Americans are about to learn something horrifying: how irrational it is for health insurance to be linked to your employment status
By Wendell Potter
The Guardian, March 27, 2020
The tragic effects of our battle with the novel coronavirus are seemingly endless. But arguably the most mind-blowing is this: the very pandemic that threatens to infect and kill millions is simultaneously causing many to also lose their health coverage at their gravest time of need.
Here’s how: the virus has caused a public health crisis so severe that people have been forced to stay home, causing businesses to shutter and lay off workers. And with roughly half of Americans getting their health insurance from their employer, these layoffs mean not only losing their income but also their medical coverage. In other words, just as our need for medical care skyrockets in the face of a global pandemic, fewer will have health insurance or be able to afford it.
America needs to finally get out of the business of linking health coverage to job status. Even in better times, this arrangement was a bad idea from a health perspective. Most Americans whose families depend on their employers for coverage are just a layoff away from being uninsured. And now, when many businesses are shutting down and considering layoffs, it’s a public health disaster.
It’s worth noting that even in good times, the employer-based model fails to cover enough of us, with the number of Americans covered through an employer steadily dropping in general. Since 1999, the percentage of those with job-based coverage has declined by nine points. And it most certainly will drop like a rock in the coming weeks and months.
By Don McCanne, M.D.
A well designed single payer model of an improved Medicare for All would meet the health care financing needs of everyone forever while being affordable for each of us based on our ability to pay. Yet some politicians and pundits keep telling us that we want to protect our choice of continuing to be covered through private insurance, which for about half of us means keeping the insurance we receive through our employment.
But that’s a fallacy. Think back twenty years ago. Do you have the same insurance now that you had then? Likely not, unless you are over 85 and on Medicare or perhaps if your long-term employer has provided benefits under Kaiser Permanente. But most of you have not had the opportunity to continue on the plan you had twenty years ago.
Coverage under employer-sponsored plans is highly unstable. The most common reason is that, each year, over 60 million people leave their jobs and thus lose the coverage they had, if any. Though many will find other coverage through a new employer, through ACA exchanges, through Medicaid if income eligible, or through Medicare if age eligible, virtually none will be able to keep their previous plan once COBRA runs out. Also employers frequently change the plans they offer which often means changing the network of physicians and hospitals that are covered or changing the benefits and cost sharing, especially the deductibles.
Right now, job instability due to the coronavirus pandemic demonstrates how fragile coverage under employer-sponsored plans can be, as Wendell Potter describes in his article. Many of those being laid off will find that their options for health care coverage may be very limited if for no other reason than that the options may be unaffordable if the individual does not qualify for a government subsidized program.
If there ever was an opportune time to talk up single payer improved Medicare for All, that time is now. With the tremendous insecurity that so many of us are facing, it would be a relief if at least we had in place a system that would ensure health security forever, no matter what crises we may or may not face. If the people demand it, we can have it.
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