Participation in the healthcare system in this country is largely tied to your employment. If you need healthcare, get a job. If your employer doesn’t offer healthcare insurance,  you are likely to simply go without. Stay at your current job for another 8 years, no matter how much you hate it so your coverage will continue when you retire.  For a majority of the population, this is unfortunately the current paradigm. 

Ross Douthat just published an op-ed in the New York Times that suggested that “Employer-provided health insurance is an idea whose time has passed”.

I strongly agree.

And I would take his argument further and state that the disconnect in the system between the health insurance customer (the employer) and the covered member is one of the core factors leading to a population that is not engaged in their health and wellness and is willingly marching towards preventable chronic disease, and yes, premature death.

There is a line item on my pay stub that represents how much I contributed towards my healthcare for the month. Quite frankly, without looking it up right now, I don’t even know how much I pay. I don’t look at those pay stubs, just the total amount that is automatically deposited in my account. I do know that my health plan requires me to pay fixed co-pay amounts for most of the healthcare services I utilize – so I think of my healthcare expenses as these fixed copays. $10 here, $20 there.  

But the truth is that employers pay about $16k per year for an average covered employee and her family. That is $16k being spent on my behalf and it is completely separated from my awareness and my experience with the healthcare system.

I am suggesting that if we knew how much health care costs and were more directly involved in paying it, we would take a whole bunch better care of ourselves. I’m reasonably healthy, I don’t think about healthcare insurance much, but if I was paying $16k a year out of my pocket you’d better believe I’d have an entirely different level of engagement with my insurance and with my health and wellness.

A few weeks ago I wrote an “Imagine If Your Health Plan Was…” post that painted an entirely different picture for what a relationship with a healthcare insurance company could be. But the only way this utopian vision could work is if employer-provided healthcare ended and health insurance became something to be owned and managed by individuals instead of by corporate America. 

My health and my selection of and engagement with a health insurance plan should absolutely not be linked to my job, that is just ridiculous.

Instead, pay me $16k more per year, and put that amount into a separate income category that is not taxable and has to be spent on healthcare – and get back to the business of making cars, developing iPhone apps and running your restaurants.