Private business and health insurance

[Anonymous]

Why has the business community not lobbied harder for a single pay healthcare system? I don't mean insurance companies, hospitals, etc but rather non-healthcare companies that end up paying through the nose to insure its workers. I understand it started as a perk after WWII, but it seems as though it has morphed into a monster that does nothing for the company except cost money. In thinking about it more, it seems as though it would be easier for businesses to be able to pay a healthcare tax and have the government deal it instead of having to pay people to negotiate it, administer it, listen to the complaining about rates rising, etc.

Please don't turn this into a "should we have single payer healthcare?" conversation.

[Anonymous]

Why has the business community not lobbied harder for a single pay healthcare system?

Because the business community is in the business of doing business and not lobbying for social welfare programs.

[Anonymous]

Business lobby a fair amount for other things, and this could be one of them. I think one of the things Paul Ryan proposes is to lower the non-taxable nature of benefits. That would discourage businesses from offering health insurance. It might be good in the long term to separate the two.

As someone who comes from outside the US, I think there were- and maybe will be again now they want to repeal Obamacare- at least 5 crazy things about the US system:

1) the fact that sick people-who need it most- can't get insurance...because of course it makes no sense from a market stand point, but from a humane stand point that is just...sick.

2) the fact that people can go bankrupt for health reasons. It seems like it's not your fault if you get sick, and even if you have insurance, pre-obamacare many put a cap where you would be kicked to the curb anyhow.

3) that insurance is tied to employment- and that the only way to get covered if you have a condition is through work, except of course you can't work if you are sick.

4) that prices negotiated by insurances are so different from those charged if you pay "cash"

5) that market oriented people expect the patient to be able to evaluate cost/benefits and choose wisely like you might do when buying a car. I think most people are not equipped with the time and expertise to make such decisions, especially when faced with an emergency.

[Anonymous]

Anonymous wrote:

Why has the business community not lobbied harder for a single pay healthcare system?

Because the business community is in the business of doing business and not lobbying for social welfare programs.

They should have been pushing for better healthcare options that individuals can get for themselves rather than having healthcare tied to employment as it was for so long. For many years it was a perk of employment but that was always an unsuitable and unsustainable arrangement.

[Anonymous]

Insurance companies should operate across state lines. Increase market size. Will reduce costs. Only thing about trump I agree with. In addition to term limits

[Anonymous]

Paying for health care for employees is a significant burden on US businesses. They shouldn't have to pay it (and European branches of US businesses do not). That's why Obamacare works for businesses.
I lived in other countries and although sometimes you have to wait a while to be seen for a non-emergency, the health care was excellent and free. Why more Americans and American businesses don't lobby for single-payer is based on a mix of reasons:
1. We've been told our system is the best in the world and we don't want to rock the boat. In a better world, we'd have something like the German system, a mixture of private and public. But generally, we don't look to Germany (for historic reasons), we look to the UK and France, and their systems are very different and not respected here. So--we're stuck .
2. People lobbied HARD to get medical bills exempt from bankruptcies but the credit card industry lobbied harder. We lost. We have to keep fighting. It's inexcusable that medical bills can cause someone to go bankrupt.
3. Medicare for all. It will come--but only after we've explored every other option. And only when businesses lobby for it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Why has the business community not lobbied harder for a single pay healthcare system?

Because the business community is in the business of doing business and not lobbying for social welfare programs.

They should have been pushing for better healthcare options that individuals can get for themselves rather than having healthcare tied to employment as it was for so long. For many years it was a perk of employment but that was always an unsuitable and unsustainable arrangement.

I am just not sure what "better healthcare options that individuals can get for themselves" is (I am not snarky, just genuinely curious). I come from Europe, never saw a medical bill until I came to the US. with a system where people get private insurance (though work or in the open market) I don't see how they can get a better option by themselves. insurers are for profit and they simply do not insure people who are sick or likely to get sick. in the open market I cannot see how an individual can get a good option unless the individual is 25 and perfectly healthy. and this is what has been going on in the US, people who were sick could not get insurance, or could get a very limited coverage for outrageous prices. I frankly agree with OP, this is something business should have lobbied for. they would not have to pay for their workers, and having people who do not have to worry about going bankrupt or losing the house because they get sick is a good thing for a business IMO.

