Employment-Based Health Insurance

Obtaining health insurance through the workplace has been the primary mechanism for health coverage for the American population under age 65, but the percent of people with this source of coverage has shown a steady decline.  A new report from the Robert Wood Johnson foundation gives an update on the status of and trends in employer-sponsored health care coverage.   (RWJ Report)   The decline is illustrated by the change from 69.7% of the population in 2000 to 59.5% in 2011.  This is driven by many factors, including the aging of the population and recent declines in the working population following the recession, but the greatest factor is undoubtedly the unrelenting growth in the cost of health care and consequently the cost of health insurance, which in the time period referenced above doubled for single coverage and rose 125% for family coverage.  The higher prices have both led a number of employers to not offer insurance at all, particularly small companies, and have led to more of the premium and other costs being passed on to employees, which means that more of them choose not to participate in the health plan.  The percent of covered individuals and the trend in coverage has varied greatly by state, due to income, demographic and other factors, but almost every state has seen a decrease and no state has seen an increase in coverage, including Massachusetts.

So now we are embarked on a great experiment in health “reform”, which everyone now recognizes will only drive costs and premiums higher, really much higher, and despite a “mandate” for coverage, may paradoxically result in fewer people with health insurance, at least through their employers, and which dramatically increases the burden on taxpayers to fund health care coverage through Medicaid and Medicare.  The likely collapse of this experiment will leave many individuals with no insurance and create chaos in both the insurance and health care delivery marketplaces.  And it is hard not to suspect that part of what has driven some recent policies is a hostility to the private insurance industry, so making plans more expensive and less affordable is for many ideologues just part of a scheme to eventually move to the nirvana of a single-payer system.  Just what we need, even more government involvement in health care, since it has amply demonstrated what a great job it does in the area.  Far, far better, to move back to a system in which individuals are responsible for paying for their health care, with coverage for true catastrophic expenses, and assistance for those individuals who are really financially incapable of accessing needed health care.