
Ask HN: Should your employer pay for your primary health care? - jobless
Is ethical to expect from your employer to pay for primary health care for you and your family?
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giardini
Before World War II people bought their own health insurance. When the US
government imposed salary freezes during the war, employers offered benefits
such as health insurance to entice potential employees. Those benefits were
also tax-free. When the war ended the system stayed in place.

IOW we once had no employer-paid health insurance and we could shift back to
such a system. All the same, I would expect a pay raise if it happened.

"History of USA employer-provided health insurance":
[https://www.peoplekeep.com/blog/part-1-the-history-
of-u.s.-e...](https://www.peoplekeep.com/blog/part-1-the-history-
of-u.s.-employer-provided-health-insurance-post-world-war-ii)

~~~
rumanator
Something is very wrong in a society when a worker depends on retaining his
employment relationship with his current employer to have access to
healthcare. Your employer should not have such power over the health of you
and your family, and conversely the power to cut off your and your family's
access to healthcare.

~~~
taurath
It’s great for the employers, and all they have to do is astroturf their
employees that it’s somehow good for them and they’re getting a great deal and
any alternative is worse.

~~~
rumanator
I mean, it's also great for the employee to have access to healthcare. Better
to have than to have not. Yet, a society has a huge problem if the best it can
do for it's citizens is to deepen the control of employees over vital aspects
of their employees lives.

~~~
taurath
It’s not great if it means the employee gets worse quality care for more cost
than anywhere else. Better than the alternative? The problem is in the
question, not the choice.

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WheelsAtLarge
I'm one that believes that it should not be part of the workers benefits
package. We have the ability to make work more flexible with the gig economy
and should work towards detaching health insurance and other benefits from
employment and make health care mandatory for all. I think it's unethical that
some people get health care just because they have the right job while other
have to do without. The irony is that those that can least afford it are the
ones that often have to pay for it.

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fargle
Many employers offer health care for you and your family as a benefit. Some
don't. It'd be unethical to lie about the terms of employment, for example to
claim you'd be eligible and then renege.

Assuming the US, typically employers pay 50% or more of the cost. But the
total cost isn't that much different than what you'd pay on the open market.
So you just have to find out how much that benefit (and others) are worth to
you when comparing salaries. Health care is currently very expensive, and
IMHO, not that great. But it doesn't make that much difference who provides
it. You can buy it on your own, which is especially important for the self-
employed.

It's no more unethical if the company lied and said you'd get health care and
then didn't do it, than if you took a job with a certain salary and benefits
and then demanded more benefits that weren't part of the deal.

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tonetheman
It would be better if your healthcare was not tied to your employment. If that
is you pay instead then there would need to be changes to transparency on
medical pricing.

I would love to be able to change jobs and not have to think about healthcare
as part of the choice.

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gshdg
For your _care_ or for your _insurance_? Those are two different things. The
former seems potentially intrusive. The latter, well, a system where it was
unnecessary would be better. But under current conditions in the US, yes, I
think the employer should pay for insurance. And it’s to the employers
advantage anyway for their employees to be able to afford to see a doctor for
preventive care and to treat illness and injury.

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shams93
They always find ways out of it I've gone nearly 18 years now without any
access to healthcare is it ethical to be forced to fix a broken elbow with
duct tape in the richest country in the world? I had to, even after Obamacare
I still had 0 access and then was taxed to punish me for lack of access the
government should provide access they take the majority of my income but where
does it go certainly not for my healthcare

~~~
fargle
Since 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA)
requires any hospital emergency room to treat an injury like a broken elbow
regardless of ability to pay or whether you were insured. So in the richest
country on earth you do not in fact, neither before nor after obamacare, need
to use duct tape for a fracture.

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avmich
Questions "should your empoloyer..." and "is ethical..." are different.

I'd answer the first one, "should you employer...", as "no". The rationale is
that health care ideally should come equal to everybody, including those who
don't have employer or whose employer doesn't pay for any reason. That likely
means that the government should be (more) involved.

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tinktank
I'm not sure about ethical but for myself, personally, it's essential as I
couldn't afford it otherwise.

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PaulHoule
Is it ethical to expect to get paid?

~~~
krapp
Do ethics even apply to expectations?

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DamonHD
I think that's a big risk for employer that is not itself very large (ie I
suspect "no" for micro SMEs), but luckily I live in the UK so the NHS has
covered me when I've needed treatment. I suspect that I probably could not
have created a series of startups in the US...

~~~
Gibbon1
Every year our President and Accountant spend 2-3 days dicking with insurance
plans for our 15 person company. It's not the end of the world but it's
definitely a distraction they don't need.

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mistermithras
I'm not entirely sure how ethics play into this.

For full-time work, an employer is expected to pay for your health care.
That's how it's supposed to work in the U.S. anyway.

~~~
jvagner
What do you mean “supposed” to?

That’s the convention but it’s far from ideal. While it helps to have the
bargaining power and administration of a plan handled by a company such as one
you work for, the actual costs of healthcare to you are completely up to that
company and you are placed in unreasonable burdens when you switch from one
employer to another (90 days waiting period plus crazy COBRA costs are
onerous).

Your health care needs supersede the timeframes of your employment. There
would be many improvements if we separated healthcare coverage from
employment.

