Alexander Jablokov

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Healthcare and the writer

One negative feature of our current system of healthcare finance is the fact that health insurance is tied to employment.  This makes changing jobs more difficult and self-employment more expensive, since employer-provided healthcare benefits are excluded from tax while self-employed people can only deduct it from their taxes, a deduction that might be worth very little.

I have other reasons for not trying self-employment, but this is a significant barrier.  The reason it's hidden away there in that employer contribution is so that we don't know how much it actually costs, and, as I pointed out yesterday, even the obvious part costs a lot.  The self-employed see more of the real cost.

That's not to say that the cost is obviously too high.  "More than I wish I had to pay" is not necessarily too high.  But I wish we could all clearly see the cost, and that the cost didn't depend on whether you had a large or small employer, or whether you decided to provide your services on a contract basis rather than as part of firm.  None of those things have anything to do with the actual provision of healthcare services.