Types Of Exceptionalism

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American exceptionalism takes many forms. In the corporate world, one example is particularly odd: companies choose health insurance for their workers. Almost all firms with over 200 employees offer health coverage. Company sponsored insurance is common for working-age Americans. In no other big and rich country is it the norm. But this form of paternalism is diminishing fast, accelerated by Barack Obama’s health reform. The changes have broad implications for workers and the health industry.
Poll after poll shows that employers are revising their health plans. On August 18th the Federal Reserve Bank of New York reported that more than half of employers were changing insurance in response to Obamacare. The particular reforms may vary but the ailment they are all trying to treat is widespread.During the second world war, health insurance was used to attract workers made scarce as young men headed off to battle. Tax policy locked in the practice. Corporate health benefits are untaxed, so it is cheaper for firms to pad wage-packets with benefits, rather than to pay more in cash.This has side effects. Employers who cover spiralling health costs balk at also paying higher wages. Workers are prevented from choosing the right level of health cover. And fear of losing cover may trap them in jobs they want to leave.The law seeks to extend company coverage: all firms with 50 or more workers must offer insurance or pay a penalty. But the scheme new exchanges, where individuals can shop for policies, might eventually provide an alternative to company coverage. Meanwhile, companies are rejigging health plans as they deal with Obamacare’s requirements, and prepare for a tax on lavish corporate insurance that looms in 2018. Some employers are asking workers to shop not only for health care, but for insurance. Workers can use their firm’s money to choose among plans from new private

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