Employer Health Insurance Quotes

In a society in which nearly everybody is dominated by somebody else's mind or by a disembodied mind, it becomes increasingly difficult to learn the truth about the activities of governments and corporations, about the quality or value of products, or about the health of one's own place and economy. In such a society, also, our private economies will depend less and less upon the private ownership of real, usable property, and more and more upon property that is institutional and abstract, beyond individual control, such as money, insurance policies, certificates of deposit, stocks, and shares. And as our private economies become more abstract, the mutual, free helps and pleasures of family and community life will be supplanted by a kind of displaced or placeless citizenship and by commerce with impersonal and self-interested suppliers... Thus, although we are not slaves in name, and cannot be carried to market and sold as somebody else's legal chattels, we are free only within narrow limits. For all our talk about liberation and personal autonomy, there are few choices that we are free to make. What would be the point, for example, if a majority of our people decided to be self-employed? The great enemy of freedom is the alignment of political power with wealth. This alignment destroys the commonwealth - that is, the natural wealth of localities and the local economies of household, neighborhood, and community - and so destroys democracy, of which the commonwealth is the foundation and practical means.

Pick a leader who will not only bail out banks and airlines, but also families from losing their homes -- or jobs due to their companies moving to other countries. Pick a leader who will fund schools, not limit spending on education and allow libraries to close. Pick a leader who chooses diplomacy over war. An honest broker in foreign relations. A leader with integrity, one who says what they mean, keeps their word and does not lie to their people. Pick a leader who is strong and confident, yet humble. Intelligent, but not sly. A leader who encourages diversity, not racism. One who understands the needs of the farmer, the teacher, the doctor, and the environmentalist -- not only the banker, the oil tycoon, the weapons developer, or the insurance and pharmaceutical lobbyist.

What was to be a relatively innocuous federal government, operating from a defined enumeration of specific grants of power, has become an ever-present and unaccountable force. It is the nation’s largest creditor, debtor, lender, employer, consumer, contractor, grantor, property owner, tenant, insurer, health-care provider, and pension guarantor. Moreover, with aggrandized police powers, what it does not control directly it bans or mandates by regulation.

Humans and machines might merge so completely that humans will not be able to survive at all if they are disconnected from the network. They will be connected starting in the womb, and if later in life you choose to disconnect, insurance agencies might refuse to insure you, employers might refuse to employ you, and healthcare services might refuse to take care of you. In the big battle between health and privacy, health is likely to win hands down.

Another blatant case of regress as part of the capitalist progress is the enormous rise of precarious work. Precarious work deprives workers of a whole series of rights that, till recently, were taken as self-evident in any country which perceived itself as a welfare state: precarious workers have to take care themselves of their health insurance and retirement options; there is no paid leave; the future becomes much more uncertain. Precarious work also generates an antagonism within the working class, between permanently employed and precarious workers (trade unions tend to privilege permanent workers; it is very difficult for precarious workers even to organize themselves into a union or to establish other forms of collective self-organization). One would have expected that this increasing exploitation would also strengthen workers’ resistance, but it renders resistance even more difficult, and the main reason for this is ideological: precarious work is presented (and up to a point even effectively experienced) as a new form of freedom – I am no longer just a cog in a complex enterprise but an entrepreneur-of-the-self, I am a boss of myself who freely manages my employment, free to choose new options, to explore different aspects of my creative potential, to choose my priorities

The overarching structure and vision of these buy-in plans reflect a near obsession with the status quo, an insistence on the hegemonic domination of employers and insurance companies on the health and well-being of people. These technocratic nerds have adopted a shared narrow-sightedness, unable to think beyond “what is”: they never consider, for example, that this employer dominance was a historical accident, and that the suffering it inflicts is, in a sense, a slow-burning casualty of the second World War, not a divine mandate.

The only bill not overdue was for my health insurance. That’s because I don’t have any. Never have. Based on the figure the federal government claims is the average monthly cost of health coverage for someone like me who is self-employed, I’ve saved about $200,000 since opening Spirits in Clay. I

Notably, Tennessee is known as a “Right to Work” state, which, despite having the ring of a guaranteed job, is a phrase that refers to laws that ensure workers are not required to pay union fees as a condition of their employment. The “Right to Work” movement was initiated in Southern states as a way of weakening union control and, in doing so, luring factory jobs from the Rust Belt. Studies have shown that workers in “Right to Work” states tend to have lower wages, inferior health insurance, and inferior pension programs when compared to workers in states that do not have “Right to Work” laws.75

What is the goal of the system? Should an entire layer of corporate bureaucracy called “insurance companies”—which employ hundreds of thousands of people who have absolutely nothing to do with the actual provision of health care—be allowed to continue determining policies and priorities with the sole purpose of maximizing profits?

