The Stupidity Of Employer-Provided Group Insurance
Finance prof John H. Cochrane writes in the WSJ:
If your employer pays you $100 less in salary and buys $100 of group insurance for you, you don't pay taxes on that amount. Hence, the more insurance costs and covers, the less in taxes you seem to pay. (Even that savings is an illusion: The government still needs money and raises overall tax rates to make up the difference.)To add insult to injury, this tax deduction does not apply to portable, guaranteed-renewable individual insurance. You don't get the tax break if your employer gives you the $100 and you buy a policy--a policy that will stay with you if you get sick, leave employment or get divorced. The pre-existing conditions crisis is largely a creature of tax law. You don't lose your car insurance when you change jobs.
If you're like me, you know people chained to jobs because they need to stay with the employer's health insurance due to some condition they came down with while in their job. Health insurance needs to be untied from employment -- especially since there are fewer and fewer people who stay for more than a few years in a job.







Hear, hear!
Jen at February 10, 2012 4:23 AM
I learned this the hard way though I don't know what insurance was available to purchase privately or maybe because my insurance had been tied through my parents, then my job, then my ex-husband, and then job again, it never was an issue. Now that I'm out of work and couldn't afford the COBRA payments, you could say I'm in a bind.
Kristen at February 10, 2012 5:59 AM
Amy Alkon
https://www.advicegoddess.com/archives/2012/02/the-stupidity-o.html#comment-2970621">comment from KristenSorry to hear that, Kristen. Can you get an HMO like Kaiser?
Amy Alkon
at February 10, 2012 6:18 AM
Usually the COBRA amount is what an individual policy will cost. It sounds like you have a good situation w/Kaiser, there is nothing like that in the state where I live. I would be interested to know how many states in addition to CA, where there are similar policies avaiable.
nuzltr2 at February 10, 2012 7:06 AM
Amy Alkon
https://www.advicegoddess.com/archives/2012/02/the-stupidity-o.html#comment-2970679">comment from nuzltr2I lucked out. Oxford, in New York, was nowhere near as good or affordable as Kaiser. You can get Kaiser if you live in White Plains, but not in NYC. I picked Kaiser because once you're in, you're in. I got in as a healthy person in my early 20s. I'm still healthy -- and getting healthier. Recently discovering the Drs. Eades' (and Fred Hahn's) slow-burn fitness has filled in the one health item I was worried about -- bone-strengthening. They lay out in the book how weightlifting (extreme, for example) is thought to weaken bones, but the weightlifter who lifted enormous weights had enormously strong bones.
Book link: The Slow Burn Fitness Revolution: The Slow Motion Exercise That Will Change Your Body in 30 Minutes a Week.
(I also stand on one foot for 15 seconds at a time while brushing my teeth and making my eggs to improve my balance, per an epidemiologist I know. After you can do 15 minutes with your eyes open, start working on doing it with your eyes closed.)
Amy Alkon
at February 10, 2012 7:16 AM
AGREED.
If I lost my job tomorrow, I could survive on my savings for quite a while (no kids). But my fear would be going without insurance. My area does not have Kaiser or anything similar.
Individual coverage is terribly expensive. And, if you so much as had a broken wrist or a bunion in the past, it's often impossible to get.
That $100 decrease in salary per month is generally worth it for a lot of people. Few employers require health tests (so you're guaranteed coverage, even if you have serious health problems). Plus, because it's group, you're getting a lot more bang for your buck (especially if you work for a big company). My boyfriend pays about $90 for an individual plan with NO office visit coverage, NO medicine coverage and a $7,500 deductible.
...then again, he gets to keep his coverage if he decides to change careers, whereas I lose mine if I do the same. It's a tricky trade-off.
sofar at February 10, 2012 7:51 AM
Amy Alkon
https://www.advicegoddess.com/archives/2012/02/the-stupidity-o.html#comment-2970720">comment from sofarThe sick thing is, health care "reform" didn't reform much at all.
