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What new or revised public policy/law would make it easier for people to maintain a healthy weight?
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I support Mayor Bloomberg's idea of taxing 1L sodas. Maybe other types of junk should get taxed.7
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lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.1 -
sharondesfor935 wrote: »availability of healthful foods everywhere (ex: there are "food desserts") and an affordable price. some of hte cheapest foods are very hit fat/sugar/cals. and harder to get the healthful foods and meal prep with little money and working 3 jobs.
Let me try a little preemptive craziness here. What if we priced food by the calorie? More calories = more expensive. Celery, lettuce, spinach, kale, cabbage would be nearly free; fresh fruits and vegetables would be very reasonably priced; grains and beans would be mid-range; lean meats would be more expensive; fatty meats would be your splurge of the month; desserts would be cost-prohibitive and something you had maybe once or twice a year for an incredibly special event.
People would gravitate towards healthier choices, because those would be the affordable foods. The poorest people would eat the best. Obesity and all its related health issues would plummet. Publicly-borne costs for healthcare would drop dramatically.
We don't "price" foods. Price is set by the market. If celery, etc. were basically worthless (nearly free to buy), why would anyone grow them? So what would happen is a greater distortion of the market toward high cal foods. Cool!
I'm in favor of getting rid of ag subsidies, just out of principle, but I suspect the main result would be slightly higher priced meat and dairy.5 -
magnusthenerd wrote: »
Really? Why should it have been obvious?
Probably my use of the word choice.
When you mention some people don't have a choice, you demonstrate that you are trying to create a straw man argument.
If you don't understand, ask a clarifying question.
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Rockin_reese wrote: »I support Mayor Bloomberg's idea of taxing 1L sodas. Maybe other types of junk should get taxed.
IMO, if this were to happen any size would need to be taxed. Tax the product if you're going to do it and not the size.
Tax on a percent basis is the same on a 40 oz or a case of beer.0 -
tbright1965 wrote: »magnusthenerd wrote: »
Really? Why should it have been obvious?
Probably my use of the word choice.
When you mention some people don't have a choice, you demonstrate that you are trying to create a straw man argument.
If you don't understand, ask a clarifying question.
From your first post it seemed like you wanted only private insurance or no insurance at all. No employer-based, no gov't supplied or subsidized, no Medicare-type options. That would lead to a burden on people with health conditions, choice or no (and no, the vast majority of medical need is not due to bad choices). So how do you deal with that?
I think magnus's take was pretty fair given the post.5 -
Theoldguy1 wrote: »Rockin_reese wrote: »I support Mayor Bloomberg's idea of taxing 1L sodas. Maybe other types of junk should get taxed.
IMO, if this were to happen any size would need to be taxed. Tax the product if you're going to do it and not the size.
Tax on a percent basis is the same on a 40 oz or a case of beer.
OK, yeah I get that. Thx0 -
lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Please explain the bolded part above.
How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?
I would understand, that small companies struggle to make enough profit to 'write off' from, but this still doesn't qualify as 'compensation' for the employees.
Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions. In clear text: if it isn't on their W-2 form (for the US, e.g.) and part of their taxable income, it didn't happen.
Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.3 -
lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Please explain the bolded part above.
How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?
I would understand, that small companies struggle to make enough profit to 'write off' from, but this still doesn't qualify as 'compensation' for the employees.
Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions. In clear text: if it isn't on their W-2 form (for the US, e.g.) and part of their taxable income, it didn't happen.
Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.
If you are talking about US Federal income taxes, your understanding of business taxes is incorrect.
In simple terms a business's taxable income is based on its revenues less the expenses required to create those revenues, employee costs (compensation) being one of those expenses.
From a business's tax standpoint if a person gets $100k in salary and no other benefits, it's exactly the same as if the person gets $80k in salary and $20k in health insurance, $100k total. In both situations the business's expense for that employee is $100k. There is no additional "write off" for health insurance.
Under current individual tax law, certain benefits (including health care premiums) are not counted as income to the employee so they don't appear on the W-2 (although you will get a supplemental, information only form, the number escapes me now that shows the value of employee provided health insurance).
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lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Please explain the bolded part above.
How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?
What Theoldguy said. It is compensation from the perspective of the employer. That it's not counted that way to the employee (mostly) is a benefit to the employee, as they pay less in taxes.