The Unknown Citizen by W. H. Auden (To JS/07 M 378 This Marble Monument Is Erected by the State) He was found by the Bureau of Statistics to be One against whom there was no official complaint, And all the reports on his conduct agree That, in the modern sense of an old-fashioned word, he was a saint, For in everything he did he served the Greater Community. Except for the War till the day he retired He worked in a factory and never got fired, But satisfied his employers, Fudge Motors Inc. Yet he wasn't a scab or odd in his views, For his Union reports that he paid his dues, (Our report on his Union shows it was sound) And our Social Psychology workers found That he was popular with his mates and liked a drink. The Press are convinced that he bought a paper every day And that his reactions to advertisements were normal in every way. Policies taken out in his name prove that he was fully insured, And his Health-card shows he was once in hospital but left it cured. Both Producers Research and High-Grade Living declare He was fully sensible to the advantages of the Instalment Plan And had everything necessary to the Modern Man, A phonograph, a radio, a car and a frigidaire. Our researchers into Public Opinion are content That he held the proper opinions for the time of year; When there was peace, he was for peace: when there was war, he went. He was married and added five children to the population, Which our Eugenist says was the right number for a parent of his generation. And our teachers report that he never interfered with their education. Was he free? Was he happy? The question is absurd: Had anything been wrong, we should certainly have heard.

A statistician for the Prudential Insurance Company predicted the imminent extinction of Black people in his epic book that relied on the 1890 census figures. Unlike the Plessy ruling, Frederick Hoffman’s Race Traits and Tendencies of the American Negro received plenty of attention in 1896. Packed with statistical tables and published by the American Economic Association, the book was a pioneering work in American medical research, and it catapulted Hoffman into scientific celebrity in the Western world as the heralded father of American public health. At “the time of emancipation,” he wrote, southern Blacks were “healthy in body and cheerful in mind.” “What are the conditions thirty years after?” Well, “in the plain language of the facts,” free Blacks were headed toward “gradual extinction,” pulled down by their natural immoralities, law-breaking, and diseases. Hoffman supplied his employer with an excuse for its discriminatory policies concerning African Americans—that is, for denying them life insurance. White life insurance companies refused to insure a supposedly dying race. Yet another racist idea was produced to defend a racist policy.3

Romantic literature often presents the individual as somebody caught in a struggle against the state and the market. Nothing could be further from the truth. The state and the market are the mother and father of the individual, and the individual can survive only thanks to them. The market provides us with work, insurance and a pension. If we want to study a profession, the government’s schools are there to teach us. If we want to open a business, the bank loans us money. If we want to build a house, a construction company builds it and the bank gives us a mortgage, in some cases subsidised or insured by the state. If violence flares up, the police protect us. If we are sick for a few days, our health insurance takes care of us. If we are debilitated for months, social security steps in. If we need around-the-clock assistance, we can go to the market and hire a nurse – usually some stranger from the other side of the world who takes care of us with the kind of devotion that we no longer expect from our own children. If we have the means, we can spend our golden years at a senior citizens’ home. The tax authorities treat us as individuals, and do not expect us to pay the neighbours’ taxes. The courts, too, see us as individuals, and never punish us for the crimes of our cousins. Not only adult men, but also women and children, are recognised as individuals. Throughout most of history, women were often seen as the property of family or community. Modern states, on the other hand, see women as individuals, enjoying economic and legal rights independently of their family and community. They may hold their own bank accounts, decide whom to marry, and even choose to divorce or live on their own. But the liberation of the individual comes at a cost. Many of us now bewail the loss of strong families and communities and feel alienated and threatened by the power the impersonal state and market wield over our lives. States and markets composed of alienated individuals can intervene in the lives of their members much more easily than states and markets composed of strong families and communities. When neighbours in a high-rise apartment building cannot even agree on how much to pay their janitor, how can we expect them to resist the state? The deal between states, markets and individuals is an uneasy one. The state and the market disagree about their mutual rights and obligations, and individuals complain that both demand too much and provide too little. In many cases individuals are exploited by markets, and states employ their armies, police forces and bureaucracies to persecute individuals instead of defending them. Yet it is amazing that this deal works at all – however imperfectly. For it breaches countless generations of human social arrangements. Millions of years of evolution have designed us to live and think as community members. Within a mere two centuries we have become alienated individuals. Nothing testifies better to the awesome power of culture.

The pity is that many Americans outside the elite bubbles know exactly what’s wrong, but our leaders seem determined to do nothing about it. Any attempt to cut the government chains and anchors off businesses so they can get back to growing, innovating, and creating jobs is demagogued as “tax breaks for the rich” or “favors for the one-percenters.” Never mind that many of those who would benefit are small-business owners who’ve been decimated over the past few years, first by the economic meltdown, then by government policies put in place to “fix” it. The money printed by the Fed to keep the economy pumped up flows to Wall Street, not Main Street, so small businesses aren’t borrowing it to pay for expansion. Even if they wanted to expand, about a third of all U.S. workers are employed by businesses with fifty or fewer employees, and Obamacare insures that if they hire a fifty-first, they’ll face crippling new costs for mandated health care.

First, the very idea that there should be any serious kind of health insurance for Americans (beyond tiny elites) simply did not have much reality until World War II—and it was (again) the war that gave it reality. With wartime labor scarce, wage-price controls were enacted to keep bidding wars in check. Corporations, unable to offer more pay, tried to compete with benefits instead. The modern idea of widespread employer-provided health insurance developed as a strategy to attract wartime workers, and continued in many industries after the war, especially during the boom era.

