", is irrelevant. If my employer ends 401k matching, I'll treat it as a pay cut mentally. My ultimate "fantasy" is to eliminate 401k altogether and instead let everyone contribute whatever the 401k annual limit is to an IRA. The employer can simply add matching funds to your IRA and you're free to have your retirement accounts anywhere you please.

justinmchase 7y ago

If you're designing a society from scratch and you end up with employers, insurance or money at all, then you probably are doing it wrong, lol

snowwrestler 7y ago

If I was designing a society from scratch, I don't think I would create "insurance" that is expected to pay for almost every routine, non-emergency, completely predictable cost just because it's a medical cost. The employer-provided system--which arose out of WWII-era wage controls, for those who don't know--has not only created the "have/have not" dichotomy in U.S. healthcare, it has also warped expectations about what "insurance" is supposed to cover--and broken normal pricing mechanisms.

clarkmoody 7y ago

Employer-provided healthcare is an aberration created by government interference in the market. > Employer-provided health insurance has its origin in a tax policy passed in 1943, which made insurance provided by employers tax free. At the time the United States was engaged in World War II and had enacted wage and price controls, preventing employers from competing for scarce labor using the normal mechanism of offering a higher salary. Instead, businesses used the availability of newly tax-subsidized healthcare as a means of differentiating themselves. > The tax advantages were made even more attractive and fully codified in the 1954 Internal Revenue Code. Over the next few decades, the government's subsidization of employer-provided health insurance lead to the dominance of that model of healthcare delivery...[1] So steps that got us here: 1. Enter into WWII 2. Enact price & wage controls 3. Create tax loophole for employer-provided plans 4. Enshrine loophole into the tax code These are not market phenomena, since government intervention got us here. [1] https://mises.org/library/whats-really-wrong-healthcare-industry https://mises.org/library/whats-really-wrong-healthcare-indu...

heylook 7y ago
Who cares? GP didn't say anything about "market" or "not-market". It's dumb that we're here. Full stop.
- lordlimecat 7y ago
  It's dumb that we're here, but knowing the history suggests a possible solution. What if the government was able to pass legislation banning employer healthcare? I imagine the issue of healthcare coverage would resolve very shortly thereafter.