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John Geyman

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Employer-Sponsored Health Insurance: Time to Pronounce it Dead

Posted: 10/14/11 06:00 PM ET

Although many may think today that we have always had employer-sponsored health insurance (ESI) in this country, that is not the case. While some companies offered coverage in the 1930s, the basic concept gained momentum only after the start of World War II. The war effort required a rapid buildup of industrial capacity in the face of a severe labor shortage as many men went off to war. Employers needed a healthy workforce, and needed to compete for workers. Federal wage and price controls made it difficult for them to offer higher pay, so that ESI became an important recruitment tool. Employers were helped by an IRS ruling that made their costs of ESI tax-deductible; these benefits also were not taxable for employees. (Somers, AR, Somers, HM. Health and Health Care: Policies in Perspectives. Germantown, MD. Aspen Systems Corporation, 1977, pp 109-11)

We have had about a 75-year experiment with ESI, but its track record is one of continued decline over the last 30 years -- fewer people covered, less coverage for more costs, and less value of that coverage. ESI was more an accident of history than a well-planned financing system for health care. Today, rapidly accelerating costs are the Achilles heel for ESI, both for employers and employees, as they are for the entire market-based 'system' itself.

ESI arose at a very different time than today. Beyond the labor shortage, American business was dominant with little concern about foreign competition, and labor unions were strong. Many workers could reasonably expect to hold their jobs for their working life.

But those days are long gone. Most workers these days have multiple jobs, even careers, over their working years. By 2002, only about one-half of employed men or women could claim to have held their job for ten years. (Tejada, C. A special news report about life on the job--and trends taking shape there. Wall Street Journal, September 25, 2002: B5) Loyalty between employers and employees has dropped way off in recent years, part-time workers are not eligible for benefits, and union membership hovers around 10 percent of the workforce.

These markers show a long decline of ESI, as well as the decreasing benefits to enrollees:

  • In 1980, more than 70 percent of employees working more than 20 hours a week were covered; that number fell to 56 percent by 2005, with coverage already unraveling as employers shifted from defined-benefits to defined-contributions. (Mishel, L, Bernstein, J, Allegretto, S. The State of Working America 2004/2005. Ithaca. Cornell University Press, 2005)
  • Over the 13-year period that Kaiser Family Foundation has been tracking premiums for ESI, employee contributions have increased by 168 percent as compared to increased wages of 50 percent and inflation of 38 percent. One-half of employees of companies with fewer than 200 workers now have a deductible of $1,000 or more for single coverage as compared to 16 percent five years ago. (Altman, D. Rising health costs are not just a federal budget problem. Kaiser Family Foundation, September 27, 2011)
  • Premiums for family plan ESI coverage have gone up by 9 percent this year, triple the increase in 2010; family premiums now total $15,073 on average, of which $4,129 is paid by employees (consider that these costs may have little to do with what employees end up paying for their health care, especially those who are older or have one or more chronic diseases!). (Appleby, J. Costs of employer insurance plans surge in 2011. Kaiser Health News, September 27, 2011)
  • In 2012, average annual employee premiums for health insurance are expected to go up by another 10.6 percent. (Japsen, B. Companies pass on more of health costs to workers. New York Times, October 3, 2011: B3)
  • Many of the so-called ESI plans cannot really be called insurance, since they now pass along so much of the costs of care to enrollees even as the extent of coverage withers away. Retiree and disability coverage are being cut by many companies, and their employees are increasingly being herded into lower-cost networks of providers with quality of care in question. As Dr. Don McCanne, Senior Health Policy Fellow for Physicians for a National Health Program, sums up: "The new national standard in health insurance is unaffordable under-insurance". (McCanne, D. Quote-of-the-Day, September 13, 2011)
  • Beyond the increasing unaffordability of ESI for employees, employers -- big and small -- have the same problem with no end in sight. General Motors says it spends about $5 billion on health care expenses each year, adding between $1,500 and $2,000 to the sticker price of every car out the door. That burden is many times higher than what neighboring competitors just across the border in Canada pay for health care, rendering GM much less competitive in global markets. (Johnson, T. Healthcare costs and U.S. competitiveness. Council on Foreign Relations, March 23, 2010) Small business (with fewer than 100 employees), accounting for about 40 percent of the private U.S. workforce, cannot keep up with the growing cost of ESI coverage. The small employer market has been one of the most profitable for private insurers, with premiums climbing by 74 percent between 2001 and 2008.

