In his recent column, “The New Social Contract,” David Brooks argues that”…[T]he old employer-based social contract is eroding and the central domestic policy debate of our time is over how to replace it.” Employers cannot afford the high cost of health care; neither can employees or the government; and certainly neither can the non-traditionally employed American.
Cognizant of this breakdown of the once thriving backbone of health care security for millions of Americans, Brooks echoes the potential efficacy of Butler’s 4 principles of health reform: security, reciprocity, responsibility, and reasonable self-sufficiency.
However, perhaps his strongest principle is the support of alternatives to employer-based insurance. The urgent need for health reform is not just about the absolute cost of the care, but also it is about portability, continuity, and universal, equitable access. It is precisely the civil society-based model of health insurance that has great potential to bridge the gaps in coverage from which many Americans currently suffer. Civil society-based coverage would not force those who like their coverage to make any changes. It would provide portability and effective access to care for those who are not employed full-time by a big business.
Some might argue that this type of reform would diminish the incentive for employers to offer health insurance. So what? What if big businesses altogether stopped providing health insurance? If this civil-society-based system is effective at negotiating reasonable prices, just as large employers have done, then in fact we may be shifting our population slowly toward a more effective way of accessing health coverage.
Alternatively, it might remain true that offering high-quality, comprehensive health care attracts better employees. In that case, employers might surprise even the skeptics and maintain their benefits packages for the same reasons as they did when the “modern American health and pension system” was accidentally born.
0 Responses to “Beyond Employer-Based Health Insurance”