Companies offer part-time jobs instead of full-time ones because then they don't need to offer benefits that are required for a full-time job. In other words, the current rules of the game are directly incentivizing this behavior.
The incentive can be very easily removed by legislating that a part-time job would need to offer a fraction of the benefits proportional to the amount of hours the employee works per week.
Ideally, there should be some sort of a credit transfer mechanism, where an employee working multiple part-time jobs that combine to 40+ hours a week could get benefits equivalent to a full-time job at one of the workplaces, proportionally covered by all employers.
Another option would be to crack down on monopolies and large chains. If you employ 10000 corporate drones, who are expected to follow the same corporate instructions day-to-day and can be swapped out by a fresh hire without any loss of productivity, they by definition don't have any economic leverage. On the other hand, if the same market niche is occupied by 1000 independent 10-employee companies, the overall efficiency is lower, but the leverage of each employee (and the salary they can negotiate through supply/demand) is higher. Because in a smaller company you are someone the owner trusts to delegate part of their business, and not just a line on the spreadsheet.
Why not just get rid of the connection between employer and benefits? Employer pays cash, tax system allow people to manage roth/health/etc accounts based on caps and percentages of earned income.
If the free market was supposed to handle the distortion of employer benefit programs, then every employee would need to monitor their employer's yearly benefit negotiations such that 10-20% of them would be giving notice on the basis of any negative benefit change. That isn't happening.
If folks are losing their jobs (assuming they don't have a nest egg which the majority of Americans do not have) how will they be better off being personally unable to pay for health care instead of losing access to their employer provided insurance to pay for healthcare?
Also - a lot of these benefits are things we'd generally consider "necessary" - if that's the case why would we open the door wider to allowing folks to continue being paid 7.25/hr and now not even have a chance at ever seeing a doctor?
Or, if that money is personally controlled is it going to be secured against debt repayment? Will individuals have a guaranteed right to pay for medical care before any paycheck garnishing?
We already have unemployment insurance, it’s easy to imagine something like government assisted cobra for recent job loss.
We already have Medicaid for people who are chronically poor.
It’s possible to decouple healthcare from a specific employer without moving to single payer or similar. I often like to point to Germany to show there is are much more varied solutions that can be tried than people are likely to say.
Conflating all these different ideas makes it harder to find an optimal solution, IMO.
Single bidder though. A reverse dutch auction in each market region for qualified providers to offer services, and if the price in that market isn't desired then short term bring in the military docs, and longer term fund the education of more doctors with the provision that they resettle among the target areas needing coverage.
The problem with USA's private healthcare system is that it refuses to train enough doctors. You're supposed to overproduce doctors to drive prices down.
I don't think so - the implication I read from "Pay me more and let me control my money." was an entirely private individual insurance market. If I misread the comment my apologies.
I had the same impression, which is an insane idea. The reason people should have universal healthcare and universal pensions and so on is to use society's size to shield everyone from individual risks.
Swiss American here. It's not insane [1]. The state of healthcare in America is so poor, I would caution us from referring to anything as insane without empirical evidence.
If people are arguing over what I meant, this system is the one I was thinking of.
The US already implemented tax penalties on no-coverage and could adapt them to be auto-enrollement in basic coverage at a high deductible.
I have nothing against single payer, but I don't think it is worth fighting for the details of it in the US system when it can be emulated like it is in Switzerland.
(But for pricing to be fair, the more important problem in to reverse the incentive for removing lower risk individuals into group plans and make sure everyone is considering the actual price of their insurance.)
It's not too unreasonable if we could also have a transparent, competitive, reasonably priced healthcare market. Doing that would require a lot of changes to how we conduct medical school admissions, residency, and medical licensing that'd be fought tooth & nail by the healthcare industry, though.
I don't believe a transparent healthcare system is realistically achievable without essentially moving over to full government control - I wrote up a thing above[1] if it's of interest.
Part of the issue is that the insurance pool needs to include low risk individuals to work.
If everyone under 30 says “I won’t shell out for private insurance, and if something catastrophic happens, fuck it, I’ll declare bankruptcy”, the system falls apart for everyone. Unpopular as it is, this is the logic behind the ACA mandate.
