Your Health May Soon Be Lots Of People's Business
I've long argued that health care should be untied from the workplace -- especially since few people stay in the same workplace for very long these days.
I've paid monthly, independently, for my own health insurance since I was in my 20s.
It is utterly unconnected to my employment (which happens to be freelance), except as the price shoots through the roof when I have to pay for all those people who gambled and went without health care and then got sick and now want to get in at low rates.
Paul Hsieh writes at Forbes that Obamacare is turning your boss into Big Brother:
Recently, the CVS Caremark Corporation began requiring employees to disclose personal health information (including weight, blood pressure, and body fat levels) or else pay an annual $600 fine. Workers must make this information available to the company's employee "Wellness Program" and sign a form stating that they're doing so voluntarily.CVS argues this will help workers "take more responsibility for improving their health." At one level, this makes a certain sense. Because the company is paying for their employees' health insurance, they naturally prefer healthier workers. But at a deeper level, CVS' action demonstrates a growing problem with our current system of employer-provided health insurance. If our bosses must pay for our health care, they will inevitably seek greater control over our lifestyles.
Although most Americans take it for granted that they receive health insurance through the workplace, this is an artifact of federal tax rules from World War II. When the U.S. government imposed wartime wage controls, employers could no longer compete for workers by offering higher salaries. Instead, they competed by offering more generous fringe benefits such as health insurance. In 1943, the IRS ruled that employees did not have to pay tax on health benefits provided by employers; in 1954, the IRS made this permanent.
The federal government thus distorted the health insurance market in favor of employer-based plans. If a company paid $100 for health insurance with pre-tax dollars, the employee enjoyed the full benefit. But if the employee received that $100 as salary, he could only purchase $50-70 of insurance after taxes. Over time, this tax disparity helped employer-based health insurance dominate the private insurance market. In 2008, over 90% of non-elderly Americans with private insurance received it through their workplace.
Hence, government policy artificially injects the employer into the relationship between a patient and the health insurance system. Normally, what a worker ate or whether he smoked at home would be of no concern to his boss (unless it affected job performance). But U.S. government policy makes it the employer's business.
To make matters worse, ObamaCare reinforces this status quo. ObamaCare requires large employers to offer health insurance to workers (or else pay a penalty). As a result, more people are discussing how best to link employment to healthy behavior. For example, the New England Journal of Medicine recently featured a pair of high-profile editorials debating the merits of allowing companies to discriminate against smokers, "for their own good."
Read his whole piece over at Forbes.
via @ariarmstrong







Anyone care to wager that some politico down the line argues that the government should mandate what you eat, drink, and smoke (more than they already do) because of ObamaCare?
You may not be interested in the Food Gestapo, but they are interested in you.
I R A Darth Aggie at April 26, 2013 7:18 AM
Right? This is just so wrong on so many levels.
Flynne at April 26, 2013 7:23 AM
@IRA: Anyone care to wager that some politico down the line argues that the government should mandate what you eat, drink, and smoke (more than they already do) because of ObamaCare?
What you pay for private health insurance is already impacted by your lifestyle habits. But I can picture it getting far worse. Does anyone care to wager that some regulatory agency will set in place dietary and lifestyle rules that all insurers (or the government) will have to follow in determining your rates or what care you receive?
Does anyone care to wager that these rules will be driven by whatever the latest "scientific" fads are, with a healthy dose of special interest palm greasing thrown in?
Does anyone care to wager our Lovely Hostess will be dropped by her health insurer due to her unhealthy diet?
Old RPM Daddy (OldRPMDaddy at GMail dot com) at April 26, 2013 7:39 AM
And what about the dare-devils? I used to work with a guy in perfect glowing health that climbed mountains, bungee-jumped, rode in motocross and spelunked, etc. He spent way more time at the hospital than any of the fat ladies or sedentary smokers did. Head injuries are expensive.
bmused at April 26, 2013 11:37 AM
Government mandates Employer provide health insurance.
Employer now involved in mandating "healthy" choices (eat your carbs per government pie chart) to Employee to help control costs.
Employee complains to government about Employer involvement in their health care.
Government mandates how/why/when/what/where Employer provides health insurance.
Repeat until Singularity of complete Government responsibility for "citizens" health care achieved.
