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Freedom Through Chains

June 29, 2012

I was noodling on something a bit yesterday… okay for about ten seconds before I finally fell asleep after a rough week of travel.  I was thinking about how to phrase it, when I saw this piece over at SFGate.  I actually think the whole thing is well-reasoned, if opinionated (but aren’t we all?).  But through the “R’s are saying this, D’s are saying that,” discussion, there’s a little gem at the end that I like:

Some of us would actually welcome the ability, for the first time ever, to choose our own health insurance in a market exchange, rather than being imprisoned in whatever plan our employers choose for us, not to mention imprisoned in the job that provides it.

Packed in there are two points, one which has been made on and off through this whole discussion.  The lack of a market exchange for health insurance is the major cause of most health insurance sucking.  And even good health insurance sucks, let’s all agree on that.  I’ve had at least two occasions in 20 years of very good coverage where I’ve been dissuaded from going to the emergency room (once I went anyway, once I should have), and countless migrane-inducing incidents that cry for a more competitive offering to encourage competition.

I would suspect that quite a few employers will drop healthcare over time, especially as the exchanges prove to be no worse than bad coverage from a company.  Heck, I’ll even bet that some companies will PAY employees to go elsewhere and still come out better after they pay the fines.  I’d also expect that some large companies will move from “essentially self-providing” to “actually providing their own medical services” as well, but that’s another post.

The more relevant point was that last one.  More than once I’ve heard people unhappy with their jobs cite healthcare as a reason for staying.  If a viable option for coverage emerges outside the bounds of a company, how many people will actually pull the ripchord?  Well, not many, at least not right away.  But I know of several large companies that view healthcare as a benefit that’s too good to pass up, and I wonder how many of them are prepared if people with capability start to pass it up precisely because they realize that they don’t need the company anymore?

Keep an eye on this one.  It’s not necessarily a good trend, and the consequences will go much farther than anyone expects.

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