> Healthcare costs, and hence health insurance premiums, are the same with or without an employer intermediary.

If you read the fine print of a health "insurance" plan at a large company, you might discover healthcare costs are directly covered by the employer and the insurance company just administers the plan according to "set rules".

In practice, this operates as blame as a service.

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FireBeyond 3 hours ago | parent | next [-]

American health insurance is insurance in name only - picture health insurance models laid on top of your car:

Imagine your car gets totaled. Your insurer says, "Hey, we're going to pay out $25K for your vehicle. So you have a $1,000 deductible, so that's $24,000, and then your copay for a total loss is $2,000, so that brings us down to $22,000. For total losses, your coinsurance as your contribution for your vehicle coverage is 20%, which is $5,000, so here's a check for $17,000. But that's only if you're buying a Hyundai, otherwise the vehicle is out of network and you'll get a check for $8,500 instead."

> If you read the fine print of a health "insurance" plan at a large company, you might discover healthcare costs are directly covered by the employer and the insurance company just administers the plan according to "set rules".

Generally this is done by a TPA (third party administrator). In many ways you can do as you wish, but as insurers have already done the actuarial work, it's generally easier to use a plan and tweak it if desired (like "Give us this plan but pay for 1 massage/week") versus having to figure that out yourself.

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lotsofpulp 3 hours ago | parent | prev [-]

Sure, but the doctors/medicine/hospitals/liability are not any cheaper.

So the healthcare isn’t cheap, but the employer is able to gain more control over their employees by tying a piece of their non employee life to the employer creating more friction to prevent people from shopping for jobs with higher pay, and the employee is getting a small tax benefit.

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jjmarr 3 hours ago | parent [-]

Yes, but the same insurance company will screw with your coverage depending on your employer.

My mom's plan randomly denied my medications all the time as a student. My current job's plan always provides coverage.

Both were the same insurance company, but she's in a different field with a more stingy employer.

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jswelker an hour ago | parent [-]

It's especially fun if your employer is in a field with an aging employee population--like higher ed ironically. The insurer gives the same premium rate to all employees, meaning everyone is in the same risk pool. The old and or unhealthy employees make insurance more expensive for everyone at the employer. I've had situations where the exact same insurance plan cost two hugely different amounts of money after switching employers just because of average employee age differences. Really quite perverse.

	▲	Mountain_Skies an hour ago \| parent [-]
		Which gives employers incentive to illegally discriminate against older job candidates but good luck proving it at any specific employer.