[taylodl]

Currently the insurance company does, and since they were most likely selected by your employer whose objective was to hold down costs, what do you think that insurer's priorities are going to be? Plus, who's the customer in this situation? For whose business is the insurance company really working for?

[dnautics]

no doubt having your employment being tied to your insurance is a really, really bad idea, but may I remind that state of affairs is because of a government incentive put into place by FDR.

[markost]

I believe it was originally because of postwar wage/price controls, which led to employers giving health insurance to attract employees, which led to the IRS taxing health insurance, which led to Congress exempting health insurance from tax, which led to the current regime we have today, compounded by the McCarran-Ferguson Act as well as the HMO Act.

[taylodl]

You failed to mention the context of that government incentive - World War II. And the incentive you're referring to was put in place by the War Labor Board in 1942, during FDR's presidency. http://en.wikipedia.org/wiki/War_Labor_Board

[dnautics]

you'd think that with the end of the war, the incentive would have been removed.

[taylodl]

It was. But perqs proved popular with employers because their value were hidden from the employees. Thus large employers could use their negotiating power to procure health insurance for their employees at a relatively low cost. They were effectively getting cheaper labor, a huge competitive advantage. The ruse was up once health insurance costs started skyrocketing.