It’s a terrible outcome, unless you’re rich enough not to care about insurance to begin with. You get coverage that’s unaffordable for higher risk people who need it, and uninsured “healthy” people one stroke of bad luck away from disaster.
That isn’t insurance. You don’t need low-risk people in the pool for insurance to work. Insurance premiums are technically derived from individual risk, not the risk of an arbitrary pool. Pooling is only done to reduce the tail risk of the underwriter, it doesn’t materially change individual premiums.
You do need low-risk people in the pool if you want low-risk people to subsidize the insurance premiums of high-risk people. That is not insurance, that is just socializing the premiums of high-risk individuals. These distinctions matter when discussing policy. Socializing medical costs may be the appropriate policy choice but lets not smuggle it in by abusing a term of art like “insurance” which means something very different.
That is how your employer provided plan works, however. They negotiate a rate for the whole group, not an individual medical workup and premium for each individual.
If you want to move away from that to “just pay me the equivalent comp directly and I’ll get my own insurance”, rates are going to get ugly.
If you only get insurance once it is too late it is not insurance either. Insurers have a financial incentive to avoid paying for expensive care. If early or preventative care is cheaper they will administer it while you are "healthy".
Was hoping a Republican Congress and President would at least attempt health care market reforms, but that didn’t happen.
Would be happy with a government run plan, too, just want our government to make some attempt to address the problem, whether from the left or the right.
If you use a market to reduce cost of healthcare, it'll reduce cost for easy to treat conditions by extracting maximum profit from more difficult or rare conditions.
Healthcare being a fundamental right, this fails by not ensuring people with rare conditions get it.
I don't know the details so I appreciate your comment. You cannot have privatized healthcare while simultaneously restricting the supply of medical professionals. That's not a free market. It's welfare for specific individuals.
The biggest drivers of health care cost have little to do with physicians, their training, or licensing although they do all contribute a bit. So to make any impact you'd need a much bigger list of things to change.
I was maybe underemphasizing the labor costs - it's a real contribution. But you are right that everything is more expensive, and it's pretty interconnected. Big contributors: fee for service incentives, administration overhead, end of life care, inefficiencies due to fragmentation and licensing, insurance inefficiency (not the profit margin, but the tracking/coding level of detail), over subscription of expensive (e.g. capital heavy) procedures, pharmaceutical costs.
I agree - but the comment above was, AFAICT specifically advocating for removing both Large and Small Group insurance pools provided by employers from the equation. Folks currently get insurance from a variety of sources, Medicare, Medicaid, Military Tri-care, Fed/State/County Insurance, Self-funded plans - there's a lot of variety here. I believe the comment above was advocating for closing Small and Large Group coverage (and probably self-funded pools as well) in favor of those customers being dumped on the Individual market which does exist - and does definitely have it's own problems.
Oh, and the Individual insurance market predates the ACA and healthcare.gov - it was much harder to navigate before the ACA due to the pre-condition exclusions but there were a variety of plans on offer to individuals.
>I believe the comment above was advocating for closing Small and Large Group coverage (and probably self-funded pools as well) in favor of those customers being dumped on the Individual market which does exist - and does definitely have it's own problems.
The only problems I know of in the individual market are due to the fact that so many healthy lives are locked up in the government/small/large business group plans. If everyone, and I mean everyone was dumped onto the market, then there would be sufficient healthy lives to balance the whole situation. Basically, it would be the same as taxpayer funded healthcare, except you get to choose your insurance company.
>Oh, and the Individual insurance market predates the ACA and healthcare.gov - it was much harder to navigate before the ACA due to the pre-condition exclusions but there were a variety of plans on offer to individuals.
The individual market pre-ACA and the one that exists now are completely different. It's actually possible to compare different insurances in the one that exists post ACA due to standardization and certain stipulations for being ACA compliant.
>so many healthy lives are locked up in the government/small/large business group plans
Well, that and the fact that many young individuals who don't have health issues, aren't making much money, and aren't covered by employer plans are often opting out of paying $7K/yr or whatever for health care.
Employers require employees to pay for health insurance and subject them to deductibles and copays just like healthcare.gov. The government even pays for a portion of most of the health insurance premium under certain income amounts, so it’s not any different than people with health insurance via employers.
Also, bronze level health insurance is closer to $300 per month for young people, or $3,600 per year.