The state and the market approached people with an offer that could not be refused. ‘Become individuals,’ they said. ‘Marry whomever you desire, without asking permission from your parents. Take up whatever job suits you, even if community elders frown. Live wherever you wish, even if you cannot make it every week to the family dinner. You are no longer dependent on your family or your community. We, the state and the market, will take care of you instead. We will provide food, shelter, education, health, welfare and employment. We will provide pensions, insurance and protection.

The best available apples-to-apples comparison of inflation-adjusted earnings shows what the typical fully employed man earned back in the 1970s and what that same fully employed man earns today. The picture isn’t pretty. As the GDP has doubled and almost doubled again, as corporations have piled up record profits, as the country has gotten wealthier, and as the number of billionaires has exploded, the average man working full-time today earns about what the average man earned back in 1970. Nearly half a century has gone by, and the guy right in the middle of the pack is making about what his granddad did. The second punch that’s landed on families is expenses. If costs had stayed the same over the past few decades, families would be okay—or, at least, they would be in about the same position as they were thirty-five years ago. Not advancing but not falling behind, either. But that didn’t happen. Total costs are up, way up. True, families have cut back on some kinds of expenses. Today, the average family spends less on food (including eating out), less on clothing, less on appliances, and less on furniture than a comparable family did back in 1971. In other words, families have been pretty careful about their day-to-day spending, but it hasn’t saved them. The problem is that the other expenses—the big, fixed expenses—have shot through the roof and blown apart the family budget. Adjusted for inflation, families today spend more on transportation, more on housing, and more on health insurance. And for all those families with small children and no one at home during the day, the cost of childcare has doubled, doubled again, and doubled once more. Families have pinched pennies on groceries and clothing, but these big, recurring expenses have blown them right over a financial cliff.

The United States is famously resistant to anything smacking of redistribution. Yet it allocates 19 percent of its GDP to social services, and despite the best efforts of conservatives and libertarians the spending has continued to grow. The most recent expansions are a prescription drug benefit introduced by George W. Bush and the eponymous health insurance plan known as Obamacare introduced by his successor. Indeed, social spending in the United States is even higher than it appears, because many Americans are forced to pay for health, retirement, and disability benefits through their employers rather than the government. When this privately administered social spending is added to the public portion, the United States vaults from twenty-fourth into second place among the thirty-five OECD countries, just behind France.

Consider almost any public issue. Today’s Democratic Party and its legislators, with a few notable individual exceptions, is well to the right of counterparts from the New Deal and Great Society eras. In the time of Lyndon Johnson, the average Democrat in Congress was for single-payer national health insurance. In 1971, Congress overwhelmingly passed the Comprehensive Child Development Act, for universal, public, tax-supported, high-quality day care and prekindergarten. Nixon vetoed the bill in 1972, but even Nixon was for a guaranteed annual income, and his version of health reform, “play or pay,” in which employers would have to provide good health insurance or pay a tax to purchase it, was well to the left of either Bill or Hillary Clinton’s version, or Barack Obama’s. The Medicare and Medicaid laws of 1965 were not byzantine mash-ups of public and private like Obamacare. They were public. Infrastructure investments were also public. There was no bipartisan drive for either privatization or deregulation. The late 1960s and early 1970s (with Nixon in the White House!) were the heyday of landmark health, safety, environmental, and financial regulation. To name just three out of several dozen, Nixon signed the 1970 Clean Air Act, the 1970 Occupational Safety and Health Act, and the 1973 Consumer Product Safety Act. Why did Democrats move toward the center and Republicans to the far right? Several things occurred. Money became more important in politics. The Democratic Leadership Council, formed by business-friendly and Southern Democrats after Walter Mondale’s epic 1984 defeat, believed that in order to be more competitive electorally, Democrats had to be more centrist on both economic and social issues.

employment attorney review your severance letter of agreement before you sign it. “Even if you decide not to negotiate your financial package, you may want to negotiate other things, like health insurance and references for your next job,” she explains. Go in with the expectation that you won’t get everything you ask for, but you will get more than what they originally offered. Weinberg recommends an often-used formula to calculate severance: number of years at the company multiplied by two weeks’ pay = severance total. Request back pay for unused vacation days, plus a portion of the bonus you were expected to receive at the end of the year. Request a written letter of recommendation and assurance that it will be upheld if a prospective employer calls for references, and ask for a written agreement that any noncompete clause in your original offer is at this point null and void.

