Monday, March 12, 2012

The Coffee Cup Satire

Allysia Finley: Coffee Is an Essential Benefit Too - WSJ.com.  This satire has been making the rounds.  It goes like this:
Can you believe the nerve of employers? Many of them still seem to think that they should be allowed to determine the benefits they offer. I guess they haven't read your 2,000-page health law. It's the government's job now.

That's a good thing, too. Employers for too long have been able to restrict our access to essential health services like contraception by making us pay some of the bill. Really, it's amazing that we aren't all dead. Now, thanks to you, we'll enjoy free and universal access to preventative care just like workers do in Cuba. Even so, there are still many essential benefits that the government must mandate to make the U.S. the freest country in the world.
The article then goes on to make a bunch of nutty suggestions about things that employers should be required to provide to their employees, from fitness club memberships to the titular free coffee.

This kind of satire is thoroughly frustrating, because it demonstrates a lack of understanding. The only reason to write this is to provide partisan opposition, not to criticize policy.

Health insurance provided by employers is essentially subsidized by the way the tax code treats employer-provided care. The health insurance that your employer provides you isn't a part of your wages - it escapes taxation free and clear. If you tried to buy your own health coverage, you don't get the same tax exclusion, and so it becomes heinously expensive to purchase your own health care. As a result, we have a system where employers provide health care.

So what can a consumer of health care do to take control in this system? Employees have no real say in what coverage their company offers. Your options are to buy your own coverage or find a new job with an employer who does offer the services you need. The first option is incredibly expensive, because you will be penalized by the tax code. The second option is ludicrous. Even if a person were able to effectively research new employers' plans and actually get a job with the new employer, nothing prevents the new employer from changing the plan and effectively ruining your efforts.

So the Affordable Care Act sets up basic standard packages of care, so that people can be assured of a basic set of services. And this is where the dishonesty starts. Is the WSJ seriously opposed to setting basic standards of health insurance packages? Why?

It isn't a free market. Nobody can go buy their own coverage, nobody can pick and choose packages. You get what your employer wants to give you.

Is that fair? Maybe not, but then your issue isn't really with the Affordable Care Act, your issue is with the system of employer-provided health care. Why don't you go pick that fight, instead?

But ultimately, how can you conflate basic health services, the services provide by physicians and pharmacists, with drinking coffee. The juxtaposition indicates shortcomings not in the ACA, but in the WSJ.

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