The case for severing health care from employment entirely

09 Jul 2013 03:10 pm
Posted by: Donna

I have long thought employer based health coverage was a colossally dumb idea, and not simply because it’s immoral that sick people should go without care because they’re unemployed or their job doesn’t come with insurance. While that moral argument, in itself, is sufficient, employer based health insurance is unfair on its own merits. When equal pay for women was passed in 1963, one of the main arguments against it was that men should be paid more because they had families to support. Secretary of Labor W. Willard Wirtz scoffed at that, saying that people should be paid for the work they do, not the number of dependents they had. Employer-based health coverage is clearly a violation of the principle of equal pay for equal work. Put another way, you can have employees at the same company doing the same job at the same salary but if they get insurance coverage through work their overall compensation can vary by thousands of dollars between them, due to family size and personal health characteristics. Furthermore, labor economists say that money going to benefits is money that comes directly out of wages, which means that workers with low health care costs are earning less than they would be were it not for their coworkers with higher health care costs. When I’ve raised the possibility of dismantling employer-based insurance to people, the objections I tend to get are that it would be highly difficult to do since it’s so entrenched, people are used to it, and employers like it because it’s a good recruiting and retention tool. But that doesn’t make it right.

And now some religious business owners are making an even more rock solid case for breaking up the employer/health care relationship through their petulant hissyfit over the contraception mandate in Obamacare. These private businesses are suing to be included in the Obama administration’s exemption of churches and groups with a religious mission from having to cover contraceptives in employee health plans. Frankly, the Administration should never have exempted any employer, not even a church, from having to cover women’s basic preventive health care in insurance plans. If employers don’t want to provide adequate coverage to their female employees because the thought of them having non-procreative sex gives them the vapors, then they should get out of the insurance business entirely and find other ways to attract talented workers. These employers basically want it both ways: they want the benefits that accrue to them for having health insurance plans (attracting talent and tax breaks) while imposing their particular religious views on their workers and engaging in some rather egregious gender discrimination. As Jill Filipovic put it in her recent Guardian column:

That’s the face of “religious freedom” today, according to the radical right: that is, not simply the freedom to practice your own religion, but the freedom to limit the rights and choices of anyone over whom you hold a modicum of power.

The sexual authoritarians can’t ban birth control outright so they want to get to women’s access through their jobs. So long as we insist on keeping this unwieldy, unfair, and antiquated alliance of health insurance and employment in place the Religious Right has endless opportunities to do so under the guise of “religious freedom” and protecting private business owners. This should be viewed as the last straw. It’s time for employer based health insurance to go.


  1. Comment by BruceJ on July 9, 2013 6:23 pm

    Severing healthcare from employment will only work if there it’s a robust and affordable healthcare system in place is merely a recipe for people dying in the street. You will NEVER convince the conservatives and the insurance companies to move to such a system unless it guaranteed strip mining the 99% of every last penny.

    Also, do you thing that ANY employer will raise employees salaries to cover the new costs of insurance on the open market? HA!

    Absent a real public health care system that severs the profit motive for providing healthcare this would only be a disaster for the vast majority of the public.

  2. Comment by Timmys Cat on July 9, 2013 8:09 pm

    If the health-insurance corporations have caused the crisis in their industry and, if they wanted to , they could fix it tomorrow. All they would have to do is cover everyone. That is what real capitalists would do. They would see the 50 million uninsured people in this country, not as a massive pool of bad risk, but as a potential market, ripe for the picking.

    This is why the single pay insurance idea makes so much more sense from just the business side of the industry. With the economy still slow and unemployment still down, there are fewer employees, hence fewer insured employees. Why would a business tie their growth and profits to a dwindling market? Not to mention the huge bureaucracy need to service the thousands of small businesses each with their own plans and their inevitable problems.
    By selling directly to individuals without employer interference, not only does the pool of potential customers grow immensely, the costs of these new customers could be spread over an enormous area, helping keep plans affordable.
    As far as the contraceptive straw man, individuals could chose a plan that does not cover these items, without using their minority belief to put a strangle hold on a service the majority wants.
    This isn’t socialism or communism. It’s capitalism taking hold of a new market without the interference of self serving outside influences.


  3. Comment by Phoenix Justice on July 10, 2013 3:03 am

    I remember reading a few years back about how American companies could all become stronger (and more competitive globally) by supporting single payer universal health care.

  4. Comment by Mike Slater on July 10, 2013 3:26 pm

    Single payer universal health care is nothing more than government health care.

  5. Comment by Timmys Cat on July 10, 2013 3:29 pm

    Ah yes, it”s all about proctecting a business owners religious rights, nothing to do with the oppression of women.

    How Much Does a Vasectomy Cost?

    Vasectomies are covered by about 70 percent of health insurance plans, according to the Association of Reproductive Health Professionals. According to the Arizona Center for Vasectomy & Urology, insurers that regularly cover vasectomies include PacifiCare, BlueCross BlueShield, United Healthcare and Medicare. However, plans vary, so it is important to check with your insurer

    I think it simply boils down to a fear of womens sexuality that manifests itself as anger.
    A natural response to fear is to try to control, through restraint, intimidation or even violence, what is feared.


  6. Comment by Timmys Cat on July 10, 2013 3:47 pm

    Do marchers stand outside urologists offices carrying crosses and calling for the rights of the unborn could be babies?

    Are men spat upon and cursed as they go to their doctor?

    Will there be forced ultrasounds before this procedure?

    Will the doctor performing the procedure have to have hospital admitting credentials?

    Anyone who says this is not about the suppression of women is lying. Period.

  7. Comment by todd on July 10, 2013 4:51 pm

    Mike Slater – you are quite confused. Single payer universal health care is government health *insurance.* No need to thank me for clearing that up for you.

  8. Comment by Mike Slater on July 11, 2013 12:36 pm

    Todd, you can call it whatever you want. It’s still government (i.e. taxpayer funded.)

  9. Comment by todd on July 11, 2013 3:12 pm

    Mike Slater – Of course it is. Do you have any other tautologies for us? Water is wet? Fire burns?

  10. Comment by Mike Slater on July 12, 2013 1:35 pm

    Todd, how’s this, taxpayers get screwed.

  11. Comment by Suzanne on July 12, 2013 3:23 pm

    Good column Donna. I have enjoyed contemplating the argument.

    Timmys Cat it is good to see your comments too as well as all others.

  12. Comment by Timmys Cat on July 13, 2013 9:17 am

    Tank you Suzanne, good to be back.

    I heard a rumor the other day that all Sun City Republicans were going to band together and formally reject all Medicare and Medicade payments to their doctors. Since these programs are taypayer funded they thought it would be hypocritcal to accept them and opted to pay cash like the poor uninsured have to.
    Just a rumor I guess.

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