
Healthcare Perks - wayn3
I just read a job ad of a big company. Like all companies, they offer &quot;perks&quot; to their employees. The top of the list is routinely &quot;health, dental and vision coverage&quot;.<p>In a modern society, healthcare is not a perk. Its basic Human decency. Its a commodity.<p>Making healthcare an employment perk is like making running water an employment perk. Imagine a world in which running water in your home was default turned off and really expensive but if you found a job, the company would turn it on for you, almost free of charge. This sounds really ridiculous, doesn&#x27;t it?<p>People won&#x27;t quit thinking of healthcare as an optional goodie that comes with good jobs unless you quit calling it a perk.<p>Quit calling basic healthcare a perk. Words are powerful.
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webmaven
Things are even worse than your water analogy at most US employers:

\- Even when the water is turned on, it isn't free. Depending on your
employer, some percentage of your monthly water plan bill is deducted from
your paycheck. Furthermore, for many water uses you have to pay a set per-use
fee. In some cases, you have to stick coins into a slot to actually get water.
Of course, in an emergency, you don't have to pay in advance, but you also
don't really know how much you are going to be charged after the fire is put
out.

\- There are often strange restrictions on what you can use the water for,
with many uses triggering higher rates.

\- there is a cap on how much water you can use. No, not a per month cap, a
_lifetime_ cap. Once you go over the cap, your company sponsored water plan is
cancelled, and you have to pay for everything yourself at _much_ higher rates.

\- Your water bill is almost certainly going to increase every year by 10-15%,
and possibly quite a bit more.

\- The more water you use, the higher rate you are going to pay if you ever
have to negotiate your own (non-employer-sponsored) water plan.

\- Oddly, your water plan is in effect even when you aren't at home, but the
rate you will have to pay at a water fountain will depend on whether the
vendor operating the fountain has a prenegotiated agreement with your water
company. If there isn't an agreement in place, the percentage that you (rather
than your water co.) are responsible for paying _and_ the rate that is charged
both go up considerably. This is true even when travelling to another state,
where finding an "in-network" water supplier to keep your costs down can be a
very frustrating experience when you really just need a cool drink to
rehydrate.

In short, the jury-rigged, patchwork, inconsistent and hugely expensive
"water" system in the US is completely screwed up, and the employees who have
to rely on it get completely screwed _over_ at the time they most need it. _"
Best in the world my ass", he mutters..._

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wayn3
You may have guessed that I'm not from the US. Some additional thoughts:

I'm the last guy to want to pay high taxes, but I believe that some form of
minimalist government is generally not a bad idea.

What government is really good at is making sure that new transformative
technology, that generally turns into some form of monopoly along the way,
because there was precisely one inventor, gets properly commoditized along the
way.

Examples:

Telephony, Electricity, "Water on demand" like in your shower, THE INTERNET,
healthcare (affordable access to doctors), etc.(?)

None of you would argue that at&t, spring and whoever else is part of that
oligopoly should be able to collude and turn basic telephony into a luxury.
Maybe not so valid anymore because voip, but think 20 years ago.

Same goes for electricity and The InternetTM, which is basically a goddess
that we nerds pray to.

No one in their right mind, except for some legislators and billionaire
idiots, would argue against net neutrality. Theres way too much at stake
there. This is one of the very few true government functions, in my opinion.
Ensuring access to utilities (and at this point, the internet is a utility. it
is cheap to provide and runs the world). I have no problem with a couple
actors getting really rich providing internet access, but that privilege
should come with some rules, because the implications for society would be
immense.

^This is a natural monopoly.

The same goes for healthcare. Healthcare is immensely important to society as
a whole. Even ignoring the personal hardship of slowly withering away, having
large amounts of people die for decades costs a lot of money (because we don't
really let them die, there are all kinds of other subsidies that absorb some
cost of the dying, like social security).

Providing Healthcare is easy. Maybe not in absolute terms, but given where we
are at as a society, treating common ailments, even acutely life-threatening
ones like pneumonia, is pretty simple. In fact, we've gotten so good at
healthcare that we are continually driving up cancer as a leading cause of
death, simply because there are not many other causes of death left.

Healthcare is a monopoly in that who gets to practice medicine is strictly
regulated. Government agencies decide who gets to be a doctor and who doesn't.
The process that promotes people to doctors is probably somewhat fair and
efficient, but that doesn't change the facts. Beyond that, there is a weird
kind of monopolistic process to getting sick. People who get sick are
routinely not responsible for getting sick. A sick person NEEDS healthcare.
There are no effective alternatives to dealing with sickness (other than
suffering through it). Therefore, all hospitals hold mini-monopolies over
their region, and it has been shown that hospitals do not engage in market
mechanics. Where there are multiple hospitals to choose from, they are usually
being acquired by companies to cut out the price competition.

A very small percentage of people who've got access to healthcare pay for it
themselves, anyway. Companies pay for it, establishing a clear rift between
those who work and those who don't. And people who are sick can't find work,
for obvious reasons. Companies who are serious about the health of their
employees view healthcare as a necessity. But they don't bill it as a
necessity. They call it a perk. People who work are inherently better than
those who don't.

Last point: Opponents of regulated healthcare claim that it rewards
inefficiency. I agree with government fucking a lot of programs up in terms of
costs, but the american healthcare systems is one of the most expensive in the
world, even when just compared to those that are operated entirely by
governments. It seems to me that the government staying out of it rewards
inefficiency, in this case.

I hold a health insurance policy from an international healthcare provider,
that is not tied to any single one jurisdiction in particular. It costs me
about $1.5k per year, for state of the art healthcare, anywhere in the world,
except the U.S. (means that wherever I am, if I get sick I can walk into a
healthcare facility of my choice and receive treatment. If the countries'
healthcare standards are deemed too low, they will fly me out to a first world
country when necessary). They have no problem covering the U.S. as well, but
the plan that includes that would be $5k per year.