    The so-called health care reform legislation, the Affordable Care Act of 2010, will not fix this problem. Having handed over a combined employer and individual mandate to the private insurance industry, with minimal regulatory clout, the bill (if and when it is implemented) lacks any semblance of cost containment measures. Federal waivers already give employers whatever they want, as illustrated by a recent HHS ruling that allows McDonald's Corp. to keep its very low limits of annual coverage of just $2,000 a year. (Adamy, J, Johnson, A. Rules eased for some health plans. Wall Street Journal, November 23, 2010: B1) Whereas President Obama promised that the average American family would save $2,500 a year on health insurance premiums, the Congressional Budget Office later projected that their cost would only increase. (Hemingway, M. Obama promised $2,500 health care savings; CBO says plan is $2,300 price increase. Washington Examiner on line, March 10, 2010)

    M. Obama promised $2,500 health care savings; CBO says plan is $2,300 price increase. Washington Examiner

    Adding all of this up, we can only conclude that employer-sponsored health insurance, and the overly expensive, wasteful private insurance industry upon which it is based, is in its death throes. As the Vice chairman of Ford Motor Co. said in 2004: "Right now the country is on an unsustainable track and it won't get any better until we begin -- business, labor and government in partnership--to make a pact for reform. A lot of people think a single-payer system is better." (Downey, K. A heftier dose to swallow. The Washington Post, March 6, 2004). Some 50 years ago, Walter Reuther, as the national president of United Auto Workers, saw the future this way:

    "When American corporations reached the point where they couldn't make their business more efficient without making it less profitable, when their dependency ratios soared to unimaginable heights, when they got tens of billions behind in
    their health-care obligations, when the cost of carrying thousands of retirees forced them to stare bankruptcy in the face, they would come around to the idea that the markets work best when the burdens of benefits are broadly shared." (Reuther, W. as cited by Gladwell, M. The risk pool: What's behind Ireland's economic miracle and GM's financial crisis? The New Yorker, August 28, 2006, p 35)

    We have to move beyond denial of this problem, and rein in markets that fail the public interest. We can no longer afford ESI or the private insurance industry. Unless we move past political gridlock on this big issue toward a new partnership between labor, business and government, they can bankrupt us all!

    There is an answer, of course, in plain sight -- not-for-profit, improved Medicare for All, funded by broadly shared progressive taxes that cost patients, families and business less than they are now paying while assuring universal coverage in a less bureaucratic and more accountable system.

    Author of Do Not Resuscitate: Why the Health Insurance Industry is Dying and How We Must Replace It and Hijacked! The Road to Single-Payer in the Aftermath of Stolen Health Care Reform (Common Courage Press, 2008 and 2010)

    To buy books from John Geyman visit: http://www.copernicus-healthcare.org

     
 
 
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thereisonlyoneparty
more amazing than you
12:30 AM on 10/20/2011
For being an expert in public health the good doctor avoids discussing costs of health care.

He calls for a new model while ignoring the fundamental differences in those models: less care (no reduction in outcomes) and less compensation for practitioners.

He discusses increasing premiums, but does not mention that rates of profit for insurance companies are pretty much fixed.   Insurers make about %3 profit of all money that flows through them.  $100 yields about $3 in profit.  $200 yields about $6 in profit.  The percentage appears to be fixed.

If cost is the problem, then address cost.  Address the unnecessary treatment and the overcompensation of some health care workers (mostly physicians).  Address the belief that more care means being healthier.
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cyclone70
if there was a time to reach for the pitchfork
11:07 AM on 10/17/2011
•In 1980, more than 70 percent of employees working more than 20 hours a week were covered; that number fell to 56 percent by 2005, with coverage already unraveling as employers shifted from defined-benefits to defined-contributions. (Mishel, L, Bernstein, J, Allegretto, S. The State of Working America 2004/2005. Ithaca. Cornell University Press, 2005)

