Health insurance coverage, primarily for my wife, is one of the biggest reasons I have a full time job right now instead of expanding the contracting I was doing previously or trying to start a business. For various reasons, she is nigh-uninsurable, and she's working two part time jobs, which of course offer no health insurance whatsoever. When I was contracting, we had two separate private insurance policies, with a combined deductible of something like $6,000.
The bolded point at the top of the article is absolutely true: If you cannot afford health insurance, you can't afford to freelance. I often wonder if being shackled to a job by the specter of being uninsured isn't built into the system on purpose.
I don't think it was intentional. My understanding is that getting health insurance through your employer became a major thing when wage controls during World War II prevented employers from competing on salary. It remains a major thing because it enjoys a status as non-taxable income (also dating from World War II).
But even if it was accidental, it is morally perverse. For anyone with a serious illness, you can turn the statement around -- "You can stop working for me, but then you won't be able to get the medicine you need" -- and it sounds a lot like slavery.
One of the things that's perverse about it is that medical "insurance" is handled on a monthly basis, rather than on a per-diagnosis basis. Think about how insane that would be in another field. What if car insurance paid for things on a monthly basis rather than a per-accident basis? What if life insurance worked per-month rather than per-death?
My dream health insurance plan would insure me against the possibility of getting cancer -- and if I was diagnosed with it, it would be their responsibility to cover treatment, not just in any month in which I paid my premiums, but for the lifetime of any disease discovered while I was current on the plan. My dream health insurance plan would be willing to help me insure against variations in the cost of treatment for pre-existing conditions, but for conditions I truly couldn't pay for, would refer me to a charity.
I'm of the opinion that the misalignment is a result of businesses trying to keep employees healthy rather than the natural result of individuals mitigating risk.
The link between health insurance and employment needs to be severed yesterday.
I absolutely think that the system is preserved that way to keep down wages, but has the perverse systemic effect of lowering labor liquidity. There's no lobbying group for labor liquidity, though.
The bolded point at the top of the article is absolutely true: If you cannot afford health insurance, you can't afford to freelance. I often wonder if being shackled to a job by the specter of being uninsured isn't built into the system on purpose.