This week had another story worth telling, about the newfound efficacy and efficiency of the US healthcare system.
I got a flu shot.
It was the first time since being cast to the winds of fate, that I have been able to get such basic healthcare. And it is thanks to important reforms that were passed that allowed me to buy the insurance I need to cover such things.
My flu shot took exactly 22 minutes. I left my house, went to the hospital, and had my shot, within 22 minutes. And my out-of-pocket costs at the time of service? $0.
That is an amazing outcome for public health in the United States, where we have previously allowed preventable diseases to roam freely amidst the gap between a patchwork of hopelessly underfunded and reachless free clinics on one side, and the ever-dwindling pool of half-decent employer-provided health insurance.
The new healthcare law is working for me, and millions of other Americans. Supposedly it’s in for a major rewrite now that both houses are under Republican control. Two things I’ve heard about, that are actually feasible, are changes to the employer mandate and medical device tax.
A repeal on the medical device excise tax is rather troublesome. Part of the reason why health costs are spiralling out of control is an uncontained willingness to buy various expensive inventions. Most of these devices are simply thrown away after use. Isn’t that wasteful enough to be worthy of a sin tax?
What would have positive effect would be a solution to the employer healthcare mandate that makes the marginal cost of labour favour full-time employment again.
My concept is a refundable payroll tax on all employers tied to the cost of the second-cheapest silver plan for an employee’s state of residence. That cost, say $260 a month, is divided by 130 hours — the same as an average of 30 hours per week, working out to perhaps $2 an hour. That tax, plus any curve tweak designed to re-incentivise full time employment, is charged to the employer for every hour an employee works. The tax is then refunded if the employer provides qualifying insurance that the employee is enrolled in, otherwise, it subsidizes the employee or the employee’s exchange plan. Excess tax collections (from the large number of employees with multiple part-time jobs) would then be used to cover individuals who need exchange subsidies or work for non-profits.