by Patrick Appel
Here's a cost-saving reform I've heard of, that's not in there, because the president rejected it at the very beginning of this process: Place individuals on equal tax footing as employers when it comes to purchasing health insurance plans, so that we can transition from the post-WWII Company Man artifact of health-insurance-as-reward-for-employment, to a competition-spurring, cost-reducing model of individuals owning and shopping around for their own policies. In other words, markets, not mandates.
From the article Welch links to:
The employer-based health insurance system must be dismantled, and the money spent by employers for insurance should be converted to additional income. This would immediately inject cost consciousness into health insurance decisions.
As a matter of policy, this is exactly correct. But ending employer coverage would expose Americans to true health care costs for the first time. These expenses are currently sheltered from view because employers pay the bulk of them. Even though delinking coverage and employment would be offset by higher wages, there would be a lag between ending employer benefits and wage increases. And Americans do not typically understand the that benefits come out of wages. The public would react like a massive financial burden had been created regardless of reality.
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