Covering Costs
When I first started working, one of the benefits my employer offered was life insurance. As I moved from one company to another, seeking a career, workplace benefits increased in number so that I soon had medical insurance, too, fully paid for by my employer. Within a short period of time, I was paying a portion of that cost, and every year thereafter, my percentage of the premium rose right along with the annual rate increases imposed by the insurers. My second job post-graduate school was in a small employee-benefits consulting outfit, where we sold mid-size companies restructuring plans to save money on benefits offerings even as they increased what they made available to their employees. “Cafeteria”-style programs, where the “value” of a group life plan was sold as part of a total compensation package, and HMO’s, PPO’s, and conventional hospital coverage presented different advantages and costs to be borne by employees along with their employers (the 401(k), relatively new at the time, and because it was little understood, became the hook on which the sale of our services depended) . . . all these now familiar offerings are a seemingly inextricable part of operating a business today. The employer subsidization of these offerings was translated by Human Resources departments into alternative compensation. You don’t just get a salary, you get all these things, too. As this became more common, more expected, the salary savings never materialized. Maybe because the cost of the insurance kept growing, even for the employee, as did the cost of accessing the care provided for in the insurance package, with co-pays and out-of-pocket minimums and deductible thresholds, all of which also grew, year-by-year. Employers have become increasingly disgruntled over providing insurance, giving rise to contract hires and the use of temporaries, all to avoid giving out benefits the value of which have increased right along with the price tag, despite group experience ratings (or because of them). It’s a Catch-22 situation, increasingly, in the States: you need a large enough group to get the lowest possible rate, but utilization of plan benefits increases the experience rating, raising premiums. It’s a system that’s breaking down, and Australia’s buying into it even as it starts to collapse in America. There are many opponents, but socialized medicine seems a better alternative (even while it’s under attack here) than allowing the present situation to continue through to its apparently inevitable failure, where only a few can afford insurance and health care itself grows further out of reach for the rest of us.