Our nation's health care problems continue to mount. It's overpriced, doesn't serve patients equitably, and the wrong people make money from it. I can't address every bit of it in this post, but I do want to talk about a fundamental flaw in the way we approach health insurance.

As I understand things, health insurance as an employer-provided fringe benefit is something that rose after the Second World War. Prior to that, most people didn't have health insurance. Let's consider the economics from the employer side first. To the employer, health insurance as an employee benefit is a cost. Costs are anathema to a business, so the employers would only offer this if absolutely necessary. Why offer it? To attract employees and compete for labor, of course. So, if an employer can find other ways to attract labor, he would cut health insurance, right? If you want to consider an example, see Wal-Mart. That company offers health insurance for full-time employees, so naturally Wal-Mart has a majority of part-time employees. Nice! I imagine the various ways that an employer can avoid offering health insurance are as diverse as snowflakes--no two strategies are alike.

So why are we sticking to this model of organizing health insurance around employment? There are no jobs-for-life these days, so insurance is as transient as the next job. And how are children served by a model that requires employment to get insurance? They're innocents and it's not their fault that they can't get insurance when their parents fail to. To those who say that people are responsible for getting jobs and the related insurance, I ask: "what about children?"


And what about adults? Businesses have a powerful incentive to avoid the cost of insurance for their employees, so this is a clear conflict. Adults also need the ability to change jobs without fear of losing insurance at key moments of life's journey. None of this is served by the current model, let alone the tremendous cost burden it puts on businesses when they compete against foreign businesses.

Are we really going to stick to this economic model based on some bizarre notion of "personal responsibility"?

CDs listened to today:

• Ben Folds Five: Whatever And Ever Amen