I agree with that - in 1980 I worked in a supermarket. part timers got a basic health plan. full timers got full boat - dental, optical and so forth

there was no such thing as a deductible or co pay - they payed it all. the premium was only a few bucks out the paycheck as well
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cyclone70
if there was a time to reach for the pitchfork
11:04 AM on 10/17/2011
I seldom see the business community speaking out about what a competitive disadvantage the costs of health care are for US business

Plus as mentioned below - that the US health system makes labor mobility more dificult
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Charles Mills
09:31 AM on 10/17/2011
I could not agree more here. It's time for our health insurance to be changed to at the very least, not be a component of your employment. We have so many models and templates to use for a National single payer system that we could not fail in my opinion if we simply gave it the attempt and put HALF the effort and time we have into the current system into a new one. We already know from those others what does and does not work and we are in a unique position to apply those lessons moving forward and craft what would literally be a National piece of ART!
03:29 AM on 10/17/2011
I have seen some comments below complaining that if you had universal health care paid for through the tax system your taxes may go up.

Well Duh, but the difference is that EVERYONE pays 2-3% more in taxes and EVERYONE is covered. That means the old, young, pre-existing conditions, disabled, rich, poor.

Employers would no longer need to worry about the administration of their employees health insurance.

Employees would be free to move between employers as they would no longer be tied to an employer who can fund their health insurance.

In Australia we have a much higher minimum wage and comparatively similar tax rates to the US and we manage to have a fairly good universal health care system.

Sorry did I use the word EVERYONE.... hmmm sounds like communism to me. (Have you noticed that the ONLY country on the world that keeps rattling on about communism is the US go figure)
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parlimentMike
Don't settle for less evil, demand good
12:20 AM on 10/17/2011
Yes, the actual reform you specify was the answer in 2008, and 2009, and 2010 too. Actual reform is incompatible with Obama in office. Obama is all about revolutionary Change through problem continuance.
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Shrank
We are sorry, your micro-bio is not PC
04:56 PM on 10/16/2011
After decades of waiting for health insurance reform, I am now convinced that it won't come to America in my lifetime. Knowledgeable students of the health care industry, informed citizens, and even premium-paying employers know that health care is being priced out of the reach of average Americans. But conservative ideologues have sold enough people on the fear of "Socialized Medicine" that Republicans can block any meaningful reforms in cost containment and health insurance accessibility. In theory, the United States does have some of the highest quality care in the world, especially for high-ticket items like surgery, and cancer therapies. But what difference does that make in the lives of most people, who can't afford access to basic primary care, and the most commonly prescribed medications?

Mr. Geyman is right about one thing. Businesses are abandoning employer-provided health insurance in droves. Within a few years, only the largest and most profitable corporations will still be offering these benefits. Most Americans will either be uninsured or underinsured. By then, the political environment may make reform inevitable. But for now, most Americans would rather cling to the philosophical illusion of high quality, free-market health care, than opt for a practical single-payer alternative.
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Gestas
Mountain Man
02:41 PM on 10/16/2011
I'll bet Wal-Mart will give you Health Insurance, Sick Leave, Paid Vactions,Employee Discounts and Paid Leave to GrandMa's Funeral... All of this plus Free Parking.
01:00 PM on 10/16/2011
Why can't we get the Democrats in Congress to go on Obamacare? They voted it in for us.
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SonOfUgh
Your micro-bio is empty
06:45 AM on 10/17/2011
Why won't the Repuglicans in Congress go off of their government provided "socialised" health care?
07:55 AM on 10/17/2011
Because the Repubicans want to enable employees to keep their employer-provided insurance without any change. Since the government is their employer, they are entitled to this employer-supplied health care, Democrats, on the other hand, are taking measures which will take employer-provided health care away from employees (and has already made it more expensive for them). Since Democrats want this change, they should be bound by its rules. They excluded themselves from Obamacare, however, and paid off their big money contributing unions by excluding them also from Obamacare and from paying for it.
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bcmom
Stop breeding puppies
11:30 AM on 10/16/2011
Yep, those days are gone forever. We had better find another way to provide health care.
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margem1
11:43 PM on 10/15/2011
Not only would national health insurance guarantee access to care for all Americans at a lower cost, but it would allow entrepreneurs to leave their stiffling companies, where they are hanging on to jobs they hate just for the insurance. This would open up those jobs to people who want the confines of an office. Companies would save millions (and consumers of their products would not have to pay higher prices for goods and services) if there was national health insurance. How the heck did we wind up with the mess we have now? I was so hopeful two years ago until the GOP and their insurance-exec buddies (and the stupid Tea Partiers who fell for Fox lies) defeated a common-sense/common-good plan for universal coverage. Dems are guilty too of a lack of courage and having their hands out to the ins. co. lobbyists. I really hope the OWS movement makes national health insurance a priority.
01:01 PM on 10/16/2011
Just so it is clear - income taxes would not increase on anyone if national health insurance were adopted?
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Donell Wickett
Right is wrong
01:44 PM on 10/16/2011
Just so it is clear,premiums now are a form of tax. For most people insurance premiums are the largest deductions coming out of their paychecks.
iridium53
Semper Fi
12:13 AM on 10/17/2011
As an employer, I pay part of my employees insurance - the part that is basic and just for them. They pay part - the part for their family and for additional services.

