One day soon I will presumably receive a notice from the D.C. health exchange informing me how much my family’s health insurance will cost for 2015. That I’ve not yet been made privy to this salient bit of information mere weeks before I have to decide whether to change providers is a function both of the low level of competency that can be expected of any government dabbling in commerce as well as the politicization of the exchanges.
In its first year of existence, the D.C. government’s health exchange has worked much as I anticipated—not very well. It took months to navigate the website to actually purchase insurance, and the communiques from the exchange have ranged from irrelevant to unhelpful to factually incorrect.
However, its existence—more precisely, my ability to buy insurance at a price unaffected by my family’s health status—saved me thousands of dollars and was what allowed me to quit my job and start my own business. But the ability to obtain health insurance at a reasonable price is more than just a boon for me: More broadly, insurance that no longer unduly locks people into jobs could ultimately be beneficial for the economy. Whether the current exchanges manage to achieve this has yet to be determined.
The horror show of Obamacare has caused some to forget “job lock” and other dark aspects of generous, employer-provided health insurance. A personal illustration: Twenty years ago I was completing graduate school and applying for academic jobs. I limited my search to states contiguous to my home state of Illinois, which in retrospect was a lousy idea. The only school that showed any interest was the University of Wisconsin, Oshkosh, a public university with 12,000 undergraduates.
But I clearly did not impress them: After my first interview there was no contact, and I continued applying for other jobs, to no avail. Two months later—and still no job in sight—I received a call out of the blue inviting me for a second interview.
Upon my arrival, an indiscreet faculty member let me know I was the third choice of the department, but the first two candidates had bowed out. The sticking point for each, it turned out, was a law requiring new state employees to pay for their health insurance during their first six months on the job.
The rub was that, being a state government entity, the university provided health insurance that was very, very good, and the price reflected it: $15,000 per year ($24,000 in today’s dollars). My starting salary, on the other hand, was just $40,000. That meant, after taxes and pension contributions, more than half of my take-home pay would go to the insurance company. For a new professor of English or music at the school, where starting salaries then were closer to $30,000, paying for insurance meant six months of penury, but it was what every new faculty member chose to do.
Except for me. I told the dean I would accept the job and forgo health insurance for the first six months.
The dean (a Marxist in good standing) did a double-take and carefully explained the disaster that could befall me, a 27-year-old male in perfect health with $500 in the bank and no dependents (besides a bartender), should illness strike. I said I was willing to take that chance. Visibly bothered, he repeated his spiel, only more slowly. Not wanting to scotch my first job, I feigned listening carefully and responded that, upon his measured advice, I would purchase health insurance before starting.
I called an insurance agent friend for advice who told me to not piss away money I didn’t have on a health care plan I didn’t need. I survived the interregnum without incident and for good measure went another four years without seeing a doctor, during which time my employer paid handsomely so that I had first-dollar coverage for any malady that might arise.