Julie Appleby has written an article for USA Today discussing the decline of employer-sponsored health insurance in the US. As group health insurance premiums continue to rise, it’s impractical to expect employers to keep absorbing the costs. More and more employers are collecting larger premium percentages from their employees, and the number of employers who offer group health insurance is down to 60%, from 69% in 2000.
If we really think about it, having health insurance tied to employment doesn’t make much sense. People change jobs and even careers many times in their working lives now, unlike previous generations that tended to stick with the same employer for a lifetime of work. Health insurance premiums have become a major budget issue for employers, which is reflected in the declining number of companies that offer coverage to their employees.
There is something intrinsically unfair about a system that allows employers to pick the type of coverage – if any – that they will offer to their employees, along with how much of the premiums they will pay. And businesses realize that they can cut costs significantly by hiring more part-time workers who don’t qualify for benefits like health insurance.
Then there’s the dilemma that people with pre-existing conditions face: in most states – including here in Colorado – individual health insurance is medically underwritten, so group health insurance is the best bet for a person with pre-existing conditions. But what if their employer stops offering coverage, or they lose their job, or want to make a career change but can’t because of health insurance? Health insurance should not be tied to employment. Yes, we have COBRA, but have you ever looked at the premiums that an average family will pay for 18 months of continued group coverage? The financial burden is huge – we’ve seen lots of COBRA premiums that are higher than our mortgage payment. And what do we do after a person has exhausted COBRA? If they have been hired by another company that offers group health insurance, all is well, but if not, they will have to find individual health insurance, which is almost always contingent upon being healthy.
Attaching health insurance to employment leaves too many cracks for people to fall through. There’s too much luck involved in finding a good job and making sure that it also offers health insurance, and then keeping your fingers crossed that it continues to do so.
We need to move away from an employer-sponsored health insurance system, towards one that is more equitable for everyone. Health insurance should be a permanent part of a person’s life – not something that comes and goes depending on employment. Whether we move towards a system where everyone buys their own health insurance or a single payer system run by the government, we need to work at making it as fair and all-encompassing as possible. Everyone should have health insurance, and whether they work as a Wall Street banker or a taxi driver or a waitress should be immaterial.