I don't understand why this doesn't get more discussion. It's a much more conservative step than "medicare for all" and would do a lot of good.

As I understand it, you need collective bargaining against insurers to keep individual premiums down. Employers do that today, and if employers just pay out their insurance spend to employees, the employees will get less insurance as a result. A single payer system means the government negotiates on behalf of all of the citizens, allowing it to keep costs down much more than our current system.

Or you mandate that the insurers can only rate on certain variables (e.g. zip code) and/or you mandate a pooling system so that insurers who have many low risk people on their books subsidise insurers who have many high risk people.

Right, there are other solutions, but "just cut the insurance check to employees" isn't a good option for employees.

It has no clear advantages over M4A, and the critical problem is it has no cost-control consequence.

It astonishes me that a global health crisis can ironically trigger loss of healthcare for millions. That's such an abject failure of a system.

You're right, healthcare has no business being tightly coupled to employers -- or employment, in my opinion. Everyone should have healthcare.

My health insurance isn't taxed, or at least effectively not anywhere near what my top salary bracket is. Our tax law means there would be no short-term advantage for either me or my employer to shift that compensation into cash.

If my employer offered additional desirable insurance to replace an equal amount of pre-tax salary, I would gladly except that extra compensation too.

Self employed and businesses get a tax break/expense for that. It could be the same with personal insurance. Doing things only for the tax break leads you to all sorts of finagling twisted fixed markets.

I'd always take real wages over total/real compensation which is supposedly about 30-35% of your pay.

Binding healthcare to employers also makes for less competitive consumer markets as the target customers of medical services are insurers and employers, not the actual users of the service, individuals.

A good first step to break this legacy grip and fixed market would be allowing individuals to expense out their healthcare cost, it would also benefit people that have health issues and not make it so detrimental to their quality of life.

Right now healthcare is a cartel borg bureaucracy because of being tied to employers and not a direct consumer service.