4 ms·

I agree that starting a business isn't for everyone. I'm doubtful that I would enjoy it, but I would like to be an early employee at a company. If that compan

I agree that starting a business isn't for everyone. I'm doubtful that I would enjoy it, but I would like to be an early employee at a company. If that company can't afford health coverage, then I can't take that risk for my family. It just baffles me that health coverage is so tied to where you work. What if you could only send your kids to the schools that your employer selected, or eat at the restaurants the your company had a deal with? It's just weird. I don't know if government provided insurance is the solution, but employer provided just doesn't make sense as the only solution.

jkeel 14y ago
What I think would be a better solution that could fit in everyone's worldview (those that want a more socialized health care system and those who don't want a powerful federal government) is to have cities provide a public health insurance option that a person or business could buy into. I think that the risk pool would be large and the members would be local (thus giving more rights to local communities rather than the federal government). I think it could then encourage cities to be more healthy cities (less pollution, more activities for locals, encourage walking/biking rather than driving) in order to drive down health care costs for their citizens. Being a healthier city would then encourage people to move to there thus increasing the risk pool. Citizens wouldn't be required to purchase through them but the plans could still be managed by private companies like Aetna, Cigna, etc. so that the plans could be used when local citizens travel to other parts of the country.
- astrodust 14y ago
  You could do it on a state-by-state basis, where each may provide a differing level of coverage but all of them would provide at least a base-line care for citizens that are residents of that state. This could lead to a form of "competition" where some states might provide perks to help encourage people to migrate there from other parts of the country or make it more attractive for prospective employers. This is the way it's done in Canada. Each province has differing rules as to what's covered, but emergency treatment and preventative care is never impaired by cost or a lack of insurance.
- Anechoic 14y ago
  have cities provide a public health insurance option that a person or business could buy into. That only works if all cities have plans, otherwise you can find yourself trapped staying in a city that same way that one might find himself trapper working for an employer.
  - jkeel 14y ago
    Good point! I guess I was looking at it as an advantage and other cities would start their own program to compete just like employers do today. I just figured people tend to not move geographically as much as they change jobs.
yummyfajitas 14y ago
Providing health insurance to employees is a massive tax dodge. Providing schools to their children (or auto insurance, etc) is not. If employer-sponsored housing was a similar tax dodge, you'd see employers bidding for employees with salary + rent free living.
- kgrin 14y ago
  Interestingly enough, according to one post I read just today, that's exactly what Chinese factory employers are doing: http://www.slate.com/blogs/moneybox/2012/10/18/foxconn_factory_photos_is_investment_spending_masking_wages.html http://www.slate.com/blogs/moneybox/2012/10/18/foxconn_facto...
  - yareally 14y ago
    It actually goes back much farther than that. The Krupp family provided their workers with free housing, schools, health care, etc. At the same time, it bound the employees to their employer for life, more or less. Krupp established the Generalregulativ as the firm’s basic constitution. The company was a sole proprietorship, inherited by primogeniture, with strict control of workers. Krupp demanded a loyalty oath, required workers to obtain written permission from their foremen when they needed to use the toilet and issued proclamations telling his workers not to concern themselves with national politics. In return, Krupp provided social services that were unusually liberal for the era, including "colonies" with parks, schools and recreation grounds - while the widows' and orphans' and other benefit schemes insured the men and their families in case of illness or death. Essen became a large company town and Krupp became a de facto state within a state, with "Kruppianer" as loyal to the company and the Krupp family as to the nation and the Hohenzollern family. Krupp’s paternalist strategy was adoped by Bismarck as government policy, as a preventive against the Social Democratics. http://en.wikipedia.org/wiki/Krupp#Overview http://en.wikipedia.org/wiki/Krupp#Overview Similarly, in coal mines across the US for years, they would do the same thing. They would pay the workers in "script" so they could not earn real money and thus, escape the life of being a coal miner. That was what the famous song by Tennessee Ernie Ford was about (http://en.wikipedia.org/wiki/Sixteen_Tons http://en.wikipedia.org/wiki/Sixteen_Tons). Many other industries, such as trucks/shipping in the UK also paid employees in script, thus forcing them to only buy from the company stores. http://en.wikipedia.org/wiki/Truck_system http://en.wikipedia.org/wiki/Truck_system
Evbn 14y ago
In most of the US your public school is fixed by your address, so people have to uproot and move to change schools.
goggles99 14y ago
>It just baffles me that health coverage is so tied to where you work. What if you could only send your kids to the schools that your employer selected, or eat at the restaurants the your company had a deal with? It's just weird. I don't know if government provided insurance is the solution, but employer provided just doesn't make sense as the only solution. Does it baffle you that the school location for your kids is so tied to where you live? Does it baffle you that your employer decides how much it wants to pay you as well? How about what size your desk is or how up to date your computer at work is. How about your 401k match? Bonus size? Vacation days? Promotions? Who your boss is? Dress code? Where does it end? Do you think every employer could actually afford to let you get the health care plan and provider of your choice? You are free to look for another job at a company who offers health care from the provider that you wish to use. Let me ask you though. What if your employer would give you the money they put toward your health care to choose the provider of your choice (even if you had to pay the difference for any shortcoming)?
- ams6110 14y ago
  My first job with a large consulting firm offered exactly your last option. You had benefit "flex dollars" on top of your salary and you could shop among the plans they offered or you could take the cash and go buy your own (or not). Of course due to group rates their plans were cheaper than what you could buy as an individual, but not by a lot, and if you were a single young male (i.e. didn't need maternity coverage) you might even do better. I do think we'd be much better off if health insurance was not seen as an employment benefit but as aomething you are responsible for yourself, like car insurance, rent, utilities, groceries, clothes, and all the other necessities of life. (I'm not saying that the government should provide it or administer it though).
  - TallGuyShort 14y ago
    In theory I agree with you, but there would need to be a more even playing field. I used to buy my own insurance, and I would get screwed every time. There was always some little loophole they gave me as to why the visit I pre-approved with ended up not being coverable. Am I supposed to have the resources to try beat them in court myself? No, so I switched companies and told them why. This happened twice. Now I'm on my employers plan with a successful company. Everything gets covered no-questions-asked... The argument against social medicine is inevitable injustice and slowness of beaurocracy, but what difference is an insurance company that doesn't really care if they have my business or not? If they're small enough to care, can you trust them with big financial commitments?