Also, the tax issue is totally irrelevant here -- in real terms it is compensation for the employment provided to employees (or not) and from the employee's perspective ought to be understood as part of what's being paid for the job (part of compensation), but frequently is not, which is one reason the understanding of the costs of health insurance is often flawed in the US (employees may think they get free health care or count only the premiums they pay). Some who get employer-based insurance don't understand how much is actually being paid for it (and that at least in some cases their salaries in cash would be higher if not for the insurance part).Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions.
This is confused. I'm not saying they have a contract for $65K or $100K or what not and then are paid an amount less the cost of insurance. I'm saying that from the employer's standpoint what they are receiving in real terms is the $65K plus the additional cost of insurance, even if in the employer's mind the cost of insurance to the employer is not considered and if insurance costs go up they would still expect the same type of raise as in other years.
I'm not sure what you mean by right to compensation anyway, since the amount of the compensation is not a right, it's offered by the employer and accepted (or not) by the employee. Above minimum wage (and these are salaried employees, some exempt and some non exempt), there is no right to a specific amount of compensation per year outside of whatever was agreed to be paid. There is also no right to a particular raise per year.
What in fact happens is that most people take insurance, since ours is good, but in the rare cases where someone doesn't (perhaps the spouse has better insurance), their salary is often higher as a result, as that seems fairer. But if the employees compare salaries, I suspect it won't be seen as fair.Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.
More realistically, it's provided in fields in which payment of such is market and standard, so you need to provide it to compete. It's not a reward. And employers will of course take it into account in considering the real cost of employing an employee.
Like I said before, I don't think employers should be the source of health insurance in an ideal world.2 -
Theoldguy1 wrote: »lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Please explain the bolded part above.
How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?
I would understand, that small companies struggle to make enough profit to 'write off' from, but this still doesn't qualify as 'compensation' for the employees.
Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions. In clear text: if it isn't on their W-2 form (for the US, e.g.) and part of their taxable income, it didn't happen.
Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.
If you are talking about US Federal income taxes, your understanding of business taxes is incorrect.
In simple terms a business's taxable income is based on its revenues less the expenses required to create those revenues, employee costs (compensation) being one of those expenses.
From a business's tax standpoint if a person gets $100k in salary and no other benefits, it's exactly the same as if the person gets $80k in salary and $20k in health insurance, $100k total. In both situations the business's expense for that employee is $100k. There is no additional "write off" for health insurance.
Under current individual tax law, certain benefits (including health care premiums) are not counted as income to the employee so they don't appear on the W-2 (although you will get a supplemental, information only form, the number escapes me now that shows the value of employee provided health insurance).
But payroll taxes, which are 7.65% for the employer as well as the employee are based on salary and not total compensation. So they may save 7.65% on the 20k in benefits costs as they don't have to pay matching payroll taxes for that portion of compensation.
Therefore, there is some tax incentive to offer benefits.
If it still makes sense or not is a whole additional issue. But Income Tax is not the only tax an employer (or an employee as we are reminded by many) pays. So there may still be incentives to offer fringe benefits instead of paying a higher salary.2 -
I just want people to have the freedom to decide for themselves. I don't want politicians deciding how best to buy votes with taxpayer money by suggesting they are the arbiters of the greater good.
That freedom would include each person deciding and choosing to contribute to helping one another as they, and not politicians see fit.tbright1965 wrote: »magnusthenerd wrote: »
Really? Why should it have been obvious?
Probably my use of the word choice.
When you mention some people don't have a choice, you demonstrate that you are trying to create a straw man argument.
If you don't understand, ask a clarifying question.
From your first post it seemed like you wanted only private insurance or no insurance at all. No employer-based, no gov't supplied or subsidized, no Medicare-type options. That would lead to a burden on people with health conditions, choice or no (and no, the vast majority of medical need is not due to bad choices). So how do you deal with that?
I think magnus's take was pretty fair given the post.
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lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
I agree that viewing health insurance as the employer's responsibility is problematic and also agree that it would be beneficial to allow for the option of higher wages in place of providing insurance as an employee benefit.
However, I dont believe that making health insurance a government institution is the answer.
I'd much rather see it turned over to the free market and allow insurance companies to compete for my business through better coverages and lower costs. Give independent agencies the opportunity to promote different plans and companies based on my needs much like personal and commercial casualty and liability insurance is handled now.
Force CIGNA and Blue Cross to fight over me and find ways to better serve me so that I choose their company. Let them find ways to make my coverage more affordable or more comprehensive while remaining profitable.
Open the doors for new companies to innovate new ways of offering coverage, similar to what Root is doing with car insurance (moving from the demographic model to a model which measures actual individual risks).
