An end to employer-based health insurance is exactly what the American healthcare market needs. Far from being a calamity, it would represent a giant step toward ending the current system’s worst distortions: skyrocketing premiums, lack of insurance portability, widespread ignorance of medical prices, and overconsumption of health services.
With more than 90 percent of private healthcare plans in the United States obtained through employers, it might seem unnatural to get health insurance any other way. But what’s unnatural is the link between healthcare and employment. After all, we don’t rely on employers for auto, homeowners, or life insurance. Those policies we buy in an open market, where numerous insurers and agents compete for our business. Health insurance is different only because of an idiosyncrasy in the tax code dating back 60 years – a good example, to quote Milton Friedman, of how one bad government policy leads to another.
Americans who would never think of using auto insurance to cover tune-ups and oil changes grew accustomed to having their medical insurer pay for yearly physicals, prescriptions, and other routine expenses.
When patients think someone else is paying most of their healthcare costs, they feel little pressure to learn what those costs actually are – and providers feel little pressure to compete on price. So prices keep rising, which makes insurance more expensive, which makes Americans ever-more worried about losing their insurance – and ever-more dependent on the benefits provided by their employer.
De-linking medical insurance from employment is the key to reforming healthcare in the United States.
[Emphasis added. —R]