What Doctors Like Me Know About Americans' Health Care Anger

[ShazzieB]

38. Any system wrhere most people havevto depend on their employer for their health care coverage is messed up.

Add to that the fact that the employers then get to decide what care to actually provide and how much (If any) of the premiums to subsidize and you have nothing but a patchwork of inequalities and insufficiencies.

The first job I had after college, in 1975, was working for a state university as a lowly library clerk. The pay was chickenfeed, but my health insurance didn't cost me a dime. It was good coverage, too.

Since then, the costs of health care in the U.S. have gone up, up, up, up, which means that insurance costs have gone up, up, up, up. And THAT means it's gotten more and more expensive for employers to provide decent coverage to their employees. Throughout my life, working for a variety of employers, I saw the following:

Health insurance premiums: UP
Co-pays: UP
Deductibles: UP
Portion of costs subsidized by employers: DOWN

I'm not even going to get into the rules regarding what's covered and what isn't, or what hoops have to be jumped through to get certain things covered, because that stuff is ALL OVER the place.

This has caused problems for employers, because the amount of their HR budget that goes into covering health insurance has increased so much. You'd think larger employers would welcome a national health care plan that would allow them to wash their hands of the whole thing. But for whatever reason, they aren't.

You'd think less rich employers would be happy not to have to complete for good employees against richer employers that can afford to offer more lavish health care benefits. You'd think the really small employers, who can't offer those benefits at all (and aren't required by law to do so) would welcome a program that would give them a more level playing field for attracting good employees, instead of having to compete with employers that can afford to offer health care benefits. But as far as I know, none of them are in favor of a national plan like Medicare for all, at least not in impactful numbers.

The only thing I can figure is that the bigger, richer employers (who have the most impact) don't want to give up the power this system gives them over employees. How many of us have stayed in a job we weren't happy with longer than we wanted to, because we couldn't afford to take a chance on being without health insurance (or known someone who did that)? I'm guessing a high percentage, because losing one's health insurance coverage is one of the scariest things that can happen to an American worker.

And some of the biggest, richest, and most powerful companies of all are the health insurance companies themselves, who have plenty of lobbying money to spread around, to make sure that they don't lose the stranglehold they have on the rest of us to a national plan that treats everyone equally.