Time to cut employers out of the healthcare loop

Daniel Froomkin asks one of the right questions in the wake of yesterday’s ruling in the Hobby Lobby case: “Why should employers have anything to do with people’s health insurance anyway?”

Post by Dan Froomkin.

I alluded to this argument on Facebook yesterday, but Emily Divito does a more thorough job than I did. Her argument: that the Hobby Lobby challenge and decision were, to some degree, set in motion by the passage of the Affordable Care Act’s short comings. The ACA, she says, “is fatally flawed” and it “is clear we now need a public, single-payer health care system.”

The Hobby Lobby case, she writes, “exposes the primary and unavoidable weakness of the ACA.”

Because it still requires that private companies enforce what should be considered public policy – health care – the ACA will always face potential legal contention with the personally held religious beliefs of employers.

Uwe Reinhardt, a health-care economist at Princeton, calls our approach illogical and says the Hobby Lobby ruling “raises the question of why, uniquely in the industrialized world, Americans have for so long favored an arrangement in health insurance that endows their employers with the quasi-parental power to choose the options that employees may be granted in the market for health insurance.” The choices often are proscribed based on the size of the company, he said, and “the arrangement induces employers to intervene in many other ways in their employees’ personal life – for example, in wellness programs that can range from the benign to annoyingly intrusive, depending upon the employers’ wishes.”

And what kind of health “insurance” have Americans gotten under this strange arrangement? Once again, uniquely in the industrialized world, it has been ephemeral coverage that is lost with the job or changed at the employer’s whim. Citizens in any other industrialized country have permanent, portable insurance not tied to a particular job in a particular country.

Nor has this coverage been cheap by international standards. American employers can be said to have played a major role in driving up health spending per capita in the United States measured in internationally comparable purchasing power parity dollars, to roughly twice the level found in other industrialized populations. As a recent article in the health policy journal Health Affairs reported, a decade of health care cost growth wiped out real income gains for the average American family during the period from 1999 to 2009.

The ACA offers some improvement over what had existed — though its full impact is still difficult to gauge. But it still leaves most of what is wrong with the American health care system in place. In the end, that is the real problem with the contraception mandate and much of the rest of the ACA.

While this issue has been framed as a fight between women’s rights and religious freedoms — which it is, at least to a degree — and the outrage over the court’s decision is real and warranted, we should use the decision to put single-payer back on the table. If we don’t want our employers making these decisions, then we should cut them out of the process.

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Author: hankkalet

Hank Kalet is a poet and freelance journalist. He is the economic needs reporter for NJ Spotlight, teaches journalism at Rutgers University and writing at Middlesex County College and Brookdale Community College. He writes a semi-monthly column for the Progressive Populist. He is a lifelong fan of the New York Mets and New York Knicks, drinks too much coffee and attends as many Bruce Springsteen concerts as his meager finances will allow. He lives in South Brunswick with his wife Annie.

5 thoughts on “Time to cut employers out of the healthcare loop”

  1. I, for once, agree.I would say why should Gooferment or its corporations be in charge of \”health\”, \”health care\”, \”health care insurance\”, or something else?Look at \”life insurance\”. \”Cheap\”, easily available, and virtually unregulated.Even \”car insurance\” is relatively the same when compared to \”health insurance\”.When you think about it, the current \”system\” comes from the WW2 wage and price controls. There, the Gooferment, created the problem and \”they\” keep \”rescuing\” us from the problem they created.Could we at least consider an alternative?If the problem was \”uninsured\”, (which I dispute), then could \”we\” NOT bought every uninsured person a policy and avoided the financial and systematic débâcle that was Obamacare?I think that you liberals think that only the Gooferment can solve \”problems\”. When in actuality, it causes the problem it seek to proclaim it's solving.

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  2. We should have single payer or Medicare for all but it was not politically possible given that the insurance industry and the health care industrial complex have a stranglehold on government and the legislators. Profits are more important than people's health in the USA. In this country, if you are under 65 and can't afford insurance but don't qualify for Medicaid, then tough luck, just die (though the ACA has alleviated the situation). Before Medicare, older people could not get timely needed care. They suffered in silence or just died. Medicare has saved lives and given older people over 65 a shot at decent medical care.

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  3. Countries like Germany, Switzerland and Holland have universal health care but it is quite different from the UK's health care system. Germany supplies health care through private and public options and many people do get health care through their employers. The difference is that the insurance industry is regulated and is not allowed to get obscene profits as they do in the US.

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