Health insurance as a benefit of employment is ridiculous when you think about it. If we forbid group rates for insurance, it would no longer be cheaper for large employers to provide to their employers than it would for small employers or even individual consumers.
The way it stands now, people don't even have a choice as to how they insure their healthcare needs. Their employer gives them a couple or a few options and that is it -- the individual doesn't get to really decide what deductible they prefer to cover their risk tolerance, etc.
We need to be able to AFFORDABLY buy health insurance the same we we insure our homes and cars - each individual determines what they are comfortable in paying (i.e. coverage, premium, deductable, copays, coinsurance) in accordance with their risk tolerance. It isn't very possible in our current set-up because you can't get lower costs without a group rate, so very few people buy their own insurance as a result.
You might know the story behind how we stumbled into that system...
During WWII, there were some pretty strict price controls, wage controls, and high taxes, all designed to help pay for the war. Not going to want to litigate if those were good ideas or not, but German and Japanese imperialism sure needed stopping, so there was a worthy goal behind all this.
Workers understandably became very scarce during the war due to so much war production and so many men being sent overseas in the armed services. To get around wartime price controls, companies started offering fringe benefits to workers, one of the main ones being health insurance benefits.
Eventually the war ends. And the IRS has to decide once and for all if health insurance provided by an employer is essentially part of your salary and therefore taxable. They decided not. They did this because the people who had such benefits -- mostly well-off professional and government employees -- liked their tax break, and unions (who negotiated generous benefits for their membership) didn't want that gold-played health insurance plan they just secured all the sudden become taxable income for members.
So the
massive tax advantage of having employer-provided insurance was enshrined. Buying health insurance with post-tax dollars is way more expensive than with pre-tax ones.
It's like the world's worse case of herpes. We'll never be rid of it.
But there is a historical chain of events about how we got here.