What Happens If No One Needs Health Insurance?

Why do you go to work?

If you ask most people, they’ll say, I need the money.  But the answer expands a bit if you ask people who work for a large company, or the government.  Dig a little deeper and you’ll find many people work for big organizations simply because they need the health insurance.

Lots of entrepreneurs are only able to be entrepreneurs because their spouse carries health insurance.  I know, for a decade I was one of them.  My husband’s job provided affordable insurance for our family while I was building up my business.  If I’d had to self-pay the insurance for our family of four, it’s likely I would still be working for a big company.

But what if everyone had health insurance that wasn’t tied to their employer, like they do in many other countries?  What if health insurance no longer played a part of the employer/employee relationship?

In her LinkedIn piece, “What Would Medicare for All Mean for Talent Retention? “ my business partner Elizabeth Lotardo writes, “Medicare for All would fundamentally change talent retention in the United States.  In a Medicare for All world, employment decisions won’t be based on the need for medications, the ability to see a specialist, or the access to primary care for employees and their families.”

Lotardo cites five big changes that will likely ensue if everyone – no matter what their job – has access to affordable health coverage:

1. Disengaged employees will leave quickly
   Employees checking the box in the name of keeping their health insurance will rapidly depart.
2. The gig economy will spike
   Newfound flexibility will give rise to a new wave of consultants, freelancers, and solopreneurs.
3. Interviews will become more transparent (on both sides)
   For employers, the likelihood of getting an honest answer to “Why do you want to work here?” increases.  For employees, comparing offers gets easier without reading the fine print of 74-page health benefit packages.
4. Small businesses will become more competitive
   Small businesses will be able to compete with their giant corporate counterparts for top talent.
5. Workplace culture will matter even more
   When employees aren’t bound to employers out of necessity, personal fulfillment, learning and development opportunities, and establishing a positive culture will carry even more weight.

In short, if everyone has health insurance, the employee/employer relationship becomes more about the work and less about people trying to protect their family from the financial ruin of illness.

When my husband left his big company job, and we had to self-fund our insurance, it was over $2,500 a month.  No, there’s not an extra zero on there.  For the last decade, we’ve paid over $25K a year for health insurance to cover our relatively healthy family of four with the most basic of policies.

We’re lucky; we’ve made enough money to pay it.  But having just added this up, and realizing I’ve spent over a quarter of a million dollars on health insurance in the last decade, it’s a tough lump to swallow.

I don’t know where we’ll go with health insurance as a nation, nor do I profess to have perfect solutions for this complex issue.  I do however, see the groundswell of support for a system that provides more people, more access to affordable healthcare.

Employers who provide great health insurance are wonderful.  Employers who can retain employees even when they don’t need health insurance are poised for the future.