Turning the health insurance industry over to government control would stifle the kinds of innovation that the free market encourages and would eliminate any real competition. Coverage and pricing models would likely become standardized and fixed in such a manner that affordability and better coverage would be unattainable for many in that there would be no flexibility. That's aside from the fact that government run health care would necessitate a mountain of bureaucracy.
I'd much rather be able to pick and choose my coverages and be underwritten based on my individual circumstances for better coverage and better rates, just like I can do now with my car insurance.
Privatization and trading my employer paid coverage for a $500 increase in wages per paycheck (what my employer already pays for my current plan) so that I can afford to buy my own plan makes that possible much more simply (and far more dependably) than a government run health care program.
As for the tax benefit of employer paid coverage, make health insurance premiums tax deductible and you're covered there as well.
And side note on taxes, I think allowing HSAs (health savings accounts) for those not covered by high deductible plans would be beneficial as well.1 -
Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone.7
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What is our alternative? Leave it to the same government that has to keep extending the retirement age of Social Security and pays AIME (Average Indexed Monthly Earnings) at three different rates.
Some wages are are paid at 90%, then 32% and finally 15% up to the maximum AIME.
Those earners getting paid at 32 and 15 percent are getting the shaft in the program. Why not pay everyone 90% of every AIME dollar earned in the formula?
Or better yet, let people decide if they want to be part of it, and/or how much. I.E. I wouldn't mind contributing up to the 90% payout rate, but I really don't want to keep "contributing" when my "benefits" drop to 32 or 15 percent.
Let us contribute up to the 90% AIME value and then let us invest the rest as we, not Uncle Sam sees fit, which seems to be spending it immediately and putting an IOU in the Social Security "lock box."
I don't trust the same people who set up a system that pays those who contribute the most the least per dollar "contributed" to operate in my best interests when it comes to other benefits.Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone.
6 -
Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone.
And the government has done better with social security?4 -
Carlos_421 wrote: »Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone.
And the government has done better with social security?
Not great, but better than most people of my acquaintance do with their 401Ks, 403Bs, 457s, IRAs and whatnot.
I have no solution.tbright1965 wrote: »What is our alternative?
<snip for length>
Heck if I know. I'm not an economist or financial planner.
Personally, I did fine with a middle class family income (never reached 6 figures per annum, not even very close) plus 403b, 457, IRAs (Roth & conventional), and a bit of "nonretirement" investments (a bit of the above funded by my employer, but by far most by me). I'm not at all wealthy, but I'm not terrified about my future, either.
But I've been very lucky: Stable employment, no financial catastrophes along the way.
Nearly no one around me without an employer pension (defined benefit type) has been able to retire at 65, and most take SSI as soon as they hit 65 if not 62. Many people I know say they don't expect to be able to stop working for pay, ever. They have negligible retirement savings.
Stats I read suggest that what I see in others around me is pretty common.
I don't know what the answer is, but it seems an inescapable but logical conclusion that most people either have really a lot of bad luck, or aren't very good at managing their own money.
I don't see why they'd do any better with health care than with retirement, sadly.
If policy doesn't work with actual humans . . . it doesn't work.5 -
lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Please explain the bolded part above.
How can a company count this as 'compensation', when health insurance costs can be written off as business deduction. Is your company cheating on the taxes and writing it off as expense twice..once as compensation, twice as business cost?
What Theoldguy said. It is compensation from the perspective of the employer. That it's not counted that way to the employee (mostly) is a benefit to the employee, as they pay less in taxes.
Also, the tax issue is totally irrelevant here -- in real terms it is compensation for the employment provided to employees (or not) and from the employee's perspective ought to be understood as part of what's being paid for the job (part of compensation), but frequently is not, which is one reason the understanding of the costs of health insurance is often flawed in the US (employees may think they get free health care or count only the premiums they pay). Some who get employer-based insurance don't understand how much is actually being paid for it (and that at least in some cases their salaries in cash would be higher if not for the insurance part).Employees have (by law) the right to their compensation, free and clear of any hidden or implied compensations or deductions.
This is confused. I'm not saying they have a contract for $65K or $100K or what not and then are paid an amount less the cost of insurance. I'm saying that from the employer's standpoint what they are receiving in real terms is the $65K plus the additional cost of insurance, even if in the employer's mind the cost of insurance to the employer is not considered and if insurance costs go up they would still expect the same type of raise as in other years.
I'm not sure what you mean by right to compensation anyway, since the amount of the compensation is not a right, it's offered by the employer and accepted (or not) by the employee. Above minimum wage (and these are salaried employees, some exempt and some non exempt), there is no right to a specific amount of compensation per year outside of whatever was agreed to be paid. There is also no right to a particular raise per year.
