Employer-Based Health Coverage Doesn't Cut It

'It's hard to believe the government's going to put the same boss who won't change the 5 yr-old candy in the break room because it would cost too much in charge of your health care.' --Michael Feldman

SEATTLE POST-INTELLIGENCER EDITORIAL BOARD

Monday, May 17, 2004

It's difficult to understand how America can come to grips with its widening health care coverage crisis as long as it dependent upon an employer-based system. The dynamic tension inherent to that arrangement can only mean continuing conflict between workers and employers between their conflicting interests, driven by opposing special interest groups acting in their behalf.

That conflict played out last week in Congress, where lawmakers proposed health care solutions tailored to their vested constituencies. Republicans focused largely on reducing costs to business of providing health care coverage through tax credits, subsidies and discounts. Most of which, Democrats argued, shifted costs to employees and accomplished little to decrease the legions of those working but not covered by health insurance.

The Republican-controlled House voting largely along party lines, passed bills that would cap non-economic damages in medical malpractice awards and let small employers save money by buying into national health insurance plans. But critics say malpractice caps reduce injured patients' ability to recover damages and that the group buying plans would be largely exempt from state regulation. Even a seemingly employee-friendly bill to allow employees to roll over tax-free "flex" accounts into the next year's expenses or into medical savings accounts still represented a way for employees to carry more of the burden of health care costs.

An employer-based health coverage system creates a health care system fundamentally divided between those with jobs and those without. The divide continues between those whose jobs offer benefits and those whose jobs don't.

Hit hardest by this secondary divide are the working poor whose jobs don't offer such benefits and the small businesses that can't afford to offer them.

As long as health care coverage remains an essentially a form of compensation, employers will cut health care costs by reducing benefits or shifting more of the cost to employees. Conversely, increasing or merely retaining employees' health care benefits will come only at the cost of the employer's bottom line.

An employer-based system also feeds the dual fantasy that only those who have insurance coverage get health care and that those who do have insurance are paying only the cost of their care.

The most sensible alternative to the crumbling, expensive, inefficient and unfair employer-based approach is a national, universal health care system that more appropriately distributes both the coverage and the cost.

They got that right. Next year in Jerusalem....