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I’ve been following the healthcare reform debate pretty closely (although I haven’t the time to do really hard-core analysis of all the various policy proposals like Jim Manzi does).  In another post on The Corner, James Capretta argues

At his press conference today, President Obama scrambled to “clarify” his promise to Americans on health care. It won’t work…For months now, going all the way back to the early days of the 2008 campaign, President Obama has been promising Americans that, if they like the insurance plan they have, they will get to keep it. He didn’t just mention this once or twice. It was a staple of his pitch, repeated over and over again.

The president’s “clarification” seems highly unlikely to be the final word on this. For starters, it doesn’t matter much to the voting public who pulls the trigger. They don’t want today’s stable, job-based coverage turned upside by “reform.” When they hear that tens of millions of people will get moved out of employer plans and into the “government option,” they will wonder if they themselves will have to switch insurance — and most don’t want to. The president’s comments today aren’t likely to put their fears to rest.

His main point aside, this sparked a new thought that hadn’t occurred to me before: why aren’t free-market advocates trying to make the case for interstate deregulation and decoupling the tax deduction of health expenses from employment on the grounds of job choice?

Consider: if you’re unhappy in your current job and want to find something else, what do you do?  You’re somewhat trapped in your current job until you have something else lined up with some certainty, unless you’re willing to pay months of Cobra premiums, which aren’t cheap even for people who have full incomes.  Getting that next job lined up can be a chore – getting the job you really want requires a lot of time invested in personal networking, which is hard to do if you’re still obligated to full-time work for the employer you don’t want anymore.

Then, imagine if any individual could take advantage of the same tax deductions for health premiums that employers currently enjoy – suddenly, the employers will find it advantageous to simply make contributions to your health premium costs, but no longer need benefits management companies to tailor plans for specific employers.  A tax-advantaged FSA could be set up, and then you would be perfectly capable of purchasing your own plans on the market – which now makes them portable.  You would no longer be bound to your job simply because your child has an illness that requires expensive treatment to manage.  Your employer would also have a greater incentive to make your job more desirable because there would be one less obstacle between you and the door.

There are alternative scenarios, but they all would mean it would be easier for you to leave your job and still have a good health insurance plan.

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