What in fact happens is that most people take insurance, since ours is good, but in the rare cases where someone doesn't (perhaps the spouse has better insurance), their salary is often higher as a result, as that seems fairer. But if the employees compare salaries, I suspect it won't be seen as fair.Personally, I understand company-provided insurance as benefit and reward for employees who contribute through their attendance (min hours for part-time) or fulltime commitment. It should hold talent in the company, and not make people miserable by holding their well deserved pay raise hostage.
More realistically, it's provided in fields in which payment of such is market and standard, so you need to provide it to compete. It's not a reward. And employers will of course take it into account in considering the real cost of employing an employee.
Like I said before, I don't think employers should be the source of health insurance in an ideal world.
Thanks for taking time to elaborate on that. I understand now what you mean.
The thing that threw me off, is that your company is so obviously paying different salaries for the exact same work performed. Yes, the employees would definitely see this as unfair.
As for a better world in healthcare, read about https://en.wikipedia.org/wiki/Healthcare_in_Germany .
I think that's something to consider. It isn't free, but it definitely contributes to peace of mind, and a better quality of life.1 -
Carlos_421 wrote: »Yes, let's pay people more, and ask them to purchase their own health care or services on the open market (or not, based on their own self-perceived economic interests) . . . since expecting most people to plan for and fund their own retirement income has worked out so super well for everyone.
And the government has done better with social security?
Not great, but better than most people of my acquaintance do with their 401Ks, 403Bs, 457s, IRAs and whatnot.
I have no solution.
Probably because they expected social security to take care of them.
Most people of my acquaintance (around my age) don't even have much hope that they'll receive social security benefits in retirement.3 -
lynn_glenmont wrote: »FireOpalCO wrote: »FireOpalCO wrote: »There are 168 hours in a week.
It is not your employer's responsibility to manage 2% of your time to exercise.
Along that vein, it shouldn't be our employer's responsibility to manage our health care. Yet they do. I'm all for replacing what we have with a single payer system.
My husband doesn't like his job and he's really tempted to move to another employer. But it would potentially cause such a disruption to our son's medical care and he can't lose his providers. Changing ABA therapists is such a bigger deal then finding a new family doctor or even a specialist like cardiologist.
Your employer doesn't see it this way. Part of your compensation is provided in sponsored healthcare. Are you aware of the cost?
You can choose to outsource responsibility, but this comes at a great cost.
I'm very aware of the cost. I'm an HR manager for an employer of approximately 14,000 people. I have my SPHR (Senior Professional in Human Resources). Many employers would LOVE to get out of the business of providing health care for their employees. It would be much easier for us to take that employer cost and pay it as a payroll tax towards single payer and not have to deal with all the headache of shopping and managing health insurance plans.
I'm a partner in a small firm, and health care and salaries are things we talk about every year at our year end meeting. I totally agree with you. Not only would my company love to not have to deal with health care, but it affects negatively who we can hire and salaries -- we consider health care as part of salary, necessarily, but what that means is a less valuable employee who has no health care costs (because on the spouse's) may get more "salary" from us than someone we value more and would like to give a larger raise. We know, however, that the employees don't count the health care expenditures as salary. Since in our industry good health care is standard, it's basically required that all provide it, even though it's not really a function that we are specialized for.
I think due to the structure few have an understanding of what they are paying for health care, or specific procedures, which precludes real cost competition (so there's no real free market now), but it does preclude people from changing jobs and especially being entrepreneurs. My dad started his own business when I was in my late teens (my sister was younger), but largely only because he had the freedom to because my mom had a job with good insurance.
?? In the case of someone you're compensating with a higher salary because they get their health insurance through their spouse's employer, what happens if the spouse loses their insurance (e.g., loses their job; dies; suffers long-term disability; decides to become a stay-at-home parent or has to take a hiatus to care for an elderly parent). Do you tell them they have to take a pay cut if they want to sign up at the next open enrollment period?
No, but it would likely affect future raises, since health insurance is part of compensation. That's why the current system is screwed up. Employers understand that health insurance costs = compensation, but most employees don't.
At my firm, gov't taking responsibility for health care would result in higher salaries/bonuses. I know that's not true everywhere, but this is my particular first hand experience.
Devil's advocate but if the cash salaries were raised say $20k in lieu of health insurance, that becomes taxable income to the employees at their marginal rate, i.e, $5-7k pay cut when the tax impact is considered to their total compensation.3
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