Ask HN: Should your employer pay for your primary health care?

9 points by jobless ↗ HN
Is ethical to expect from your employer to pay for primary health care for you and your family?

20 comments

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Is it ethical to expect to get paid?
Do ethics even apply to expectations?
They always find ways out of it I've gone nearly 18 years now without any access to healthcare is it ethical to be forced to fix a broken elbow with duct tape in the richest country in the world? I had to, even after Obamacare I still had 0 access and then was taxed to punish me for lack of access the government should provide access they take the majority of my income but where does it go certainly not for my healthcare
I'm curious as to what circumstances caused you to have no access to healthcare? If your job doesn't provide it you can get it through an exchange (possibly with subsidies).
Since 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires any hospital emergency room to treat an injury like a broken elbow regardless of ability to pay or whether you were insured. So in the richest country on earth you do not in fact, neither before nor after obamacare, need to use duct tape for a fracture.
I think that's a big risk for employer that is not itself very large (ie I suspect "no" for micro SMEs), but luckily I live in the UK so the NHS has covered me when I've needed treatment. I suspect that I probably could not have created a series of startups in the US...
Every year our President and Accountant spend 2-3 days dicking with insurance plans for our 15 person company. It's not the end of the world but it's definitely a distraction they don't need.
Before World War II people bought their own health insurance. When the US government imposed salary freezes during the war, employers offered benefits such as health insurance to entice potential employees. Those benefits were also tax-free. When the war ended the system stayed in place.

IOW we once had no employer-paid health insurance and we could shift back to such a system. All the same, I would expect a pay raise if it happened.

"History of USA employer-provided health insurance": https://www.peoplekeep.com/blog/part-1-the-history-of-u.s.-e...

Something is very wrong in a society when a worker depends on retaining his employment relationship with his current employer to have access to healthcare. Your employer should not have such power over the health of you and your family, and conversely the power to cut off your and your family's access to healthcare.
It’s great for the employers, and all they have to do is astroturf their employees that it’s somehow good for them and they’re getting a great deal and any alternative is worse.
I mean, it's also great for the employee to have access to healthcare. Better to have than to have not. Yet, a society has a huge problem if the best it can do for it's citizens is to deepen the control of employees over vital aspects of their employees lives.
It’s not great if it means the employee gets worse quality care for more cost than anywhere else. Better than the alternative? The problem is in the question, not the choice.
I'm not entirely sure how ethics play into this.

For full-time work, an employer is expected to pay for your health care. That's how it's supposed to work in the U.S. anyway.

What do you mean “supposed” to?

That’s the convention but it’s far from ideal. While it helps to have the bargaining power and administration of a plan handled by a company such as one you work for, the actual costs of healthcare to you are completely up to that company and you are placed in unreasonable burdens when you switch from one employer to another (90 days waiting period plus crazy COBRA costs are onerous).

Your health care needs supersede the timeframes of your employment. There would be many improvements if we separated healthcare coverage from employment.

It would be better if your healthcare was not tied to your employment. If that is you pay instead then there would need to be changes to transparency on medical pricing.

I would love to be able to change jobs and not have to think about healthcare as part of the choice.

I'm one that believes that it should not be part of the workers benefits package. We have the ability to make work more flexible with the gig economy and should work towards detaching health insurance and other benefits from employment and make health care mandatory for all. I think it's unethical that some people get health care just because they have the right job while other have to do without. The irony is that those that can least afford it are the ones that often have to pay for it.
Many employers offer health care for you and your family as a benefit. Some don't. It'd be unethical to lie about the terms of employment, for example to claim you'd be eligible and then renege.

Assuming the US, typically employers pay 50% or more of the cost. But the total cost isn't that much different than what you'd pay on the open market. So you just have to find out how much that benefit (and others) are worth to you when comparing salaries. Health care is currently very expensive, and IMHO, not that great. But it doesn't make that much difference who provides it. You can buy it on your own, which is especially important for the self-employed.

It's no more unethical if the company lied and said you'd get health care and then didn't do it, than if you took a job with a certain salary and benefits and then demanded more benefits that weren't part of the deal.

Questions "should your empoloyer..." and "is ethical..." are different.

I'd answer the first one, "should you employer...", as "no". The rationale is that health care ideally should come equal to everybody, including those who don't have employer or whose employer doesn't pay for any reason. That likely means that the government should be (more) involved.

I'm not sure about ethical but for myself, personally, it's essential as I couldn't afford it otherwise.
For your care or for your insurance? Those are two different things. The former seems potentially intrusive. The latter, well, a system where it was unnecessary would be better. But under current conditions in the US, yes, I think the employer should pay for insurance. And it’s to the employers advantage anyway for their employees to be able to afford to see a doctor for preventive care and to treat illness and injury.