jkeel 14y ago

What I think would be a better solution that could fit in everyone's worldview (those that want a more socialized health care system and those who don't want a powerful federal government) is to have cities provide a public health insurance option that a person or business could buy into. I think that the risk pool would be large and the members would be local (thus giving more rights to local communities rather than the federal government). I think it could then encourage cities to be more healthy cities (less pollution, more activities for locals, encourage walking/biking rather than driving) in order to drive down health care costs for their citizens. Being a healthier city would then encourage people to move to there thus increasing the risk pool. Citizens wouldn't be required to purchase through them but the plans could still be managed by private companies like Aetna, Cigna, etc. so that the plans could be used when local citizens travel to other parts of the country.

astrodust 14y ago
You could do it on a state-by-state basis, where each may provide a differing level of coverage but all of them would provide at least a base-line care for citizens that are residents of that state. This could lead to a form of "competition" where some states might provide perks to help encourage people to migrate there from other parts of the country or make it more attractive for prospective employers. This is the way it's done in Canada. Each province has differing rules as to what's covered, but emergency treatment and preventative care is never impaired by cost or a lack of insurance.
Anechoic 14y ago
have cities provide a public health insurance option that a person or business could buy into. That only works if all cities have plans, otherwise you can find yourself trapped staying in a city that same way that one might find himself trapper working for an employer.
- jkeel 14y ago
  Good point! I guess I was looking at it as an advantage and other cities would start their own program to compete just like employers do today. I just figured people tend to not move geographically as much as they change jobs.

yummyfajitas 14y ago

Providing health insurance to employees is a massive tax dodge. Providing schools to their children (or auto insurance, etc) is not. If employer-sponsored housing was a similar tax dodge, you'd see employers bidding for employees with salary + rent free living.

