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My recollection is that health care and other, similar benefits were incentives employers could offer to attract and retain talent during a period when FDR had wage and price controls in place. That is: healthcare was exempt from wage controls, so you could offer a healthcare plan or an improved plan in lieu of a raise.

Then, employers noticed, "you mean offering them healthcare makes it harder for our employees to leave? And public perception of healthcare means it will probably always be a tax advantaged way to allocate our expenses?"

And here we are, eight decades and change later.

Note: I think public perception of healthcare as a moral good in principle is correct. It's just that there's a wicked mal-alignment of incentives which leverages that perception to cement a bad solution in place.




That's basically my understanding of how we got into that mess. There are still significant tax subsidies for employer provided health insurance and most people don't realize that the COBRA price is the actual cost of their "cheap" or "free" employer provided insurance for the same reason they think their "income tax refund" is actually "free money" from the IRS rather than their money that the government held onto without interest.

The average person is not very smart and half of the population isn't even that smart so of course they fall for these intelligence insulting tricks invented by politicians.


Most people are otherwise able to navigate their life just fine, but they struggle with systems that are ridiculously complex and opaque. Industrial society reduces your direct agency and forces you to rely on more sophisticated forms of influence.


"Note: I think public perception of healthcare as a moral good in principle is correct. It's just that there's a wicked mal-alignment of incentives which leverages that perception to cement a bad solution in place."

That is everywhere now. Birth, education, courtship/marriage, employment, ... all the way to death - everything is analyzed, pessimized, and stripmined for every last penny. "Enshittification" is all over HN and with good reason.




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