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A Misguided Way of Thinking
The notion that employers either provide a specified level of coverage or pay a penalty, the so-called "employer mandate," is the wrong way to think of the employer's role.
Employers have a greater potential to improve the health of their employees, to be an engine for delivering superior, lower-cost health care in collaboration with community providers and to design health plans that drive healthy behaviors and high-quality, lower-cost health care.
There are three reasons for this:
• Because employers are responsible for other health-related costs, such as workers compensation and disability, and suffer financially from the absenteeism and reduced productivity caused by medical conditions, they have more potential financial paybacks from investing in employee health than other stakeholder. If their stake in health care costs is disconnected from wellness and health care delivery actions, they will not have financial incentives to invest in workforce health. This is a fundamental problem with the U.K. and Canadian systems, and with any system not based on employer-sponsored health plans.
• They can collaborate with the community to deliver care conveniently and around the clock close to where people spend their waking hours. Care delivered at the workplace is less expensive and, because it is delivered by salaried professionals, less hurried.
• Because self-insured plans are less regulated, employers can innovate more and avoid or correct coverage mistakes faster. Government-run or government-regulated plans have problems with politically-driven coverage mandates.
Employer mandates are highly risky. If the penalty for not having coverage is too low, many employers will drop coverage and the poorest risks will end up in other plans. If the penalty is too high, it will be a job killer.
Lawmakers should figure out how to expand high-quality employer coverage, not milk it for revenues or compete with it.
By
Michael Critelli
|
October 6, 2009; 9:12 AM ET
| Category:
Employer health plans
,
Health Care Reform
,
Insurance
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Posted by: boosterprez | October 8, 2009 1:22 PM
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Mr. Critelli makes valid points, but employer-based health insurance does not solve the problem of portability and security.
I would like to see all insurance obtained on an individual basis. Employers could do their part by supplying employees with vouchers to be specifically used for health care, but it is the responsibility of the individual to shop for health care with those dollars. In this way, individuals can shop for a plan that best suits their needs. Employer-based care is often one choice - meaning no choice at all - and health care is not a one-size-fits-all proposition.
Making individuals have a direct connection with their health care costs will make consumers more aware of what things actually cost, which will, in turn, make them more conscientious consumers.