I don’t disagree. But the basic point is that a lot of younger people in poorly paying jobs still consider, whether one agrees or not, health insurance as being more than they’re willing to pay for.
Yes, I agree that there should be no tax benefits for employer's providing matching contributions to retirement accounts they can restrict investment options for.
I recently hit this up in Canada with a matched group RRSP which has a heavily restricted panel of options for investment and while contributions are matched and the transfer fees aren't too steep they are there and intended to capture clients within their spread of options.
I would prefer if group retirement plans had more flexibility on in/out flow and had to legitimately compete with the open market.
I'm not sure if you meant it this way, but way benefits work you'd actually be getting paid less (total compensation), as one of the driving forces behind benefits packages is it costs the company less than it would for you to get it on your own.
If you are happy with cash salary + (what benefits cost the company ) rather than the bigger cash salary + (nominal value of benefits) then this can work, but you have also be happy with the idea that some of the benefits you are used to become less (or un) affordable to you.
You're assuming that those "benefits" aren't something that can could leverage the scale of an entire country's government. The biggest example of a benefit that's cheaper for a company to provide in bulk is healthcare, and basically every developed country has demonstrated that it's cheaper to let the government handle that. Pensions, paid days off, childcare, and others all make sense to provide at a societal level rather than relying on a company to do right by its employees.
I hear this point a lot about the power of group purchasing. If everyone purchased their own insurance the market would be larger and be able to offer larger discounts.
Doing it at the company level doesn't make sense. Companies with larger sizes have better leverage under this model.
Would the purchasing power be greater at the state level or federal level?
I don’t think it’s purchasing power so much as risk pool. Or really a bit of both, it’s number of healthy vs unhealthy people in the pool. Employees of a company tend to be healthier. People on ACA tend to be part time / low wage, and have more health issues. Insurance companies pass that through by charging based on risk. I imagine what would happen is this would average out, the total cost(including employer contribution) would go up for most of the hn crowd who can afford it, but down for others who currently can’t
I would like this. It would simplify how I manage my own finances. For example, my 401(K), healthcare, dental, and insurance plans are all tied into poorly made apps I have to manage through an employee dashboard.
On the other hand, my personal finances are pretty easily managed through much better apps and services I selected myself.
If I just received cash compensation, I could manage my own finances much more easily.
Companies often select benefits providers based on ease-of use for the corporate customer rather than the end user. Shifting the purchasing decision to the end user will change incentives for the benefits providers.
Unfortunately moving that bargaining to the individual level would also result in a lack of negotiating power. What with forced arbitration and restrictions on class action suits being a thing the legal system can't properly serve a large number of individual bargainers that all individually suffered small damages in a just manner.
Collective bargaining comes with a lot of benefits - doing it at the employer level is just extremely unfortunate for jobless persons.
This might have been true before the internet, but it’s completely unnecessary now that it is trivial to shop and compare prices for insurance and investment funds.
There’s tons of near zero cost investment options from Vanguard/Schwab/Fidelity, you can go to healthcare.gov for health insurance, and you can go to term4sale for life insurance, etc, etc.
The only difference nowadays is that employers large enough to do non discrimination testing and handle the paperwork have an unfair advantage over small business and individuals by being able to compensate people with tax free benefits, whereas small business and individuals can’t.
I work in a healthcare adjacent business and while there is a large amount of information out there and a lot of market participants it isn't nearly enough information to make an informed decision. Whether a drug you currently use will be reimbursed at your local pharmacy and about what your out of pocket cost will be is entirely opaque to the consumer - it's even opaque to drug manufacturers and, in many cases, the precise cost is opaque to insurers until the pharmacy actually states their fill cost to the insurer for reimbursement - and these charges are arbitrary and continuously in flux.
When shopping for individual insurance you're trying to balance a lot of future unknowns - will you puncture your kidney in the next year and need dialysis? How likely is it and how much is 50% POC (Price of Charge) coverage worth to you? Are you going to need an oncological drug due to a sudden cancer diagnosis - those can easily run into the hundreds of thousands of dollars a month - I hope you don't accidentally choose an insurance that covers treatment for all variants of cancer except the one you need treated.
