Healthcare Insurance for Workers


Please write a synthesis from 3 classmates.


Blake’s Post:

Discuss the advantages and disadvantages of a company having healthcare insurance for their workers.

Health care is a topic that is heavily scrutinized and debated. As with anything in life, companies having healthcare insurance for their workers can be an advantage and disadvantage. Some advantages of employer healthcare would be value based purchasing, risk spreading, reliable payment. Value based purchasing means the company would be the one dictating the essentials and differences in the plans due to the employee being unable to determine their health insurance needs. Risk spreading is thought to decrease the risk involved in a group insurance model. Reliable payment speculates that employees are more probable to pay when the money is taken directly from their paycheck. Some of the cons are lack of portability, restriction of consumer choice, and ethical/religious concern. Lack of portability means there is no reasoning that the insurance should have to change when an employer changes. Restriction of consumer choice means employers are making the decision on health insurance and restricts the employee’s choice. Ethical/religious concerns meaning if the employer health insurance model was gone, health insurance would belong to the employee and employers’ grievances have potential to be taken away from it completely (Honermann, 2014).

Is this cost effective when we see a worker missing work for weeks at a time?

It does not seem that it is cost effective when we see a worker missing work for weeks at a time.  

There was a study conducted that showed the total yearly costs linked to lost productivity was eighty-four billion dollars (Forbes, 2013). Losing that amount of money should alarm any employer. With that being said, it would seem unethical to not allow people to be paid if they have to miss work for sickness or any other serious issue.  

What are the legal implications if one is not allowed to take as much time as they need to recuperate?

Employees are eligible to take up to twenty-six weeks of unpaid leave per year depending on what the situation is. Law states that you can take family or medical leave without losing your job. This means that when you return to work the employer must give you the same job you had prior to your leave or a job with equal benefits, pay, work conditions, and seniority (Workplace fairness, n.d.). This is extremely important for employees. Medical and family leave can be a very difficult and stressful time and knowing that they will be taken care of is incredible.


Nathalie’s Post:

Priorities change as you go through different phases of your life. What a 16, 20, 26, and 32-year-old need from their employer are different. It’s not until your mid 20’s that you realize health coverage is not a nice to have but more of a need to have. And in your 30’s when you have a family you will not take a job unless it offers some kind of health coverage for you and your family. In a 2016 Aflac workforce report it was found that 16% of the workforce recently turned down a job or left a job based on benefits alone and 60% would take a job with a lower salary if the benefits are better (Goldstein, 2018). The advantages of providing health coverage to your employers are your employees feel taken care of, they are not stressed about how they can take care of themselves or their family and that leads to healthier employers resulting in more productivity for your company.

As an employer providing health coverage for employees does come with some added costs, added administrative load, and often times an added headache. It’s expensive and when you’re a small business just starting out it might be something that has to be put on the back burner. Recently premiums for small group insurance plans have become 15% more expensive (Pen, 2019). The administrative burden is enough to throw in the towel.

Whether you offer Health insurance or not your business still falls under federal and state labor and employment laws. When we discuss cost effectiveness COVID-19 has brought in a whole new perspective when dealing with missed work due to illness. Losing an employee for an extended period of time is never cost effective but you have to outweigh the cost other than just the present money lost. If the employee comes to work with symptoms and infects everyone else or contaminates the location, you’re going to lose more money and future income. The legal implications are outlined by the Department of Labor and most often the law is always on the side of the employee, as an employer you end up just paying the wages or fees because you don’t want to drag out the process so it’s important to know all the requirements under the department of labor laws for the family medical leave act.


Robert’s Post:

The majority of people with healthcare insurance reeive it through the comapnies they work for.  Receiving healthcare insurance through your can have many advantages such as the employer choosing the plan for eliminating leg work on your part, lower cost due to the employee splitting premiums with the employer and certain tax breaks. (Medical Mutual, 2020)  On the downside if you lose your job you could lose your coverage.  You also dont have as much choice about which doctors and hospitals you can been seen at with the company plan.  In my experience being on a company provided healthcare insurance plan has overall been a good thing.  My biggest issue is having to be seen by my primary provider multiple times before being reffered to a specialty provider.  If had personal insurance it would be possible to go straight to the speciality provider if needed.

It is never going to be cost effective when you see a worker missing work for weeks at a time, however I think health insurance can help mitigate this issues.  Having health insurance encourages people to utlize it and go get checked out when they are sick.  This can help to diagnose what is wrong prevent minor issues from becoming chronic issues that could potentially have employees missing even more time from work.

When someone is sick and given the opportunity to stay home and recover fully, it lessens the risk of getting others sick and makes the workplace more productive.  (NPFW, 2020)  Many companies have a certain number of paid sick days which incentives peole to stay home when they are sick.  Forcing someone to work when they are sick especially with a disease like TB could have the company footing the bill for any chronic conditions that devlop if they knowingly force someone to come to work.


Please see Example below:

The concept of gatekeeping in healthcare is controversial. Sheena, Timothy, and Brooke attest to the fact that there are as many advantages to gatekeeping as there are limitations. The rationale behind the concept is that by controlling access to specialist services, the government can control healthcare costs. Sheena confirms that the informed gatekeeper, the primary care physician, determines patients whose conditions are beyond their scope, and therefore need specialist services. Ideally, this arrangement makes sense. Using the services of primary care physicians is less expensive than using specialist services at every instance (Wammes et al., 2014). However, in practice the situation has been less than straightforward. Brookes argues that primary care physicians are overworked because all patients have to consult the before being referred to specialists. Since the ratification of the Affordable Care Act (ACA), access to care has increased, thus significantly increasing the workload of primary care of physicians (Wishner & Burton, 2017). Timothy maintains that the use of gatekeepers is also a hindrance for individuals who require specialist attention on the go such as elderly patients. Visiting primary care physicians wastes time, thus increasing the likelihood of adverse outcomes. Lastly, the gatekeeping system is not popular among patients. It minimizes the autonomy of patients since they cannot choose when to seek specialist care (Greenfield & Majeed, 2016). For the gatekeeping system to succeed, authorities should look to minimize the impact of the limitations discussed. Increasing flexibility on groups of patients who can be exempted from seeking referral letters from primary care physicians would prevent unnecessary visits. Better communication between gatekeepers and specialists would also expedite the process.

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