Earlier this month, there was a front page New York Times article on Google, and in particular the lavish benefits that workers get:
The perks of working at Google are the envy of Silicon Valley. Unlimited amounts of free chef-prepared food at all times of day. A climbing wall, a volleyball court and two lap pools. On-site car washes, oil changes and haircuts, not to mention free doctor checkups.
I was reminded of the article when I had a newspaper reporter ask me last week if our employer-based health care system is dead.
As more and more employers either scale back or drop coverage altogether, I do worry about the 19 million Californians who get their health coverage through an employer. I do worry that we may reach a dangeous tipping point, when enough employers in an industry drop coverage, causing all their competitors to follow suit, in a disastrous race to the bottom.
But that’s simply not going to happen with certain types of jobs for certain highly-skilled, highly-competitive jobs. Google wants to attract key engineers and programming specialists, and they do so partially with an attractive health benefits package.
There will always be some employers who offer a health benefit to attract key talent, regardless of what our health system looks like: whether in the best case of universal system (on top of what is offered by the single-payer system), in the worst case of an everybody-for-themselves system of individual vouchers or HSAs, or even in a pay-or-play-type system where employers have a choice of providing it directly, or buying from a common pool even is that plan is attractive.
The question is what happens for everbody else: The new trend is that not just low-income workers are finding themselves without benefits: it’s middle-income families, it’s the jobs that are becoming more prevalent in our economy. Unless you are in a highly-specialized, highly-sought-after field, you could be one job away from being uninsured. And even many in Silicon Valley are very aware of this.
But my point is this: even if the employer-based health care system collapsed tomorrow, it would go from covering over 50% of the population now to 10-20%, and there would probably still be several million people with employer-provided health benefits.
But right now, there’s around 5%–a little over one million people–who buy coverage as individuals.
The real question should be: is the individual insurance system dead?