In her book The Government-Citizen Disconnect, the political scientist Suzanne Mettler reports that 96 percent of American adults have relied on a major government program at some point in their lives. Rich, middle-class, and poor families depend on different kinds of programs, but the average rich and middle-class family draws on the same number of government benefits as the average poor family. Student loans look like they were issued from a bank, but the only reason banks hand out money to eighteen-year-olds with no jobs, no credit, and no collateral is because the federal government guarantees the loans and pays half their interest. Financial advisers at Edward Jones or Prudential can help you sign up for 529 college savings plans, but those plans' generous tax benefits will cost the federal government an estimated $28.5 billion between 2017 and 2026. For most Americans under the age of sixty-five, health insurance appears to come from their jobs, but supporting this arrangement is one of the single largest tax breaks issued by the federal government, one that exempts the cost of employer-sponsored health insurance from taxable incomes. In 2022, this benefit is estimated to have cost the government $316 billion for those under sixty-five. By 2032, its price tag is projected to exceed $6oo billion. Almost half of all Americans receive government-subsidized health benefits through their employers, and over a third are enrolled in government-subsidized retirement benefits. These participation rates, driven primarily by rich and middle-class Americans, far exceed those of even the largest programs directed at low income families, such as food stamps (14 percent of Americans) and the Earned Income Tax Credit (19 percent). Altogether, the United States spent $1.8 trillion on tax breaks in 2021. That amount exceeded total spending on law enforcement, education, housing, healthcare, diplomacy, and everything else that makes up our discretionary budget. Roughly half the benefits of the thirteen largest individual tax breaks accrue to the richest families, those with incomes that put them in the top 20 percent. The top I percent of income earners take home more than all middle-class families and double that of families in the bottom 20 percent. I can't tell you how many times someone has informed me that we should reduce military spending and redirect the savings to the poor. When this suggestion is made in a public venue, it always garners applause. I've met far fewer people who have suggested we boost aid to the poor by reducing tax breaks that mostly benefit the upper class, even though we spend over twice as much on them as on the military and national defense.

Rich, middle-class, and poor families depend on different kinds of programs, but the average rich and middle-class family draws on the same number of government benefits as the average poor family. Student loans look like they were issued from a bank, but the only reason banks hand out money to eighteen-year-olds with no jobs, no credit, and no collateral is because the federal government guarantees the loans and pays half their interest. Financial advisers at Edward Jones or Prudential can help you sign up for 529 college savings plans, but those plans’ generous tax benefits will cost the federal government an estimated $28.5 billion between 2017 and 2026. For most Americans under the age of sixty-five, health insurance appears to come from their jobs, but supporting this arrangement is one of the single largest tax breaks issued by the federal government, one that exempts the cost of employer-sponsored health insurance from taxable incomes.

Over time, states and markets used their growing power to weaken the traditional bonds of family and community. The state sent its policemen to stop family vendettas and replace them with court decisions. The market sent its hawkers to wipe out longstanding local traditions and replace them with ever-changing commercial fashions. Yet this was not enough. In order really to break the power of family and community, they needed the help of a fifth column. The state and the market approached people with an offer that could not be refused. ‘Become individuals,’ they said. ‘Marry whomever you desire, without asking permission from your parents. Take up whatever job suits you, even if community elders frown. Live wherever you wish, even if you cannot make it every week to the family dinner. You are no longer dependent on your family or your community. We, the state and the market, will take care of you instead. We will provide food, shelter, education, health, welfare and employment. We will provide pensions, insurance and protection.

Parents like Jennifer, Susan, and Rae express desires that are quite modest. Full-time hours come first. That is a prize that can be astonishingly hard to wrest from a low-wage employer who wants to avoid added costs associated with full-time employment, such as health insurance and paid time off. A predictable schedule, so parents can arrange for safe, reliable child care, comes next. A few say they would be happy if they could get just those two things. Yet finding a job with even those basic attributes is something Susan Brown feels she can only dream of, not expect. Most parents, like Jennifer and Rae, hope for a little more. If they could just make $12 or $13 per hour, they say, they could make it; $15 per hour is really shooting the moon. Safe working conditions, and some sick or personal days, would be a real plus. The other “extras” that once came routinely with a full-time job—health insurance, vacation days, and retirement benefits—don’t often come up in conversations with the $2-a-day poor. These perks are so uncommon among the jobs available to low-wage workers that they seem all but outside the bounds of reality.

comprehensivist.” (IBM’s Grundy coined this term. He’s also president of the Patient-Centered Primary Care Collaborative, a set of large employers, provider groups, and private insurers looking to transform health care.) Comprehensivists are skilled project

About half of employer-provided health plans in the United States are self-insured plans, giving employers even more latitude in designing and administering such plans.

Today 60% of workers in the private sector receive their insurance through their employer. I believe that by 2025 fewer than 20% of workers at private companies will continue to receive their health insurance through an employer-sponsored program. Nevertheless many will still receive an employer contribution, a so-called defined contribution toward the purchase of health insurance in the exchange. I believe the majority of private-sector workers will get their coverage through the exchanges.

Development is the strategy of evasion. When you can’t give people land reform, give them hybrid cows. When you can’t send children to school, try non-formal education. When you can’t provide basic health to people, talk of health insurance. Can’t give them jobs? Not to worry, just redefine the words ‘employment opportunities’. Don't want to do away with using children as a form of slave labor? Never mind. Talk of 'improving the conditions of child labor'. It sounds good. You can even make money out of it.

The final shoe to drop will be the pain inflicted on Americans employed by large companies. Roughly 100 million Americans get their health insurance from large-group employers, and as the costs of Obamacare rise and rise and rise, we will see more and more large-group employers cutting their health insurance and dumping all of their employees into the public exchanges, where they will suffer along with everybody else.

Anyone under the age of 65 that has private health insurance is not the true customer in American healthcare. Large and small group employers are.

