The costs of receiving health insurance through employers continue
to grow. A new paper shows ?rising health costs are forcing many
employees who want to retain coverage to surrender both income and
benefits.? As with a higher minimum wage, ?Every 10 percent increase in
health insurance costs reduces the chances of being employed by 1.6
percent. It also reduces hours worked by 1 percent.? (tip: NCPA)
Employer-provided
health care also leads would-be reformers to think in black and white.
Alain Enthoven says integrated systems should compete, not individual
providers as Michael Porter has suggested. The criticisms of Enthoven
and Porter, as well as their solutions, are based on the
employer-provided system, so they miss the potential for some people to
prefer enrollment in a system and others to prefer payment for
individual visits. Again, the market has already synthesized the
ideas?Access Health Care in Apex offers set prices for those with
infrequent needs and subscriptions for those with chronic conditions
such as diabetes. Medical tourism is another cost-effective way to meet some acute needs?and it’s much nicer to recover in Phuket Bay than in Philadelphia.
Some other suggestions:
- Move insurance purchase decisions from employers to individuals (more choices, better suited to specific needs)
- Eliminate mandates (why should Mormons pay for alcoholism treatment?)
- Allow cross-state purchases
- Allow greater variation in premiums based on behavior (pricing works better than preaching)