Health insurance is a topic that has received a lot of attention over the last decade, and particularly so in this, an election year.  While the economy as a catch-all continues to be the most important issue on voters’, and, by extension, the public’s minds, health insurance is the aspect of the issue that evokes the most visceral, emotional responses because it is the one that can most easily be associated with the word “catastrophic”.  The costs of health care and health insurance are obviously linked, and they are both skyrocketing.  For employers this cost is reflected most immediately in the costs of health insurance for employees.  The current ratio of employer contribution to employee contribution for single coverage for an employee is 3.5 to 1; for family coverage it is 2 to 1.  These numbers are a subject of concern, but they do not tell the whole story – the rate at which these rates are increasing.  At some point, perhaps some point that has already passed, an employer has to consider what they are getting for contributing to their employee’s health coverage.

Current numbers are that 60% of private employers in the US offer employees health benefits, and 73% of employees who have the option take advantage of it.  While 73% may seem a little low given public concerns with health coverage, part of the explanation for those who do not choose to take advantage of the offer of health coverage may be that their spouse has coverage for the family.  Not just a majority, but a heavy majority of the US workforce gets its health coverage from employers.  A recent article in the New York Times examines the ways in which health coverage has started to affect people’s decisions to marry and divorce; a health care issue has become more important than the sanctity of marriage in certain cases, and this trend is likely to continue and become more prevalent.  At this point, benefits are a primary consideration for people seeking employment, and the quality of coverage is more the consideration than the mere offer of coverage, which has come to be almost taken for granted.  Reduced to basics, employers who do not offer benefits eliminate themselves from the consideration of a large number of job seekers.

That being said, there would still be plenty of candidates for the positions employers are looking to fill, if for no other reason than the spouses of those who already carry family coverage have greater flexibility.  However, employees with health coverage have advantages for employers that, while less immediately apparent, are actually of potentially equivalent significance in the long-term.  The first point to consider is that people without health coverage are more likely to go to the ER for primary care, resulting in longer waits, both for them and for others.  More time at the hospital is less time to be at work or getting to work.  In addition, the people who go to the ER for primary care are causing costs to increase at rates higher than are dictated by more general economic considerations.  Finally, employees without primary care physicians are less likely to schedule time off for health care, instead seeking treatment as needed, at that time, which means that employers are less able to compensate for time lost.

The final point to consider regarding health coverage for employees is one of perception, and this is obviously the one most amenable to interpretation.  Numbers available from the US Department of Labor demonstrate that the larger the company, the more likely they are to offer health coverage to their employees.  At a certain point, these ideas are linked in public perception – it may not be a causal relationship, but it is a correlative one, and what it means to people is that a company that starts offering health coverage is growing, and plans to be there for the long run.  Conversely, when the majority of US private employers offer health coverage, the workforce becomes more skeptical of the motives of those employers who do not, and that has an effect on employees’ job satisfaction.  One way that job dissatisfaction can manifest is in workers’ compensation claims, some of which may be incidents that occur off the job, and are subsequently identified by employees as work-related.  Additional examples of negative responses by employees who feel disenfranchised by their employers include theft of goods, theft of services, and other fraudulent claims against their employers.  These are not rational or ethical responses, but they are ones that employers bear the brunt of in a ratio that is roughly equivalent to their contribution to employee health coverage.  At some point, employee perception does become tangible to the employers, and the way it becomes tangible can go straight to the bottom line.

-Felix Miller