From the start, Obama’s adversaries on the religious right—from officials of the Catholic Church to leaders of antichoice organizations to evangelical celebrities—portrayed Obamacare as a socialist takeover that would force taxpayers to pay for coverage of abortion services. That was not true, but it proved a potent talking point, priming the base for outrage when the Obama administration, in early 2012, finalized a regulation under the act requiring employer-sponsored health plans to cover contraception without a copay. Even after the Obama administration exempted houses of worship from the requirement and offered religious nonprofits an “accommodation” that permitted them to opt out by signing a form that would put the onus of coverage on their insurers, the regulation triggered a series of overheated, Republican-led congressional hearings, activist protests, and years of protracted litigation.

Finally, as I’ve emphasized, there is the level of conscious public policy. A Soviet official issuing a planning document, or an American politician calling for job creation, might not be entirely aware of the likely effects of their action. Still, once a situation is created, even as an unintended side effect, politicians can be expected to size up the larger political implications of that situation when they make up their minds what—if anything—to do about it. Does this mean that members of the political class might actually collude in the maintenance of useless employment? If that seems a daring claim, even conspiracy talk, consider the following quote, from an interview with then US president Barack Obama about some of the reasons why he bucked the preferences of the electorate and insisted on maintaining a private, for-profit health insurance system in America: “I don’t think in ideological terms. I never have,” Obama said, continuing on the health care theme. “Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents one million, two million, three million jobs [filled by] people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”9 I would encourage the reader to reflect on this passage because it might be considered a smoking gun. What is the president saying here? He acknowledges that millions of jobs in medical insurance companies like Kaiser or Blue Cross are unnecessary. He even acknowledges that a socialized health system would be more efficient than the current market-based system, since it would reduce unnecessary paperwork and reduplication of effort by dozens of competing private firms. But he’s also saying it would be undesirable for that very reason. One motive, he insists, for maintaining the existing market-based system is precisely its inefficiency, since it is better to maintain those millions of basically useless office jobs than to cast about trying to find something else for the paper pushers to do.10 So here is the most powerful man in the world at the time publicly reflecting on his signature legislative achievement—and he is insisting that a major factor in the form that legislature took is the preservation of bullshit jobs.

Income volatility can also interfere with the existing social safety net. Some welfare programs require beneficiaries to work a certain number of hours each week, assuming that the number of hours worked is under the control of the employee, rather than the employer.53 Qualification for programs like food stamps and health insurance subsidies is based on an average monthly income threshold. But of course volatile incomes mean that families bounce in and out of eligibility.54 Bouncing in and out of Medicaid ineligibility causes interruptions in care for chronic conditions, particularly in places where the doctors who accept Medicaid and private insurance don’t overlap.55 There can also be severe penalties for “fraud” in these programs, receiving benefits when your income is too high. But households subject to volatile incomes may not, themselves, know when or whether they will cross thresholds of eligibility. For instance, as of 2016, the Pennsylvania Medicaid Application asks whether anyone in the household has a hard time predicting their income, but in the very next question requires applicants to do exactly that—for the next twenty-four months—in order to establish eligibility.

Between 2003 and 2013, health insurance premiums for employer-provided health benefits rose by 73 percent—and workers’ share of that increase was 93 percent. Deductibles more than doubled.

Perhaps less pernicious but still worrisome is reliance on “wellness” programs, which most medium to large employers in the United States have, despite the fact that, overall, they have not been validated to promote health outcomes. Typically, a wellness program combines step counting, weight and blood pressure readings, and cholesterol lab tests, as well as some incentive for employees to participate (such as a surcharge on an employee’s contribution to the cost of insurance). But wellness is poorly defined, and the cost effectiveness of such strategies has been seriously questioned.50 One way such programs could be improved, however, is through the use of virtual medical coaches, which could gather and make use of far more granular and deeper information about each individual.

I think it’s interesting to note that courses in business ethics are taught in the best graduate schools of business, which I see as mainstream acceptance of the principle that practicing good ethics is good business. As employers, we are still pretty much on our own as we continue to face daily challenges to our conscience, our integrity, our honesty, and our sense of fair play. Will we provide health insurance to employees, even if the law doesn’t require it? How “creative” will we be in our accounting? Will we carry employees through hard times, or leave them to fend for themselves? As employees, we will still need to find meaning and take pride in our work. Will we serve customers poorly or well? Will we create goods and services with care or carelessly? Will we make our daily labor the expression of the best that is in us, or the worst?

