[rsweeney21]

This is an interesting idea. Is this an unintended consequence of binding health insurance to your employment?

According to the NYT: "During World War II, federal wage controls prevented employers from wooing workers with higher pay, so companies started offering health insurance as a way around the law. Of course, this form of nonmonetary compensation is still pay. When the war ended, the practice stuck."

I would much rather have a system where I was paid more and got to choose my health insurance provider. That way I could keep my insurance when I change jobs or if I wanted to freelance.

I run a company that helps software engineers find contract work, and the #1 question we get is "how much should I charge?". The #2 question is "what do I do for health insurance?"

It would seem like businesses brought this on themselves by offering benefits to get around compensation limits imposed by the government. Or you could say that this was caused by the government imposing limits on compensation. Super interesting to think that the root cause of our current problem could have been created 80 years ago.

[UncleOxidant]

Moving to a single payer system would unleash a lot of latent entreprenurial activity and free companies of all sizes from having to provide health insurance. Great documentary here on the business case for moving to single payer: http://fixithealthcare.com/

[aidenn0]

I think part of the problem in the US is that the current status is so bad, that everyone has a different proposed solution.

Single payer is also seen as too paternalistic by a large minority of the US, so there is that as well.

[bobthepanda]

The real problem is that the current status is so bad, that those who are relatively better off (probably still bad) are scared of change because they've seen what "worse" looks like and a better system seems mostly aspirational.

There is a reason why ACA messaging from Democrats always included the fact that you could keep your existing insurance if you wanted.

[skrtskrt]

> I think part of the problem in the US is that the current status is so bad, that everyone has a different proposed solution.

“Everyone has different solutions” as in the two parties, both corporatist through and through, are only willing to offer solutions that nip around the edges of the problem with ridiculously complex regulations that ultimately result in less competition and higher profits for healthcare conglomerates.

Single payer in the vein of “Medicare for All” is popular for voters of both parties. It’s just that our representatives represent us in name only.

> Single payer is also seen as too paternalistic by a large minority of the US, so there is that as well.

Again there’s a disconnect between the discourse you can see on corporate cable news and major newspapers and what people actually think and want.

That said, the corporate media and Dems/Rs have been very very successful in 50 years of messaging that everything the government does = bad, inefficient, rationing. And everything corporate = dynamic, efficient, desirable. Almost everything that can be privatized has been privatized via crony capitalism, but they can still say “govt has big budgets, shitty results” when it’s their privatization that is the exact reason for the decay.

It’s depressing how effective it all is.

[aidenn0]

I don't watch cable news. I know dozens of people who are vehemently opposed to single-payer. The reasons are paternalism and distrust of government to get things right.

To a certain extent, I agree with the second; I'm kind of glad that the current administration doesn't have control over my health care...

[alistairSH]

It would seem like businesses brought this on themselves ...

It's potentially good for employers, as it increases friction in the labor market.

[rsweeney21]

Good point. Health insurance is a form of golden handcuffs. The pain of switching health insurance providers has definitely deterred me from changing jobs before. Microsofts insurance in the early 2000's was so good, I stayed there long enough to become grossly underpaid. When I finally did leave, my salary increased by 50%!

There is really isn't much incentive for companies to stop offering health insurance as a benefit.

[kyrra]

Another big bit is tax deductions. I believe when the employer provides healthcare, the amount they pay and the employee pays is 100% pre-tax.

If you pay for medical insurance yourself, it starts getting complicated[0]. They honestly just need to make it so any medical insurance payments should be 100% deductible, regardless of anything else. It would help level the playing field.

[0] https://www.investopedia.com/are-health-insurance-premiums-t...

[adrianmonk]

> I would much rather have a system where I was paid more and got to choose my health insurance provider. That way I could keep my insurance when I change jobs or if I wanted to freelance.

I would rather see employment and health insurance totally separated from each other.

But if people aren't open to that for whatever reason, one alternative would be a system where the employee freely picks any insurance plan, but the employer pays the premiums tax-free like they do now.

If you make it so the set of insurance choices is the same for all employers and for individuals paying their own way, then you could move around between employers or freelance.

Right now, big employers have bargaining power due to their size, so you'd lose that, but perhaps stronger competition (from everyone freely choosing) would make up for it.

[raizinho]

I'm surprised that you'd suggest that "businesses brought this on themselves." It's a cut and dry government failure.

[syshum]

>>It would seem like businesses brought this on themselves by offering benefits to get around compensation limits imposed by the government.

That is a strange way to Phrase that... Government imposes unethical pay caps, and the "business" brought this on, not government?

No this problem is 100% the fault of the government not business