kgrin 14y ago
Interestingly enough, according to one post I read just today, that's exactly what Chinese factory employers are doing: http://www.slate.com/blogs/moneybox/2012/10/18/foxconn_factory_photos_is_investment_spending_masking_wages.html http://www.slate.com/blogs/moneybox/2012/10/18/foxconn_facto...
- yareally 14y ago
  It actually goes back much farther than that. The Krupp family provided their workers with free housing, schools, health care, etc. At the same time, it bound the employees to their employer for life, more or less. Krupp established the Generalregulativ as the firm’s basic constitution. The company was a sole proprietorship, inherited by primogeniture, with strict control of workers. Krupp demanded a loyalty oath, required workers to obtain written permission from their foremen when they needed to use the toilet and issued proclamations telling his workers not to concern themselves with national politics. In return, Krupp provided social services that were unusually liberal for the era, including "colonies" with parks, schools and recreation grounds - while the widows' and orphans' and other benefit schemes insured the men and their families in case of illness or death. Essen became a large company town and Krupp became a de facto state within a state, with "Kruppianer" as loyal to the company and the Krupp family as to the nation and the Hohenzollern family. Krupp’s paternalist strategy was adoped by Bismarck as government policy, as a preventive against the Social Democratics. http://en.wikipedia.org/wiki/Krupp#Overview http://en.wikipedia.org/wiki/Krupp#Overview Similarly, in coal mines across the US for years, they would do the same thing. They would pay the workers in "script" so they could not earn real money and thus, escape the life of being a coal miner. That was what the famous song by Tennessee Ernie Ford was about (http://en.wikipedia.org/wiki/Sixteen_Tons http://en.wikipedia.org/wiki/Sixteen_Tons). Many other industries, such as trucks/shipping in the UK also paid employees in script, thus forcing them to only buy from the company stores. http://en.wikipedia.org/wiki/Truck_system http://en.wikipedia.org/wiki/Truck_system

Evbn 14y ago

In most of the US your public school is fixed by your address, so people have to uproot and move to change schools.

goggles99 14y ago

>It just baffles me that health coverage is so tied to where you work. What if you could only send your kids to the schools that your employer selected, or eat at the restaurants the your company had a deal with? It's just weird. I don't know if government provided insurance is the solution, but employer provided just doesn't make sense as the only solution. Does it baffle you that the school location for your kids is so tied to where you live? Does it baffle you that your employer decides how much it wants to pay you as well? How about what size your desk is or how up to date your computer at work is. How about your 401k match? Bonus size? Vacation days? Promotions? Who your boss is? Dress code? Where does it end? Do you think every employer could actually afford to let you get the health care plan and provider of your choice? You are free to look for another job at a company who offers health care from the provider that you wish to use. Let me ask you though. What if your employer would give you the money they put toward your health care to choose the provider of your choice (even if you had to pay the difference for any shortcoming)?

ams6110 14y ago
My first job with a large consulting firm offered exactly your last option. You had benefit "flex dollars" on top of your salary and you could shop among the plans they offered or you could take the cash and go buy your own (or not). Of course due to group rates their plans were cheaper than what you could buy as an individual, but not by a lot, and if you were a single young male (i.e. didn't need maternity coverage) you might even do better. I do think we'd be much better off if health insurance was not seen as an employment benefit but as aomething you are responsible for yourself, like car insurance, rent, utilities, groceries, clothes, and all the other necessities of life. (I'm not saying that the government should provide it or administer it though).
- TallGuyShort 14y ago
  In theory I agree with you, but there would need to be a more even playing field. I used to buy my own insurance, and I would get screwed every time. There was always some little loophole they gave me as to why the visit I pre-approved with ended up not being coverable. Am I supposed to have the resources to try beat them in court myself? No, so I switched companies and told them why. This happened twice. Now I'm on my employers plan with a successful company. Everything gets covered no-questions-asked... The argument against social medicine is inevitable injustice and slowness of beaurocracy, but what difference is an insurance company that doesn't really care if they have my business or not? If they're small enough to care, can you trust them with big financial commitments?