JFP at April 26, 2013 2:56 PM
Does anyone care to wager our Lovely Hostess will be dropped by her health insurer due to her unhealthy diet?
Isn't that a pre-existing condition?
And what about the dare-devils?
They'll get pain pills.
Repeat until Singularity of complete Government responsibility for "citizens" health care achieved.
Thread winner.
I R A Darth Aggie at April 26, 2013 5:34 PM
Amy Alkon
http://www.advicegoddess.com/archives/2013/04/26/your_health_may.html#comment-3690893">comment from I R A Darth AggieDoes anyone care to wager our Lovely Hostess will be dropped by her health insurer due to her unhealthy diet?
You mean "unhealthy," right?
I'm probably one of too few Americans whose Vitamin D level is not in "starvation substrate."
Meat has the perfect nutrients in the perfect proportions for the human body.
My blood pressure and other health stats are "enviable," as a nurse once told me.
True, what I eat doesn't correspond with the non-evidence-based diet doctors recommend. But, I'm healthy as fuck.
Oh -- also, I don't have an "employer."
Amy Alkon
at April 26, 2013 6:05 PM
And of course, none of this would be an issue if...
Radwaste at April 26, 2013 6:48 PM
Pay cash. It's the only way to be sure.
Jim P. at April 26, 2013 6:52 PM
The federal government continues to explore macroeconomics by doing massive experiments on the populace of peasant guinea pigs.
Consider an employer of more than 50 full-time workers. The penalty supposedly "on the employer" for not providing health insurance is a complicated brew, up to $2,000 per employee. Soon, we will be able to measure experimentally the comparative elasticity of labor supply, labor demand, and investment demand. In simpler terms, we will find out how much of the penalty produces lower wages, a lower return on investment (and less investment in new jobs), and/or produces higher prices. The data will be a boon to economics professors, who will study it for years.
It may seem that the employer is paying for most of health insurance. But, all costs of employing people, including health insurance, are paid for out of the production of the employee. If the employer did not pay for health insurance, then that part of employee compensation would be paid in cash to the employee, through competition for workers. This has been studied (at the link below).
The penalty, supposedly on employers, will mostly reduce the employee's benefits and cash wage by $2,000 yearly. Any increase in insurance costs mandated by ObamaCare will also mostly reduce cash wages. Companies are finding ways to limit their costs under ObamaCare because they don't want to directly reduce wages and they want to stay in business.
Ironically, if an employer-provided health benefit now costs more than $2,000, the employee's salary will go up by the savings. But, the employee will then have to buy insurance privately at an exchange. The employee is effectively taxed $2,000 at work, possibly to be given a subsidy at the exchange. People will never understand this complexity.
Many employers want to entirely escape these taxes which must fall on the worker. Their workers can't afford the reduction in cash salary which would result from participation in Obamacare. Their workers would quit to work for some other company who could offer a larger salary, to work for a company of less than 50 full-time employees.
ObamaCare is designed to put the employer in the middle, so that workers will be angry at the employer for any problems. This is part of the anti-business stance of Team Obama. The eventual failure of ObamaCare will be blamed on supposedly greedy businessmen who would not supply reasonable insurance to their employees. But, it is entirely a government failure.
Company Paid Health Insurance is Part of Your Salary
The employee earns his health benefits as part of what he is paid. The employer merely writes the check for him.
Andrew_M_Garland at April 26, 2013 8:38 PM
"True, what I eat doesn't correspond with the non-evidence-based diet doctors recommend. But, I'm healthy as fuck."
Of course I was being facetious. The point I was making was that if the government makes the rules, they get to decide what the "science" behind them is, too, objective facts notwithstanding.
Old RPM Daddy (OldRPMDaddy at GMail dot com) at April 27, 2013 10:12 AM
Amy Alkon
http://www.advicegoddess.com/archives/2013/04/26/your_health_may.html#comment-3691549">comment from Old RPM Daddy (OldRPMDaddy at GMail dot com)In fact, my doctor's exam room had all sorts of stuff up about eating "healthy whole grains." (There is no such thing -- wheat is terrible for you.)
She mentioned "Wheat Belly," and I mentioned that I'd had Dr. Davis (the author) on my radio show. And Dr. Volek. And the Drs. Eades.
Amy Alkon
at April 27, 2013 11:14 AM
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