Amy Alkon
at February 10, 2012 8:00 AM
Actually COBRA is what your employer would be paying plus a bit for administration - say 5% - it depends per organization. Your individual insurance would likely be a lot more. My COBRA payment was $300/month. Had I not found a job in time, I would had to pay over $1000 month for just me (after COBRA ran out). Yes, I got a quote.
The Former Banker at February 10, 2012 8:37 AM
Kaiser isn't available where I live. There doesn't seem to be much that is affordable which is why I'd like to see changes in the insurance industry. As you point out, things have changed. People aren't tied to jobs for life and when insurance is tied to a job, it creates problems later for some. I have to be honest and say it was something I always took for granted. I don't know if it was something my parents even thought to look at differently because for them too it was always tied to their life long career.
Kristen at February 10, 2012 9:36 AM
We can thank New york for making insurance even more expensive by mandating what it must cover. You can thank New York for spending much more on Medicaid than any other state. Part of that is your money, but more of it is mine, thanks to the NY Legislature passing much of the cost down to the counties who get it from me.
I am sorry to disillusion anyone, but more government interference isn't going to fix the mess that they created.
MarkD at February 10, 2012 11:17 AM
COBRA is MORE expensive than BCBS through work.
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By the way, repeat this line often:
Why do you think more government involvement will make your health care easier? Do you think having more IRS agents around will make your taxes go down?
Radwaste at February 10, 2012 1:11 PM
An overlooked reason why insurance coverage for ordinary, expected costs like contraceptives drives up total costs more than you would expect.
07/26/11 - HealthBlog - Free mandates raise insurance premiums
== ==
[edited] The Institute of Medicine report on women’s health coverage advocates free birth control. But, this isn’t really free. It will raise premium costs.
Chris Jacobs: "The Congressional Budget Office in November 2009 analyzed expected premium increases under Obamacare. CBO noted that Obamacare's richer benefit packages would raise insurance premiums by 27% to 30%, with two-thirds due to lowering copayments and deductibles."
According to the CBO, lower deductibles and copayments alone will add 10% to health insurance premiums under ObamaCare
== ==
Consider this situation. Fred tries a new restaurant. The waiter seats him at a group table for 10; this is an adventure. He isn't very hungry; a ceaser salad for $5 will do. The waiter asks "Will that really be all, Sir?" "Yes, just the salad."
The other nine people at the table all order lobster for $25! The person next to him explains that this is a Lunch Club which encourages community and good feeling. The costs for everyone are added together, and the bill is divided equally among the people at the table.
Fred quickly calls back the waiter and orders lobster.
Shared payment is the problem. Fred faces an average cost he can't control. Say he can get a salad for $5 or a lobster for $25. The change in his personal cost is just $2 [ ($25-$5)/10 ]. He would rather have the lobster for $2 more. This does not depend on the restaurant charging "fee for service" or any lack of choice by the customers.
If he can, he will avoid the restaurant unles he loves lobster. He pays just $2 more for the lobster, but of course pays $25 overall.
Everything would work well if each customer is billed separately. But, our health care reformers insist that we all pay the average costs together. They want to force us into lunch clubs just like that one, and have already gone far in doing this.
Andrew_M_Garland at February 10, 2012 1:36 PM
"If you're like me, you know people chained to jobs because they need to stay with the employer's health insurance"
Pretty sure I would have never gotten married if it weren't for the health care too. It's a crappy reason to get married, but de-coupling would likely discourage marriage, for better or for worse.
$100? Maybe the example would have more punch if you used real numbers: $2,100. Per month! Fer reals. That's a family rate, PPO, $400 deductible. Who here doesn't want a 25 thousand dollar raise?
smurfy at February 10, 2012 4:55 PM
We looked at Cobra when DH switched jobs, just to make sure we had no gap. It was going to be something like $1800 a month for the family. We decided to risk a possible gap. DD broke her hand during that gap. I still saved $1200 on that month alone.
momof4 at February 10, 2012 6:19 PM
So. You should pay NOTHING until you GET medical services.
Why do you think otherwise?
Radwaste at February 11, 2012 9:24 PM
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