People employ what economists call “rational ignorance.” That is, we all spend our time learning about things we can actually do something about, not political issues that we can’t really affect. That’s why most of us can’t name our representative in Congress. And why most of us have no clue about how much of the federal budget goes to Medicare, foreign aid, or any other program. As an Alabama businessman told a Washington Post pollster, “Politics doesn’t interest me. I don’t follow it. … Always had to make a living.” Ellen Goodman, a sensitive, good-government liberal columnist, complained about a friend who had spent months researching new cars, and of her own efforts study the sugar, fiber, fat, and price of various cereals. “Would my car-buying friend use the hours he spent comparing fuel-injection systems to compare national health plans?” Goodman asked. “Maybe not. Will the moments I spend studying cereals be devoted to studying the greenhouse effect on grain? Maybe not.” Certainly not —and why should they? Goodman and her friend will get the cars and the cereal they want, but what good would it do to study national health plans? After a great deal of research on medicine, economics, and bureaucracy, her friend may decide which health-care plan he prefers. He then turns to studying the presidential candidates, only to discover that they offer only vague indications of which health-care plan they would implement. But after diligent investigation, our well-informed voter chooses a candidate. Unfortunately, the voter doesn’t like that candidate’s stand on anything else — the package-deal problem — but he decides to vote on the issue of health care. He has a one-in-a-hundred-million chance of influencing the outcome of the presidential election, after which, if his candidate is successful, he faces a Congress with different ideas, and in any case, it turns out the candidate was dissembling in the first place. Instinctively realizing all this, most voters don’t spend much time studying public policy. Give that same man three health insurance plans that he can choose from, though, and chances are that he will spend time studying them. Finally, as noted above, the candidates are likely to be kidding themselves or the voters anyway. One could argue that in most of the presidential elections since 1968, the American people have tried to vote for smaller government, but in that time the federal budget has risen from $178 billion to $4 trillion. George Bush made one promise that every voter noticed in the 1988 campaign: “Read my lips, no new taxes.” Then he raised them. If we are the government, why do we get so many policies we don’t want?

People employ what economists call “rational ignorance.” That is, we all spend our time learning about things we can actually do something about, not political issues that we can’t really affect. That’s why most of us can’t name our representative in Congress. And why most of us have no clue about how much of the federal budget goes to Medicare, foreign aid, or any other program. As an Alabama businessman told a Washington Post pollster, “Politics doesn’t interest me. I don’t follow it. … Always had to make a living.” Ellen Goodman, a sensitive, good-government liberal columnist, complained about a friend who had spent months researching new cars, and of her own efforts study the sugar, fiber, fat, and price of various cereals. “Would my car-buying friend use the hours he spent comparing fuel-injection systems to compare national health plans?” Goodman asked. “Maybe not. Will the moments I spend studying cereals be devoted to studying the greenhouse effect on grain? Maybe not.” Certainly not —and why should they? Goodman and her friend will get the cars and the cereal they want, but what good would it do to study national health plans? After a great deal of research on medicine, economics, and bureaucracy, her friend may decide which health-care plan he prefers. He then turns to studying the presidential candidates, only to discover that they offer only vague indications of which health-care plan they would implement. But after diligent investigation, our well-informed voter chooses a candidate. Unfortunately, the voter doesn’t like that candidate’s stand on anything else — the package-deal problem — but he decides to vote on the issue of health care. He has a one-in-a-hundred-million chance of influencing the outcome of the presidential election, after which, if his candidate is successful, he faces a Congress with different ideas, and in any case, it turns out the candidate was dissembling in the first place. Instinctively realizing all this, most voters don’t spend much time studying public policy. Give that same man three health insurance plans that he can choose from, though, and chances are that he will spend time studying them. Finally, as noted above, the candidates are likely to be kidding themselves or the voters anyway. One could argue that in most of the presidential elections since 1968, the American people have tried to vote for smaller government, but in that time the federal budget has risen from $178 billion to $4 trillion.

HMOs have been so successful that they now occupy a dominant position in the market for health care in the United States. Approximately forty-five million Americans are uninsured. Of the remainder, about half are enrolled in some type of HMO. Most others receive some sort of managed care plan. Less than 10 per cent of Americans still have classic fee-for-service private health insurance (down from more than 70 per cent in the late ’80s). So even though many people equate HMOs with private health care, these sorts of corporations exist only because of the failure of private markets to supply appropriate health care. HMOs succeed precisely because they are more efficient than insurance markets. There should be no illusions about the character of these organizations—they are giant bureaucracies. The largest of them, Kaiser Permanente, employs over eleven thousand physicians and has more than six million subscribers in the state of California alone. This makes Kaiser larger than most of the government-run health care systems in Canada. And while the Canadian system is extremely decentralized, Kaiser Permanente is a single, vertically integrated corporation.

Net wages: “It’s not what you make, but what you net” after paying the FIRE sector, basic utilities and taxes. The usual measure of disposable personal income (DPI) refers to how much employees take home after income-tax withholding (designed in part by Milton Friedman during World War II) and over 15% for FICA (Federal Insurance Contributions Act) to produce a budget surplus for Social Security and health care (half of which are paid by the employer). This forced saving is lent to the U.S. Treasury, enabling it to cut taxes on the higher income brackets. Also deducted from paychecks may be employee withholding for private health insurance and pensions. What is left is by no means freely available for discretionary spending. Wage earners have to pay a monthly financial and real estate “nut” off the top, headed by mortgage debt or rent to the landlord, plus credit card debt, student loans and other bank loans. Electricity, gas and phone bills must be paid, often by automatic bank transfer – and usually cable TV and Internet service as well. If these utility bills are not paid, banks increase the interest rate owed on credit card debt (typically to 29%). Not much is left to spend on goods and services after paying the FIRE sector and basic monopolies, so it is no wonder that markets are shrinking. (See Hudson Bubble Model later in this book.) A similar set of subtrahends occurs with net corporate cash flow (see ebitda). After paying interest and dividends – and using about half their revenue for stock buybacks – not much is left for capital investment in new plant and equipment, research or development to expand production.