The health insurance market is insanely opaque and most employers pick a reasonable plan and, when that plan inevitably refuses to cover a necessary procedure for their employee - they bitch and moan at the company over the phone and leverage their collective bargaining. There are also some really good reasons that the ACA didn't extend the individual market as a replacement for medicare since those insanely expensive and obscure treatments get more likely as you age.
Right now we're sorta surviving on insurance supplemented by go-fund-me and good will but that's a terrible system. Sudden insane health expenses can happen to you - I hope they don't, I wish they didn't happen to anyone - but our current system treats most folks decently well and really screws over a select few, and not due to any particularly stupid decisions on their part in most cases.
Collective bargaining is most useful when the 'little guy' has few options, or the switching costs are very high. Consumers seem to do well when purchasing other types of insurance, and I think they'd do well to get rid of the principal agent problem (if they can keep the tax benefits).
I think the biggest problems with employer-provided benefits come at the 'employment transients' (i.e. the time just after leaving jobs and while getting new ones).
If group pricing were eliminated and levels of coverage standardized for a universal open enrollment period then pricing would be consumer oriented and most would be extremely competitive.
HR people can only get numbers from a small number of insurers after an excessive amount of time and have leverage as weak as someone buying a new car.
Coverage standardization would be an absolute game changer - but at that point that standard of coverage is being dictated by someone - either a cartel of the insurers or the government. It's much more likely to be done by the government but if that's the case then you essentially have medicare for all except you have a bunch of private bureaucrats in the middle draining money out of the system and adding no value.
If the precise definition of the product is dictated by the government then what differentiation are the insurers actually providing that adds value to the equation. Right now insurers actually do do a fair amount of good work trying to assess treatment efficacy and ensure that their customers get the best outcomes within a reasonable budget. If coverage is standardized then they're just acting as a pool of money - cash goes in, it comes out, occasionally one of the pools will go bankrupt and catastrophe will befall a lot of folks - or else the government will step in and save it so... why not just let the government run it?
Insurer's roles would be marginalized to competing on doing just enough administration and estimating/negotiating cost/pricing.. They also would still have incentives to cut costs as they get temporary benefits of cost cutting until copied by the other insurers. It's not a lot but it is areas medicare has problems with (and pricing would get harder still without a reference private market) and retaining a private layer is more compatible with the politics of the US even when it is a pure cost.
Insurers have actuaries to make sure they don't go bankrupt. They would be plenty happy to just sit there as middle men skimming off a cut forever. With standardization of care it becomes a lobbing fight as every other player in the industry, plus various groups representing the public, are also working to get that standard to cover everything imaginable. This already happens with state minimum coverage requirements.
That's great until you or someone in your household has a pre-existing condition, then you're hosed. Either you can't find coverage or the coverage you can find is both poor and unaffordable. The way that people with pre-existing conditions get health insurance in a company, as is, is through batch purchase of coverage. This isn't on the table through a single purchase agreement, which is what the great "free market" solution offers.
There are places where the free market is fantastic, but emergency services, like the fire department, police services and health care, seem odd places for nongovernmental intervention. Emergency services, foreign relations, trade, taxation and border disputes are what the government signed up for and they seem the least functional at the first two. 60% is a pretty non functional average.
It's been 10+ years since insurers have been required to provide health insurance to anyone that wants it, regardless of pre existing conditions.
The only thing ACA compliant health insurance can price health insurance is on age, and even that is set so the oldest person's premiums can only be 3x a 21 year old's premiums. I.e. health insurers are made to force younger and/or healthier people to subsidize older and/or unhealthier people.
The amount paid by an employer for its employees' benefits is much smaller than the sum of what all employees would have to pay for the same benefits if they were to sign up as individuals.
Employers (ie a group of employees) go through a broker to get benefits. The broker (ie a group of employers) goes to insurance carriers to get good prices for benefits. There is power in numbers.
In principle I completely agree with you, it drives me nuts to change my benefits every time I change my employment, but it would take a while for the "invisible hand" to do its job. If tomorrow, employers start giving employees the cash they spend on benefits, there would be a massive gap in premium that employees would need to cover.
This is why we need a public option for health care. There is no reason the price of healthcare should change if you lose/switch your job (you could be buying in to the same insurance plan).
It’s an accident of US labor rights history that benefits are so tightly coupled to the employer; most other developed countries don’t do it like this and get more favorable prices for similar coverage quality.
