Why am I posting this? I have no idea. I'm sorry for anyone who reads this, it just bubbled out of me. Actually, I know why I wrote it, my son is trying out for football and basketball this year, and they keep making him have physicals, of course our insurance will only pay for one per year, but they insist that the physical has to be within the last 30 days before it will be accepted by the school. Sigh. It isn't fair. Anyway, I wrote the following in a 15 minute binge of, um, creative whining, enjoy.
Health insurance in the U.S. makes no sense. I often felt like I would have gone a radically different way in life had I not been forced to seek employment for the health benefits. I’m rather conservative by nature, and a bit averse to taking risks. I’m not the type of guy that will have 17 start-ups and declare bankruptcy 6 times before finding the means of succeeding. I’m just not going to do that.
So, what was I going to say? Oh yes, the story about the history of the insurance industry is very interesting, hopefully, interesting enough to read a few hundred words about. I’m sure I’ll get a few details wrong, as I don’t believe in research. So here goes. Consider it ‘truthy’, if not accurate in every detail.
Way back when the world was young, being a good doctor, at least in the U.S., meant being nice, and having the ability to kinda sorta make people feel better if you could. It didn’t matter if what you were doing was beneficial or not, as long as you were making the effort.
Well, the scientific method had found a firm footing in Europe and some genius decided to put those methodologies into place in regards to medicine. The U.S. lagged behind a bit, but slowly, things started to catch on here too. By the late 1800’s it was still a ‘feel good’ sort of profession here. You wanted to be a doctor? Good, hang a sign in your window and open your shop. You needed more training to be a cobbler than a physician in those days.
Aspirin hit the market and guess what? It actually had some medicinal benefit. After that, folks were starting to expect their doctors to, you know, actually know what they were doing, and prescribing things that would actually help, not just get them drunk.
So, with actual money being spent to develop treatments, drugs, etc, the cost of seeing a doctor was beginning to rise. It was still affordable for the most part, it wasn’t prohibitively expensive, but it was going up. I think that cheap, but still modern medicine (in the sense that the word ‘efficacy’ was being thrown around) was the norm until around the 30’s, when the great depression was wrecking the lives of everyone and even a cheap trip to the doctor was impossible for a lot of folks. A suffering hospital went out into their community and asked if folks wanted to spread the costs out so a single trip to seek medical attention wouldn’t force folks to choose between eating and getting their broken leg set.
Yea, insurance was born. Everyone lived happily ever after.
Until WWII. Damn Nazi’s ruined everything. Companies looking to hire much needed help were competing for a small pool of applicants, with most of the young workforce off fighting across the globe there was a lot of competition for talent. Knowing this was going to be concern, and worried that paying high wages would really screw up our economy, the powers that be froze wages. Companies couldn’t offer more money, they’d have to entice folks with other kinds of… benefits.
I won’t get into how, in the 60’s, the modern a la carte model of medical services, dictated by the U.S. government, doomed us all to a runaway inflation for medical services, made middle class doctors into wealthy men, and quickly made the possibility of getting medical care without insurance impossible. That isn’t the point. The point is that every large company in the U.S. was offering health benefits to lure workers in.
That might have been a temporary thing, a stop gap measure until the boys that were off defeating the Axis powers got home to start working again, if it weren’t for one, teeny little thing, an arbitrary decision made by a no-name accountant buried deep within the labyrinth of the government bureaucracy that was asked a simple question one day.
Do we get a tax break for this?
Yep, that’s it, an urban legend was going around that companies that offered medical benefits to their employees could get tax benefits for doing so. There was nothing in the tax code that said it was so at the time, but the rumor persisted, and if the story is to be believed, when a mid-level guy was asked, formally, if this was the case. He had no idea, but said yes.
The official pronouncement spread like wildfire, the government, if they were waffling on the point, had the decision made for them. It was shortly thereafter made official and there it was.
So today, 70 years or so later, workers are tied to their jobs because we can’t pay half a million dollars for a simple procedure because that’s just a bit too much. And the employer based Insurance system we have is all we have. Sure, I could go out and get insurance on my own, but the cost of doing so is also prohibitive, and the level of care I would be getting would be far less than what I get now. For some reason, most Americans think it’s the greatest thing in the world. And if I loved the work I did, like, really loved the work I did, then I might agree. But doggone it. I’m not that thrilled with it. I could make more money doing other things in life. But the person in me who fears that he’ll wake up one day with a third arm sprouting from my skull doesn’t want to lose everything I decide to have said third armed removed. I’ll go and pay my measly little co-pay, have it lopped off, and thank my lucky stars I’ve got medical insurance.
Doesn’t seem right though. It isn’t right. I don’t know what to do about. I may write a blog post about it.