I’m personally excited to meet a number of the luminaries and hope to set up some podcasts during the event.

Please let me know if any of you will be in attendence– I’d love to catch up.

If the purpose of health-care reform is to decrease the ranks of the uninsured, these job-related tax breaks are poorly targeted, even regressive. The more generous the employer health plan, the more the subsidies increase. On average, lower-wage workers have more limited coverage as part of their compensation, usually from small- or medium-sized businesses. Estimates show that the subsidy is worth more than $3,000 for upper-income families (with higher marginal tax rates), and less than $1,000 for those on the lower income rungs.

This does bring up interesting questions on why Democrats are pushing for increasing amounts of insurance instead of increasing the equity of the insurance subsidy.

If these losses were converted to the equivalent of direct spending, the tax exemption would have cost more than $208 billion in 2006. The only federal programs that cost more are Social Security, Medicare and national defense. But all that money props up only employer-provided insurance. Individuals who buy policies don’t get any tax breaks and pay with after-tax dollars.

$208 Billion would also be a heck of a lot of money to deal with unreimbursed medical care. However, without the tax prop, most employers would likely accelerate their unloading of health insurance back onto their workers, as downward pressure on insurance premiums would accelerate.

What might the future look like without tax deductible of first-dollar employer-sponsored health insurance?

Some likely side effects:

• Families would receive higher wages, giving most far more disposable income that could be invested in education, wellness, and other priorities
• Primary care would be pre-deductible, orienting most practitioners to consumer needs (e.g., no more long waits in the waiting room)
• Primary care would focus on helping people implement the cheap basics (diet, exercise, sleep) instead of making the first priority diagnostics, insurance billing, and prescriptions
• Prescription drug costs would come way down, as consumers would gulp hard at paying 4X more for a branded alternative they don’t understand
• Insurance would become easier to understand, as it would be more limited in scope
• Prices would become transparent, as consumers would need to understand what they bought
• EMRs would become a selection criteria where consumers valued them, not where insurance companies saw value. Providers would gain competitive advantage where consumers saw benefit.