There’s been only garbage replies to your question, which is really unfortunate. In reality, we aren’t that far away from being able to do this.
If you are a 1099/gig worker and file your taxes with a schedule C, you’re almost certainly eligible for a SEP-IRA (1). This is way better than a 401k; you can contribute up to 25% of your income (max $57k per year) pretax with all the same investment options as any other retirement plan. Sure, it could be made easier to setup, but it’s been around forever and works. What we need to do is say that if you have an employer who does not provide a [baseline] retirement plan, you are eligible for the SEP-IRA on all income from that employer.
The Covid-19 relief legislation established unemployment assistance for 1099/gig workers with federal backing and administered by the states. This should be kept around, improved, and made sustainable (add a line to the Schedule SE for paying the same kind of unemployment taxes that businesses pay on behalf of employees).
Obamacare allowed for association-based health plans and the Trump administration approved one of them. I don’t recall the details or the current status, but that’s a start in the right direction. Employers pay a lot of money for health plans and their size allows them to negotiate better deals. We need that leverage outside of employers and plenty of other improvements, but at least we have the basics.
Even just eliminating the whole 401(k) shit show by converting them to IRAs and raising the contribution limits for IRAs to ~$25k (roughly the sum total of what a W2 employee can contribute to an IRA + 401(k) combined) would solve the retirement account problem fairly efficiently. I'd be willing to bet that could be accomplished with approximately a page or two of legislation.
Edit: The problem is "lack of political will," i.e.. lack of people or corporations willing to hire lobbyists to make it happen.
Edit 2: While we're at it, why not just let everybody make Roth contributions, at least up to the amount one could contribute to an IRA? Let's just get rid of the whole "backdoor Roth" shenanigans and let people contribute directly.
Just a nit pick: The limit on total employer and employee contributions to a 401(k) is $58,000 in 2021, which includes the $19,500 elective deferral, employer matches, and post-tax contributions. If the "401(k) shit show" was eliminated, I'd hope it would be replaced with similar contribution limits.
To your point about backdoor Roth shenanigans, they aren't really shenanigans, they are legit and IRS-sanctioned. Shenanigans kind of implies you're doing something morally questionable.
Fair point. Raising the total contribution limit from all sources to $58k + $6k, without differentiating between individual and other contributions would totally make sense. It's an implementation detail, but a significant one, to be sure. :-)
There's been the virtual elimination of new private sector defined benefit pensions. Which isn't even entirely a bad thing. Leaving aside issues of benefits being cut in some cases, it was always a system that was designed around people staying decade+ in the same job. And between that and SS in the US, people didn't have much choice for a huge chunk of their savings.
The problems is the various defined contribution schemes were never introduced in a systematic way as you say. 401(k)'s history is particularly unplanned.
The other component is decoupling health care and dental insurance from employment. Because that's a far bigger problem than retirement. A lot of people lost their jobs last year and suddenly had to pay full price on their insurance to keep going to their doctor.
The whole insurance system in the US is best described as a real-life re-enactment of The Trial by Franz Kafka.
Dental insurance isn't really insurance. It's a benefit that exists mostly because it's tax advantaged. [1] Health insurance is, of course, really insurance. With Obamacare the biggest issue is probably that it's really expensive to pay for a good insurance plan (or even a not so good insurance plan) on your own. Though, honestly, not so cheap even with employer participation.
[1] By not really insurance, I mean that most people with it (especially older people) may consider it a nice perk but it doesn't really protect them from out-of-pockets they can't afford.
There is nothing simple. You just have to accept this. It’s really appealing to create the perfect system, but it is just not going to happen. I’m sorry. It’s not going to happen.
> If you are a 1099/gig worker and file your taxes with a schedule C, you’re almost certainly eligible for a SEP-IRA (1). This is way better than a 401k
Not if your spouse works for an employer that offers a 401k.
You're free to do that. I have life insurance and disability insurance that are not linked to my employer. I haven't pulled the trigger on health insurance because I've heard it's super expensive but maybe I will someday.
Socialism creates another bunch of perverse incentives. If you let a central system manage everyone's funds without competing against dozens of other parallel systems, the management's incentive would be to appropriate as much of the funds as possible as management expenses, as long as they won't be called out and fired/jailed.
