You can either view basic health care as a benefit to society as a whole, like a highway or a fire truck, and socialize it, or you can view it as a product for sale.
Viewing it as a benefit of a particular employment is not logical. This is like trying to mandate that your employer pay for your car insurance... there is no connection of mutual benefit.
Basic health care needs to be connected to the individual, while "extended health care" (or additional options, etc) can certainly be offered as a benefit. The employer does have an interest in you getting back to work faster, being in better health than the average, reducing the stress of your medical issue, etc, etc.
Interestingly enough, a socialized (single payer/universal, etc.) system of basic health care with privatized add on's and extras is basically the way every civilized society on the planet operates except the USA.
*You can define "basic" differently, but for my argument I mean a level of care that ensures a respectable level of heath is maintained... usually it is simply seeing health care as a human "right" and therefore not subject to withholding by the state or other actors.
In Australia, everyone gets sufficient basic care from taxes, and if you want, you can buy extended care. It has nothing to do with your employer.
In Canada, everyone gets very basic care from taxes, and if you want, you can buy extended care, or your employer might do that for you (implied: If you're lucky).
After living and working under both systems, I find giving my employer power over my healthcare to be a nasty draconian measure that I don't like at all, and I see no benefits.
Canada and Australia are basically the same, but in Canada there is a default understanding that most employers will help to sponsor an extended health/insurance plan.
I see no real issue with this, as it certainly does NOT mean they in any way control your options. As healthcare becomes increasingly expensive, the ability for employers to offer this benefit is degraded. None of that prevents you from doing what you want in terms of extra coverage though.
Most full time jobs that are also considered "careers" will offer some form of insurance benefits, and that usually includes health care. Aside from cost, the benefits of Group Insurance is that there are no pre-existing condition exceptions. You have guaranteed acceptance as a nature of your employment. This is a huge upside for people that aren't prefect medical specimens, and as a result employer offered extended coverage is significantly cheaper for the individual.
As I said you are starting to see changes mainly due to demographics and cost increases. The switch to Flex benefits, health spending accounts and such will see more "individualization" of health care costs in the future. Personally, I think HSA's are the best possible way to offer extended health benefits to employees, and I expect they will grow in popularity; analogous to what RRSP's have done to pension plans.
I find giving my employer power over my healthcare
You simply don't do this in Canada, although many people do have that impression. Example: Me. I have my government health care, my employer health care that I pay a portion of, and some extra private care that I elect to pay for.
To play the devils advocate, linking health care to your job means that productive citizens are being taken care of. This fosters a "survival of the fittest" situation.
That isn't really how it plays out, but I think that's the allure to many of us Americans. I've spoken with others who who believe that you must work to earn certain things, such as health care. It is often toted that people who are obese, smoke, do drugs, and participate in other health risks are more likely to be on government aid than those who "earn" it. They use this fear of being taken advantage of to fuel a desire a knee-jerk reaction to health care.
Yet there are valid concerns. Especially with the migration of such an entrenched system.
If the US government is going to take on Health Care that money needs to come from funds already in the budget. The US government is poised on the edge of failure, the only thing keeping us going is a mass faith in the ability of the government to pay back it's loans, and thus receive more.
Also this points to a bigger break in the system. US Agencies (I can't speak to foreign agencies) incentivise the spending of your whole budget. If you don't spend it all then obviously you don't need it all. This creates a mad spending rush at the end of the fiscal year and an atmosphere where you have not only the right but the obligation to spend your budget.
I think a lot of people are intimidated by the concept of introducing another burden to the US budget when we are already incentivising the wrong thing.
I think if we could cut back the budget in other areas, this would make it possible to introduce a true health program.
I'm only touching on a few reasons why this isn't being done immediately. I do think that our defense budget is outlandish and could be put directly towards health care, but that is a huge transition in the work force. That is soldiers to medicare specialists. That sort of transition will take time.
linking health care to your job means that productive citizens are being taken care of
Assuming productivity is related to the selling of your time to another actor is outdated 20th century thinking. People can and are becoming increasingly productive without having "jobs" that fit a definition. Entrepreneurs, contractors, part-time workers, stay at home parents, students... all of these people are outside of the employer/employee equation and thus don't have access to health care because of it.
Tell me, who's more valuable to society, employee #992232 of big corp the next Richard Branson? Tying health care to employment ensures the former, not the latter is given incentive. This is precisely what we don't want.
If the US government is going to take on Health Care that money needs to come from funds already in the budget.
This is a much more practical argument and it is difficult to rebut directly. Essentially though, you are correct: something else would need to be sacrificed. There is, of course, an obvious target: http://armscontrolcenter.org/issues/securityspending/article...
In addition to that though, spending on Medicaid and Medicare within the current system is hugely inflated, from what I can see. US per capita administrative costs are triple that of Canada: http://pweb1.rwjf.org/reports/grr/036617.htm
So, even without a military cut back, the money is already being spent, just on HMO's instead of actual health care.
The consensus here is that society has to take care of the sick, independently of the circumstances of their life. It is important to note that I wrote society, not state. The state is seen as the agent through which society effects this, not the principal actor. The fact that it is seen as a question of ethics and a part of "we the society" probably also explains the rather vitriolic contributions that some of my European compatriots provide in discussions on the US health care situation (even though it is probably none of our business).
I simply don't trust our (the USA's) federal government to handle a socialized system with any amount of efficacy or competency. We would need a fundamental cultural change and a massive restructuring of current spending. Like that will happen any time soon.
Plus, I don't think such a system should even be possible with our form of government because of the powers enumerated by the Constitution. If there were to be a socialized system, it should happen at the state level and perhaps the federal government could help regulate / control interstate issues. Or, I suppose, we could try to pass an amendment.
You would have to be astoundingly incompetent to make a socialized system more expensive for the USA.
http://www.economicshelp.org/blog/6220/economics/global-heal...
Plus, I don't think such a system should even be possible with our form of government because of the powers enumerated by the Constitution.
Pretty sure your federal government can recognize human rights, and ensure they are respected. Health care is the one section of the Universal Declaration of Human Rights that the US has not ratified.
I share your pessimism though in any meaningful change taking place. The USA has a rather bizarre view of the role of health care in society as compared to other nations.
But of course this is a Forbes blog, and who knows what the political slant of the blogger is.
As state-mandated benefits go up, the marginal utility that an employee has to provide to be company asset go up proportionally.
"Forty-one percent of the businesses surveyed have frozen hiring because of the health-care law known as Obamacare. And almost one-fifth—19 percent— answered "yes" when asked if they had "reduced the number of employees you have in your business as a specific result of the Affordable Care Act.""
The problem with Obamacare is that it doesn't address the primary problem: health insurance is tied to employment.
Until we get past that we are going to have a broken system where the customer is not the customer. The insurance company and then your employers are the customer.
Surely care should be available to all - if you are the CEO of a fortune 500, a temp at Walmart or even unemployed.
No one did. Employer-provided healthcare (and other perks) came into vogue during the wage freezes during World War II as a way to attract employees.
https://en.wikipedia.org/wiki/Health_insurance_in_the_United...
I don't get why they keep running the thing though, it's systematically garbage, are the hits so much more important than the forbes brand?
However they merely reflect what many other type of employers do, they just are more noticeable because of their size.
"The recovering economy could also help force Walmart, and other like-minded employers, to back off this policy and hire full-time workers with benefits."
There's nothing political about the truth. To not recognize (or admit) the connection between the two is serious head-in-the-sand syndrome.
