If we want to radically improve insurance and health care in our country to ensure that every American receives the care they need, we have to be bold. And that begins with divorcing insurance from where we work.
Not only would that improve the choices of consumers, but it would also help lower costs and provide more options for people who aren’t covered in the current system. That would empower individuals to choose their health plans according to their needs.
As of March 2019, the U.S. Census estimates that 91% of the population had health insurance. Nearly one third receive coverage from government health insurance, whether Medicare, Medicaid or state employees. Left out are approximately 29.9 million Americans without health insurance — public, private or otherwise.
The number of uninsured is an important metric because it is the target group for most substantial health insurance reforms of the past decade, including Obamacare at the federal level and the expansion of Medicaid eligibility at the state level, both problematic in their own right.
According to a Kaiser Family Foundation survey, 45% of the uninsured say the cost is too high, while 31% of the uninsured lost their coverage because they made too much money for Medicaid or they changed employers.
The single largest category of the insured in our country is those who receive insurance through their jobs, approximately 54%. Why is that?
Since 1973, the federal government provided incentives to employers who set up Health Maintenance Organizations for their employees. Since then, our health insurance market has pivoted to match having a job with health insurance. Incentives to employers to cover health care for their employees is good policy on its face, but it has led to unforeseen economic consequences.