In a study Suzanne Mettler asked 1,400 Americans whether they had used a government social program. Fifty-seven percent said they had not. Then she asked if they had used one of twenty-one specific federal policies, including child-care tax credits, the Earned Income Tax Credit, employer-sponsored and thus tax exempted health insurance, Medicare, Social Security, unemployment insurance, mortgage-interest deductions, and student loans. It turned out that 96 percent of those who had denied using government programs had in fact used at least one, and the average responder had used four. This clear disconnect between Americans' perception of who benefits from government programs and the reality makes it easier to keep demonizing the "welfare state.

list of documents that may be required. It can look intimidating, especially if you’ve not been actively involved in your family finances, but don’t panic. If you can’t find all of them or don’t have access, there is a later step in the divorce process called “discovery,” when you can legally compel the other side to provide copies of anything else you need: •Individual income tax returns (federal, state, local) for past three years •Business income tax returns (federal, state, local) for past three years •Proof of your current income (paystubs, statements, or paid invoices) •Proof of spouse’s income (paystubs, statements, or paid invoices) •Checking, savings, and certificate statements (personal and business) for past three years •Credit card and loan statements (personal and business) for past three years •Investment, pension plan, and retirement account statements for past three years •Mortgage statement and loan documents for all properties you have an interest in •Real estate appraisals •Property tax documents •Employment contracts •Benefit statements •Social Security statements •Life, homeowner’s, and auto insurance policies •Wills and trust agreements •Health insurance cards •Vehicle titles and/or registration •Monthly budget worksheet •List of personal property (furnishings, jewelry, electronics, artwork) •List of property acquired by gift or inheritance or owned prior to marriage •Prenuptial agreements •Marriage license •Prior court orders directing payment of child support or spousal support Your attorney or financial advisor may ask for additional documents specific to your case. Some of these may not be applicable to you.

To be clear, the beneficiaries of Truman’s universal coverage would have been overwhelmingly white, as white people at the time made up 90 percent of the U.S. population. Few Americans, Black or white, had private insurance plans, and the recent notion that employers would provide it had yet to solidify into a nationwide expectation. The pool of national health insurance would have been mainly for white Americans, but the threat of sharing it with even a small number of Black and brown Americans helped to doom the entire plan from the start.

For a country founded on the ideals of freedom, liberty, and justice for all, having affordable health insurance tied to full-time employment is an ironic and often fatal prison of our own making. Not to mention an obvious hindrance to that other pillar of American pride, entrepreneurship.

The victories these unions won reshaped work for us all. The forty-hour workweek, overtime pay, employer health insurance and retirement benefits, worker compensation—all these components of a “good job” came from collective bargaining and union advocacy with governments in the late 1930s and ’40s. And the power to win these benefits came from solidarity—Black, white, and brown, men and women, immigrant and native-born.

Wellness programs offer important benefits, but these data policies underscore the less visible and more dangerous privacy risks they pose.82 Most are exempt from traditional health data privacy regulations. The Health Insurance Portability and Accountability Act of 1996 (known as HIPAA), for example, protects individuals’ identifiable health information in the United States. But it doesn’t apply when employers offer workplace wellness programs directly rather than in connection with their group health plans. Without laws preventing them from using the data collected through wellness programs, employers can mine the data they collect, which many do with abandon.83 Employers learn everything that employees share in the questionnaires and online surveys they complete as part of these programs, from what prescription drugs they use to whether they voted and when they stopped filling their birth control prescriptions.84 And employers are using that data in increasingly more intrusive ways.

We are the ones paying for health care, not your employer, an insurance company, or the government. If you won’t protect your money, they’re going to keep taking more of it. The customer is always right, but health care power players don’t consider you their most important customer. Even though you are the one paying for your health care and undergoing the treatment, the industry players are teaming up to enrich themselves. The business of medicine exploits your sickness for profit. It’s life and death for you. It’s dollars and cents for them. And the system is not operating in good faith. The health care industry wastes obscene amounts of your money. The solution isn’t to keep taking more money from you. The solution is to reduce the waste so you pay less. Our health care system is not broken. It was made this way. Our elected officials and health care companies have had decades to reduce health care costs. If they wanted to fix the problem, they could. We must stop being naïve and realize that saving our money is not their intent. So we need to stick up for ourselves and demand that the system change. If we don’t, the exploitation of our sickness will never stop. I

In order really to break the power of family and community, they needed the help of a fifth column. The state and the market approached people with an offer that could not be refused. ‘Become individuals,’ they said. ‘Marry whomever you desire, without asking permission from your parents. Take up whatever job suits you, even if community elders frown. Live wherever you wish, even if you cannot make it every week to the family dinner. You are no longer dependent on your family or your community. We, the state and the market, will take care of you instead. We will provide food, shelter, education, health, welfare and employment. We will provide pensions, insurance and protection... But the liberation of the individual comes at a cost. Many of us now bewail the loss of strong families and communities and feel alienated and threatened by the power the impersonal state and market wield over our lives. States and markets composed of alienated individuals can intervene in the lives of their members much more easily than states and markets composed of strong families and communities.