I buy this insurance through a Professional Employment Organization so that I can provide benefits similar to those offered by the biggest in my industry.

I'm totally indifferent whether I pay for these extra costs to insurance companies or as taxes.

Asking whether taxes go up or not, is not a useful question.

The useful question is the Total Cost of health care for the employee (and the employer) vs. the "basket" of benefits.
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thereisonlyoneparty
more amazing than you
12:33 AM on 10/20/2011
Not only would national health insurance guarantee access to care for all Americans at a lower cost
Proof of that statement.

How does changing who is paying reduce cost in any significant way?

The only benefit of a single payer system is increased ability to negotiate.  But that does not mean that people will be paying less.   When insurance companies were really strong and able to really control costs people got upset.   Why?   Because they health care provider claimed that they were not able to do their job and that the payer was making medical decisions.   People were not any less healthy, but they were upset that they were not receiving the "appropriate" level of care.
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margem1
01:22 AM on 10/20/2011
The cost of the middlemen in the insurance business -- especially the CEOs who rake in millions -- is immediately eliminated with national health insurance. The govt. runs Medicare and Veterans' health insurance at a far lower cost per insured than private insurance companies.
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10:39 PM on 10/15/2011
American conservatives: people have a right to profit from health insurance, but they don’t have a right to health insurance.
12:50 PM on 10/16/2011
correct
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SonOfUgh
Your micro-bio is empty
06:49 AM on 10/17/2011
How very Christian of you. As an Atheist, I usually discover that my morals are much more akin to those of the "Jesus Christ" of the story book called "The Bible" than are the morals of most self-proclaimed Christians.
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Gestas
Mountain Man
03:35 PM on 10/15/2011
Once, several years ago Companies wanted to train and develope a work force that was loyal to them..People would stay with them no matter how badly they were treated...The chief reason was they didn't want to lose thier Health Insurance. Now days working people have become a disposable waste of money. Wages really cut into thier bottom line.
02:15 PM on 10/15/2011
Yawn. Another Corporate apologist. It's interesting and yet bizarre, to see the parade of people trying to sell Americans the idea that Corporate profit is more important than anything on the planet. More important than your health. More important than the environment. More important than consumer protections. More important that creating jobs. More important than workers rights. How predictable is this one. Cars are overpriced because Corporations are required to provide health care to their employees. And did you hear? Affordable health care is gonna kill your granny too!
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SonOfUgh
Your micro-bio is empty
06:51 AM on 10/17/2011
I am intrigued about what made you decide the above was a "corporate apologist" writing? I did not see it that way.
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librldem
Snarking for Merika n jebus! Glory!
12:05 PM on 10/15/2011
Single payer HC should not be available to Republicans and teabaggers. They should be made to pay all HC premiums and deductibles out of pocket rather than get the increased coverage for 1/5th the cost so they would not be soshalists. Also if they have no coverage they should get no care unless they can bum the money from their church.
12:55 PM on 10/16/2011
Let the Republicans and Tea Partiers keep their employer-sponsored plans they like. You take the Obamacare where, if you work, you get to subsidize the costs of those who don't work, and you pay for any illegal who walks in for anty sort of medical care and doesn't pay for it. I agree with you thatif you have no coverage, you get no care, but as a Democrat who cares, you can pay for that person if they ever voted D in their lives. That is the only fair thing to do.