The other day, I was trying to figure out why the paycheck deduction for my health insurance was higher than I had expected. When I called my insurer to ask what the total premium was, the customer service representative said it was none of my business.
Three-fifths of Americans, the share with employer-provided health insurance, are in the same situation: Since someone else buys insurance for them, using money they would otherwise receive as wages, they are in no position to shop around and typically do not even know the true cost of their coverage. This disconnect between payment and consumption is one of the central problems with the current health care system, contributing to rapidly escalating costs, insecurity, and the general lack of choice and competition. Yet both Democrats and Republicans insist upon preserving it.
Outlining his health care reforms last week, President Obama was at pains to reassure the public that "nothing in this plan will require you or your employer to change the coverage or the doctor you have." In fact, he said employers should be forced to provide health insurance (or, alternatively, contribute to a fund that subsidizes premiums).
Obama presented himself as the protector of job-based medical coverage against those "on the right" who "argue that we should end employer-based systems and leave individuals to buy health insurance on their own." That approach, he warned, represents "a radical shift that would disrupt the health care most people currently have."
Meanwhile, the Republicans, whose last president and last presidential candidate both proposed eliminating the tax incentives that encourage employers to offer health insurance in lieu of higher pay, seem to have abandoned that idea. One of their main complaints about Obama's plan is that it would reduce the number of Americans covered through their jobs.
Senate Minority Leader Mitch McConnell, R-Ky., warns that one Democratic health care bill "would cause 10 million people with employer-based insurance to lose the coverage they have." The Republican National Committee claims "over 88 million people" who are covered through work "would lose current insurance under government-run health care."
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