A Healthcare Story
In the eighties, my mom was working for a very small, but well-known, company a few blocks from where I grew up. She loved working there and there were some nice perks, including being able to walk to work.
When I was about eighteen, one of her coworkers got cancer. I didn't know her -- and I'm sure that it was devastating to her and her family, but that is not my story. Luckily, her cancer was treatable, and I expect that she started receiving the standard treatment, and that it was all covered -- this is not a story about shoddy coverage. As far as I know, the healthcare coverage was fine.
The insurance company started raising the premiums.
They treated the company as an independent risk pool, and since there were probably about fifteen employees, it had a large effect. The company covered some of it, but what was passed through to my mom was approximately triple what she was paying before.
She stayed for a couple of months, to see if it would be possible, but ultimately we couldn't afford it any more (she was a single mom, raising two kids), so she looked for another job, which she got -- though, she has never again worked at a place she liked as much. Her career decision was based 100% on the cost of healthcare, and in ways that are completely fixable.
1. Obviously, risk pools should be based on the insurance company's entire pool, not ever broken down like this. I believe that the situation is better now, but creating a state-wide or nation-wide risk pool would be better. There is no reason why large companies should have an advantage over small companies and individuals when buying coverage.
2. We need to break the link between coverage and employment, and the only institution large enough to do that is the government. If Massachusetts passes universal healthcare, then we will have the problem that coverage is tied to address -- you'll have to live in MA -- but, that's better than what we have now.