In the current climate, they would create numerous equity and social justice committees, making sure that everyone gets a personalized pat on the back and 10% of the population will get a small bonus, while 50% of the funds will be spent on the friends of the management sitting in the committees. Anyone trying to call out the corruption will be immediately called racist/sexist by the media, and the economic state of an Average Joe will continue declining at even faster pace.
>In the current climate, they would create numerous equity and social justice committees, making sure that everyone gets a personalized pat on the back and 10% of the population will get a small bonus, while 50% of the funds will be spent on the friends of the management sitting in the committees.
Huh? We currently have a "single payer" health insurance system in the United States. It's called Medicare[0].
And the administrative costs of that system are ~17 times less (~2% for Medicare and ~34% for private insurers[2]) than that of the administrative costs of private insurers[1].
As such, I'm not really sure how you're assessing this. I'd add that administrative expenses for other national healthcare systems are also much lower (Canada ~17%[2]) than private insurers.
Please provide examples and data for your assertions. I'd certainly like to see such data and information, as it doesn't comport with the data and analyses I've seen.
> If you let a central system manage everyone's funds without competing against dozens of other parallel systems, the management's incentive would be to appropriate as much of the funds as possible as management expenses.
How is this different than the current US situation across multiple industries, especially in the medical field? Except that in the case of socialism you can actually vote the leadership out while under the current oligarchy your only recourse is to complain on Twitter.
>How is this different than the current US situation across multiple industries, especially in the medical field?
The current mess with the medical field happens because the hospitals can charge you whatever they think you can afford to pay. You can't compare quotes, pick a reasonable bidder and pay what you were quoted for. Sure, each case is unique and sometimes there are unforeseen circumstances, but currently the majority of out-of-the-network medical billing is just outright extortion. And, of course, it's done in the name of a great cause. "We are doing it out of necessity to pay for those poor folks that cannot afford healthcare". Except, most of this money is landing in the pockets of administrators [0].
>Except that in the case of socialism you can actually vote the leadership out while under the current oligarchy your only recourse is to complain on Twitter.
In the current situation you could vote for someone that would offer to bring more transparency and competition to medical billing. Except, you won't get a chance because people benefiting from the current system and people owning mainstream media play golf together and intend doing it for years to come.
>Socialism creates another bunch of perverse incentives
And capitalism creates other perverse incentives, such as middlemen all trying to get their cut of various fees, charging rents, building competitive moats, obfuscating the paperwork so you can't even figure out what basic services cost in advance... kind of like the health care system currently in the U.S.
Capitalism is good at innovation and at providing additional value but basic needs like food, shelter and healthcare are predictable enough that those needs can be met through the government providing a baseline of services.
Years ago I worked in retail as a night stocker. When I was hired, I was hired part time. Most other new employees were as well for the reason mentioned in this comment.
Eventually, the company underwent a large merger with two other regional retail chains. After this, they decided to go back to the grandfathered full time employees outside management and gave them an ultimatum: be dropped down to part time or take a small severance package and leave. Well, most decided they would take the severance. I decided since I was finally starting my software career, working some part time contracts, that I would take the opportunity to demand and wage, reduced hours, and control of my schedule. It worked at the time, probably because of their inability to hire and retain employees, albeit the raise was pathetic. Eventually however, they started shifting more and more responsibilities on us and the work was taking much longer because the newest hires we're not very good. I started spending more time there and often wouldn't go home till mid morning. I decided I didn't need it and just quit on the spot. A few months later, the company ended up filing for bankruptcy.
>legislating that a part-time job would need to offer a fraction of the benefits proportional
I mean, I think you’re spot on with the incentives but but I worry that your proposed solution would just take what is already a complicated system related to benefits like healthcare and just turn it into a bigger rats nest. It’s hard enough for people to navigate providers for in-network services, then haggle with insurance companies etc. I can’t imagine if this was fractured along different more complicated means.
I know it may be a pipe dream in the US but it seems like a better solution would be to divorce benefits from employers entirely through a single payer system
As a repeat small business owner I would say the lack of public healthcare is the biggest obstacle to entrepreneurship and business formation in the US. It is brutal trying to get a company off the ground and not being able to afford to offer benefits, as it puts you at such a huge hiring disadvantage.
