Employer-Based Private Health Insurance Needs Structural Reform

This paper argues that certain structural barriers in our employer-based health insurance system inevitably mean failure by employers, private insurers, and physicians to produce a system that provides affordable health care and insurance to the entire population with a minimum of government regulation and intervention. Key barriers that lead to failure in managing the physician-patient transaction and the competition among health care/health insuring plans are described. Finally, the minimal scale of needed reform is discussed.