Happy Birthday Emily

A couple of my recent blog posts have advocated for single-payer financing for health care in the United States as the most effective path to universal coverage and lower cost. This one is more personal, but also ends with the same conclusion.

My daughter Emily is an actor and singer. Like many artists, she gets by with a part-time job (without benefits) and professional gigs. And, until her recent 26th birthday, she had health insurance coverage as my dependent. She now faces the challenge of finding affordable coverage that will not disrupt her established patterns of medical care.

In many ways, she is fortunate. Until the ACA, she would have been booted off my insurance coverage after she graduated college, and would probably have found it impossible to get private insurance because of pre-existing medical conditions. And even now, I can extend her coverage through COBRA for up to 3 years (and can afford to do so) or she can buy insurance (with some help) on the NY State Health Insurance Exchange. So this is not a crisis for us, but it points out another fundamental flaw of how health insurance generally works in the United States – it is, uniquely among other developed countries, tied to employment.

About half of all Americans have health insurance that is connected to their (or a family member’s) job. In fact, this is often cited as a barrier to reform, since moving to a universal, government sponsored option would end employer-based insurance that a lot of people like. However:

  • Fewer and fewer new jobs come with health insurance, as our economy moves to what Thomas Friedman refers to as “self-driving people.” Airbnb doesn’t provide health insurance
  • Those with employer based insurance are paying a higher percentage of the premium – money that could go instead to fund a more efficient national coverage system
  • Employers are increasingly trying to hold premiums down by providing insurance with high deductibles, limiting the utility of coverage for many

The bottom line for Emily and for the rest of us is that it no longer makes sense to link health insurance with employment, instead of making it universally available. Decoupling employment and coverage would free businesses to concentrate on their business, provide vital security for individuals in a rapidly changing economy, and reduce the complexity of the current “system” that drives waste and cost.

What do you think?

4 thoughts on “Happy Birthday Emily

  1. Good post. Despite all the advantages to universal coverage we still cling to the notion that the practice of medicine is best left as a private corporate activity and not a humanitarian and morally positive issue. Shame on us.

  2. Unfortunately the elites have branded socialism a dirty word. It has always been that way in America. Some of the most anti Semitic agitators in American history focused on the Jewish tendency to favor socialistic policies.

    Hitler of course insisted that all Jews are latent communists and to be despised. Few people realize that Imperial Germany installed Lenin into power at the end of World War I as a way to remove Russia as Germany’s eastern adversary.

    This was a cold blooded decision by the Christian leaders of Germany at that time, that Hitler later used as an excuse to persecute Jews.

    Under Trump America seems to be reverting to the ante-bellum South’s values of paternalism, adulation of rich plantation owners and generally despising working class people and the poor.

    I only hear in evangelical churches about the rights of rich people to do whatever they want with their money. Never do they discuss the rights of workers to be paid fairly for their labor.

    Pastors love to say: The bible doesn’t condemn money, only the love of money, to which we may rightfully ask: How much money does a person need just to prove he doesn’t love it?!

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