Following last year’s failed efforts to repeal and replace the Affordable Care Act (ACA), supporters for “Medicare for all” or a government health care system are turning up the heat... and, it’s not because it’s HOT this summer in Washington, DC.
There is growing support among Democrats and Independents that health care is a right, not a privilege and government should intervene. One-third of Democratic senators and about 60 percent of Democrats in the House have endorsed a “Medicare for all” bill. Six of the senators supportive of Medicare for all are up for re-election in this year’s mid-terms, and several are potential 2020 presidential candidates, signaling that this concept could intensify in the months to come and serve as a possible campaign platform for progressive candidates.
The outcome of the mid-terms and the next presidential campaign will no doubt impact future employer-sponsored health benefits offerings. Employer advocate groups including SHRM are gearing up for what is expected to be a steamy debate. As a health care lobbyist and consumer of employer-sponsored health insurance, I’m ready to defend the system!
Let’s review the key ingredients of employer-sponsored health insurance that has made the system successful in comparison to government programs. For starters, the employer-provided health care system has a solid base that has been in place for decades, providing quality, affordable health benefits to more than 178 million Americans. Employer health care plans dominate the health care market surpassing coverage offered through government programs like Medicare, Medicaid and the Exchanges of the ACA combined.
Adding to the recipe, employer-sponsored plans tend to be more generous and expansive. Employers have had measurable success controlling costs largely, because they implement consumerist and market-friendly approaches to health insurance. Government health programs, by contrast, have struggled to contain costs due to fraud or otherwise improper payments.
Sweetening the pot, employers have greater flexibility in designing their employer health benefit plans to meet the needs of their workforce. In addition, employers are implementing other health care design options, partnerships, and structures in an effort to continue to offer desirable compensation and benefits packages as a way to recruit and retain talent.
On the other hand, the Medicare system has a lot of ordinary and some would say, generic ingredients which is not appetizing when there are many other options available. The Medicare population is typically older with more chronic conditions than the average population covered by employers. To add, based on current experience with government programs there is a lot of bureaucracy which could delay care and access to prescription drugs. This will inevitably lead to more (healthy) Americans dropping health insurance all together. With the risk pool consisting of the unhealthiest, it will result in higher costs for health insurance across the U.S.
So, what sounds more appealing to you? Employer-sponsored health insurance or Medicare for all?
Chatrane Birbal is Director, Policy Engagement at SHRM.
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