Having to pay fractional benefits etc. would not “fix” things, it would just making starting a new business even harder. For big companies it might end some bad shenanigans they pull, but more likely would just result in layoffs as they consolidated to a smaller labor force.
Or, we could just realize that when you say "benefits," what you're mostly talking about is stuff like health insurance, which can be handled more efficiently by moving to a single payer system. I don't have a reference immediately handy, but there was a study done a little before the 2016 elections that pointed out how single payer (essentially Medicare for All) would reduce costs throughout the healthcare system, while still providing an excellent quality of care.
> I don't have a reference immediately handy, but there was a study done a little before the 2016 elections
A more recent survey of studies looking at single payer healthcare plans found[0]:
"The evidence abounds: A "Medicare for All" single-payer system would guarantee comprehensive coverage to everyone in America and save money.
Christopher Cai and colleagues at three University of California campuses examined 22 studies on the projected cost impact for single-payer health insurance in the United States and reported their findings in a recent paper in PLOS Medicine. Every single study predicted that it would yield net savings over several years. In fact, it’s the only way to rein in health care spending significantly in the U.S.
All of the studies, regardless of ideological orientation, showed that long-term cost savings were likely. Even the Mercatus Center, a right-wing think tank, recently found about $2 trillion in net savings over 10 years from a single-payer Medicare for All system. Most importantly, everyone in America would have high-quality health care coverage."
What benefits are we talking here? I presume mostly healthcare, though I may me missing something. What you suggest is overly complex compared to untying health care from work. In many countries healthcare is not tied to work.
Making the cost of healthcare visible to everyone that currently thinks their employer is screwing them with $100 premiums isn't exactly going to get in the way of a better system.
Or actually solve the problem and stop making companies offer health care. This is a stupid system. So many people worry about losing their job in fear of loosing their health care. So many people do not have healthcare because they do not have a job. A job and healthcare should not be connected is any way.
Completely agree. Once I quit and realized I was only paying $50 more per month with about the same crappy insurance (most insurance is completely bonkers unless you need meds- forget natural treatments) was amazing. Making a lot more as a 1099 worker without the company politics.
> Ideally, there should be some sort of a credit transfer mechanism, where an employee working multiple part-time jobs that combine to 40+ hours a week could get benefits equivalent to a full-time job at one of the workplaces, proportionally covered by all employers.
There's actually a much simpler solution - divorce basic human rights (healthcare) from the employer.
I think a better way to do it would be to basically cut the crap and target companies based on what they're obviously up to.
If a company has more than say X% of their workforce part-time (say between 10-30 hours/week, with <10 hour employees ignored in the denominator) for a period of Y years, every part-time worker gets full benefits, unless they are working another part-time job in a similar company, in which case they get benefits from one and the other will add their average employer contribution to their salary (this reduces uncertainty). Or, if they are working a full-time job (this is unlikely, except for a few businesses e.g. bars) or attending a university that offers healthcare, the requirement can be waived or some appropriate counterbalance can be devised.
The relaxation of labor laws for part-time work is intended to allow employers to efficiently deal with acute labor shortages, not maintain a firm of intentionally precarious and uninsured employees. An exception can be made for businesses which operate less than 30 hours per week, since they have no choice.
Granted, more systemic reforms would be nice, but this problem can be dealt with directly and harshly because it simply shouldn't happen.
The incentive can be very easily removed by legislating that a part-time job would need to offer a fraction of the benefits proportional to the amount of hours the employee works per week.
Ideally, there should be some sort of a credit transfer mechanism, where an employee working multiple part-time jobs that combine to 40+ hours a week could get benefits equivalent to a full-time job at one of the workplaces, proportionally covered by all employers.
Another option would be to crack down on monopolies and large chains. If you employ 10000 corporate drones, who are expected to follow the same corporate instructions day-to-day and can be swapped out by a fresh hire without any loss of productivity, they by definition don't have any economic leverage. On the other hand, if the same market niche is occupied by 1000 independent 10-employee companies, the overall efficiency is lower, but the leverage of each employee (and the salary they can negotiate through supply/demand) is higher. Because in a smaller company you are someone the owner trusts to delegate part of their business, and not just a line on the spreadsheet.