Yeah, this is the biggest issue for me too (as an American who hasn't lived anywhere else). In particular, the tying to your employment status makes everything complicated and coverage uncertain for everyone except career employees who stay with one firm. For example, I switched from a full-time student to part-time for one semester in grad school. Oops, this means I don't get the student health insurance anymore and have to buy gap coverage. So I had to research gap insurance, fill out a bunch of paperwork, wait to be approved, and then still hope that I don't really have to use it, because now the recent change in insurance gives them excuses to claim things were preexisting and thus excluded.
And I don't even have any major chronic conditions! People with major chronic health issues are pretty much required to stay in their current job forever, because if they lose their health insurance they're screwed. The whole employment-tying thing puts a huge drain on entrepreneurship, imo, because lots of people who would start companies are scared of losing their health insurance, and even if you can figure it out, it's a huge bureaucratic hassle. One area where the private sector has managed to gallantly out-bureaucratize any government.
In short, I really, really wish that health-insurance was completely decoupled from employment. It would reduce a lot of friction in the economy, imo.
On NPR an economist said that one thing that makes the US economy different (in a good way) from the EU economy is the extreme mobility of our workforce - that when times are tough, a reasonable portion of US people can and will pack up and move to a state where they can find jobs. If that is true, conversely isn't the effect of having health insurance so tightly coupled to employment equally detrimental? I mean it just blows my mind that we tie employment and healthcare together.
And I don't even have any major chronic conditions! People with major chronic health issues are pretty much required to stay in their current job forever, because if they lose their health insurance they're screwed. The whole employment-tying thing puts a huge drain on entrepreneurship, imo, because lots of people who would start companies are scared of losing their health insurance, and even if you can figure it out, it's a huge bureaucratic hassle. One area where the private sector has managed to gallantly out-bureaucratize any government.
In short, I really, really wish that health-insurance was completely decoupled from employment. It would reduce a lot of friction in the economy, imo.