Politicians and the special interests that support them want to scare the public into believing that healthcare reform will bring rationing, yet they refuse to admit that our current system operates under extreme rationing. By covering certain groups of people through employer-based plans, Medicare for seniors, and Medicaid for the poor, the healthcare industrial complex can lull a large enough population of so-called “haves” into mistakenly believing that as bad as the system is now, they’ll end up with less if major reforms are instituted.

Separating the reality from the rhetoric, the people who perceive they have the most to lose by healthcare reform would actually stand to gain by it. So let’s start with the so-called “haves” – people who have employer-sponsored insurance to understand how vulnerable they really are.

Employer-Sponsored Health Insurance:
For all the speculation about employers dropping coverage if health reform is instituted, employees should understand that an employer is under no obligation whatsoever to provide health insurance to its workers under our current system. Employers can drop coverage at any time. In a tough economic climate where there are far more workers than jobs to fill them, employers know they could easily find people who would accept a job without health coverage.
One of the favorite buzzwords that Republicans and the so-called “free market” crowd like to use is “choice.” They proclaim that if the government offered a “public option” to compete against private insurance plans that would limit healthcare choices. Yet employees do not have a “choice” now. If you don’t like your employer’s plan, there’s nothing you can do about it.

Employer-sponsored health insurance is never portable. If you lose or leave your job, you lose your insurance. This is why both sides of the healthcare debate are being misleading when they state that “if you like your current coverage and your doctor, you can keep them.” If you change employers, most likely your new employer offers a different insurance plan with a different network of doctors and providers.

Employer-sponsored insurance is group insurance, meaning that you cannot be rejected for any medical reason. But when you start a job with a new employer, your new coverage will not cover a pre-existing medical condition for a certain period of time (anywhere from the first six months to one year depending on what state you live in). For example, a diabetic is responsible for paying for 100% of their treatment costs during the period of exclusion.

The nation’s largest employers self-insure and hire a health insurance company to act as the plan’s administrator. Medium-sized businesses purchase insurance from a health insurance company. And health insurers are allowed to medically underwrite all groups except those companies of 50 employees or less in most states. The “free marketers” try to convince young people to be opposed to healthcare reform by saying they would pay more if everyone in America had to have health insurance. Yet if you’re young and most of your coworkers are middle aged, adverse selection by the health insurers insures your policy’s benefits will be lower and your premiums higher than if you worked for a company where most of the employees are in their twenties.

Even if an employee believes they are following the rules of their employer’s plan, they could face some unexpected expenses. For example, you could have surgery performed by an in-network plan surgeon at an in-network hospital or outpatient facility.