[Anonymous]

Anonymous wrote:Paying for health care for employees is a significant burden on US businesses. They shouldn't have to pay it (and European branches of US businesses do not). That's why Obamacare works for businesses.
I lived in other countries and although sometimes you have to wait a while to be seen for a non-emergency, the health care was excellent and free. Why more Americans and American businesses don't lobby for single-payer is based on a mix of reasons:
1. We've been told our system is the best in the world and we don't want to rock the boat. In a better world, we'd have something like the German system, a mixture of private and public. But generally, we don't look to Germany (for historic reasons), we look to the UK and France, and their systems are very different and not respected here. So--we're stuck .
2. People lobbied HARD to get medical bills exempt from bankruptcies but the credit card industry lobbied harder. We lost. We have to keep fighting. It's inexcusable that medical bills can cause someone to go bankrupt.
3. Medicare for all. It will come--but only after we've explored every other option. And only when businesses lobby for it.

Europeans get free healthcare. Are you proposing that? However companies and people pay more taxes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Paying for health care for employees is a significant burden on US businesses. They shouldn't have to pay it (and European branches of US businesses do not). That's why Obamacare works for businesses.
I lived in other countries and although sometimes you have to wait a while to be seen for a non-emergency, the health care was excellent and free. Why more Americans and American businesses don't lobby for single-payer is based on a mix of reasons:
1. We've been told our system is the best in the world and we don't want to rock the boat. In a better world, we'd have something like the German system, a mixture of private and public. But generally, we don't look to Germany (for historic reasons), we look to the UK and France, and their systems are very different and not respected here. So--we're stuck .
2. People lobbied HARD to get medical bills exempt from bankruptcies but the credit card industry lobbied harder. We lost. We have to keep fighting. It's inexcusable that medical bills can cause someone to go bankrupt.
3. Medicare for all. It will come--but only after we've explored every other option. And only when businesses lobby for it.

Europeans get free healthcare. Are you proposing that? However companies and people pay more taxes.

Europeans pay different taxes but not much more. Everyone says that they do, but when you compare what we pay in taxes, as well as health insurance premiums, we pay more.

My opinion, OP, is the reason so far has been inertia. And then the government stepped in to solve the problem of health care, but years later, we all can see that it didn't. Now Trump will fix health care ... somehow.

Maybe in another decade or two, we'll get creative and actually improve health care. Possibly sooner. Possibly never.

[Anonymous]

Anonymous wrote:Insurance companies should operate across state lines. Increase market size. Will reduce costs. Only thing about trump I agree with. In addition to term limits

Insurance companies already sell across state lines in the form of opening a sub in that state so that they follow that state's laws. BCBS sells country wide. I had it in CA, and now have it in MD, both as private insurance.

If insurance companies sell across state lines without setting up a sub it will mean that no state will have any control over their healthcare laws. You take the control out of states' hands. Also, some states have already looked into doing this, but with very little success. Nor, do most experts think this is a panacea.

Trump's idea of selling across state lines means no regulation at all (goes hand in hand with his desire to reduce regulations). There would be no consumer protection. The advantage goes to big business while the little guy would be at the mercy of big busines.

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http://www.ncsl.org/research/health/out-of-state-health-insurance-purchases.aspx

"... For the last 10 months, states have been legally allowed to let insurers sell plans outside their borders. Despite the idea’s enduring popularity, no states have signaled interest in the policy, insurance experts and regulators say. And the federal government never even finished writing the rules for how it would work.

“Insurers aren’t interested at this point,” Linda Blumberg, a senior fellow on health policy at the Urban Institute, said in an interview. “It’s kind of a lot of effort for no necessary return.”....