While Roosevelt ultimately lost the 1912 election, his party’s progressive ideals planted a seed that accessible and affordable medical care might be viewed as a right more than a privilege. It wasn’t long, however, before doctors and southern politicians vocally opposed any type of government involvement in healthcare, branding it as a form of bolshevism. After FDR imposed a nationwide wage freeze meant to stem inflation during World War II, many companies began offering private health insurance and pension benefits as a way to compete for the limited number of workers not deployed overseas. Once the war ended, this employer-based system continued, in no small part because labor unions liked the arrangement, since it enabled them to use the more generous benefit packages negotiated under collective bargaining agreements as a selling point to recruit new members. The downside was that it left those unions unmotivated to push for government-sponsored health programs that might help everybody else.

We are already seeing car insurance premiums linked to tracking devices in cars, and health insurance coverage that depends on people wearing a fitness tracking device. When surveillance is used to determine things that hold sway over important aspects of life, such as insurance coverage or employment, it starts to appear less benign. Moreover, data analysis can reveal surprisingly intrusive things: for example, the movement sensor in a smartwatch or fitness tracker can be used to work out what you are typing (for example, passwords) with fairly good accuracy [98]. And algorithms for analysis are only going to get better.

Most countries with dominant social health insurance have expanded it through the formal sector by mandated employer and employee contribution.

What are your feelings from Bush to Obama? Besides being responsible for the death of half a million people, I feel like Bush dealt a huge economic and social blow to the USA, one from which we may never fully recover. He directly flushed 3 trillion dollars down the toilet on hopeless, pointlessly destructive wars in Afghanistan and Iraq …and they’re not even over! For years to come, we’ll be paying costs for all the injured veterans (over 50,000) and destabilizing three countries, because you have to look at the impact that the Afghan war has on Pakistan. Bush expanded the use of torture, and created a whole new layer of government bureaucracy (the “Department of Homeland Security”) to spy on Americans. He created Indefinite Detention (at Guantanamo and other US military bases) and expanded the use of executive-ordered assassinations using the new drone technology. On economic issues, his administration allowed corporations to run things and regulate themselves. The agency that was supposed to regulate oil drilling had lobbyist-paid prostitutes sleeping with employees while oil industry lobbyists basically ran the agency. Energy companies like Enron, and the country’s investment banks were deregulated at the end of the Clinton administration and Bush allowed them to run wild. Above all, he was incompetent and appointed some really stupid people to important positions at every level of government. Certainly, Obama has been involved in many of these same activities. A few he’s increased, such as the use of drone assassinations, but most of them he has at least tried to scale back. At the beginning of his first term, he tried to close the Guantanamo prison and have trials for many of the detainees in the United States but conservatives (including many Democrats) stirred up public resistance and blocked this from happening. He tried to get some kind of universal healthcare because over 50 million Americans don’t have health insurance. This is one of the leading causes of personal bankruptcies and foreclosures because someone gets sick in a family, loses their job, loses their health insurance (because American employers are source of most people’s healthcare) and they can’t pay their health bills or their mortgage. Or they use up all their money caring for a sick family member. So many people in the US wanted health insurance reform or single-payer, universal health care similar to what you have in the UK. Members of Obama’s own party (The Democrats) joined with Republicans to narrowly block “The public option” but they managed to pass a half-assed but not-unsubstantial reform of health insurance that would prevent insurers from denying you coverage when you’re sick or have a “preexisting condition.” The minute it was signed into law, Republicans sued in the courts (all the way to the supreme court) and fought, tooth and nail to block its implementation. Same thing with gun control, even as we’re one of the most violent industrial countries in the world. (Among industrial countries, our murder rate is second only to Russia). Obama has managed to withdraw troops from Iraq and Afghanistan over Republican opposition but, literally, everything he tries to do, they blast it in the media and fight it in Congress. So, while I have a lot of criticisms of Obama, he is many orders of magnitude less awful than Bush and many of the positive things he’s tried to do have been blocked. That said, the Democratic and Republican parties agree on more things than they disagree. Both signed off on the Afghan and Iraq wars. Both signed off on deregulation of banks, of derivatives, of mortgage regulations and of the energy and telecom business …and we’ve been living with the consequences ever since. I’m guessing it’s the same thing with Labor and Conservatives in the UK. Labor or Democrats will SAY they stand for certain “progressive” things but they end up supporting the same old crap... (2014 interview with iamhiphop)

For a country founded on the ideals of freedom, liberty, and justice for all, having affordable health insurance tied to full-time employment is an ironic and often fatal prison of our own making.

The earliest health insurance policies were designed primarily to compensate for income lost while workers were ill. Long absences were a big problem for companies that depended on manual labor, so they often hired doctors to tend to workers. In the 1890s, lumber companies in Tacoma, Washington, paid two enterprising doctors 50 cents a month to care for employees. It was perhaps one of the earliest predecessors to the type of employer-based insurance found in the United States today.

HealthcareBluebook.com or FairHealthConsumer.org to see if the prices are fair. The Bluebook site gathers payment information from employers who fund their own health plans and publishes what it calls its fair price for a service or procedure. The Fair Health site does something similar, but its data comes from what insurers pay.

Employees are shielded from being healthcare consumers because they rely on their employers’ priorities and judgment instead of their own to select insurance.

The USA government seems to have conveniently forgotten that its disability system is an insurance program to award disability benefits to ALL people that can no longer be employed due to their long term sickness.