Only three states have approved those laws — Kentucky, Georgia and Maine — although none have actually made deals with other states to sell their plans, according to the National Conference of State Legislatures.""

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http://www.modernhealthcare.com/article/20161010/NEWS/161019992

"Under the ACA, companies are allowed to sell across state lines if there is an agreement between the two states. The plans must still meet coverage requirements of the act, which also spells out licensing requirements and how disputes would be addressed.

No state has yet taken advantage of this option and no major insurers have asked for it."

[Anonymous]

3. Medicare for all. It will come--but only after we've explored every other option.

"America will always do the right thing, once all the other options have been exhausted."

- Winston Churchill

[Anonymous]

Insurance companies need to change their model. Currently they have little incentive to push costs down because they get a cut.

[Anonymous]

You can do compacts among states to sell insurance across state lines as a PP described. Far more efficient is to simply be able to sell across the country. This doesn't mean no regulation; it means federal regulation instead of state regulation.

Insurance companies traditionally have been very against federal regulation because they would have limited ability to sway a national regulator. They can easily sway state insurance regulators--often this is a political post and state legislators are very insurance company friendly--in fact many supplement low legislator salaries by being insurance brokers.

It is crazy we do not have a regime for federal regulation of insurance companies at least as an option.

[Anonymous]

Anonymous wrote:You can do compacts among states to sell insurance across state lines as a PP described. Far more efficient is to simply be able to sell across the country. This doesn't mean no regulation; it means federal regulation instead of state regulation.

Insurance companies traditionally have been very against federal regulation because they would have limited ability to sway a national regulator. They can easily sway state insurance regulators--often this is a political post and state legislators are very insurance company friendly--in fact many supplement low legislator salaries by being insurance brokers.

It is crazy we do not have a regime for federal regulation of insurance companies at least as an option.

Correct.. sometimes, state Insurance Commissioners are in cahoots with the insurance companies that they are supposed to be regulating, and end up working for them:

https://www.washingtonpost.com/investigations/drinks-junkets-and-jobs-how-the-insurance-industry-courts-state-commissioners/2016/10/02/1069e7a0-6add-11e6-99bf-f0cf3a6449a6_story.html?utm_term=.9af9604a0076

"Benafield [AK insurance commissioner] ultimately decided the case in United Healthcare’s favor — a 2008 ruling that stood to save the company millions of dollars. Nearly two years later, by the time a judge vacated the commissioner’s orders because there was “an appearance of impropriety in the proceedings,” Benafield had moved on: She was working for United Healthcare, having joined at least three of her predecessors representing insurers in Arkansas."

[Anonymous]

Anonymous wrote:

Anonymous wrote:Paying for health care for employees is a significant burden on US businesses. They shouldn't have to pay it (and European branches of US businesses do not). That's why Obamacare works for businesses.
I lived in other countries and although sometimes you have to wait a while to be seen for a non-emergency, the health care was excellent and free. Why more Americans and American businesses don't lobby for single-payer is based on a mix of reasons:
1. We've been told our system is the best in the world and we don't want to rock the boat. In a better world, we'd have something like the German system, a mixture of private and public. But generally, we don't look to Germany (for historic reasons), we look to the UK and France, and their systems are very different and not respected here. So--we're stuck .
2. People lobbied HARD to get medical bills exempt from bankruptcies but the credit card industry lobbied harder. We lost. We have to keep fighting. It's inexcusable that medical bills can cause someone to go bankrupt.
3. Medicare for all. It will come--but only after we've explored every other option. And only when businesses lobby for it.

Europeans get free healthcare. Are you proposing that? However companies and people pay more taxes.

Op here. both employer and employee pay the cost of insurance. The way I see it is that I can/my company can pay for healthcare, or we can both put our money towards a tax for single payer. I would rather know I have a set amount in taxes and am getting certain benefits. I feel like now the cost goes up while the benefits go down every year. Every year I wonder what I am getting.

It feels like companies would just want this healthcare monkey off their backs....which is why I posed the question of why they haven't lobbied harder for single payer.