While I agree that benefits tied to employment, rather than the individual, is a very big problem, it is also the only economical path currently for medical insurance. Scale and contracts that a company can negotiate aren't there for individuals. Every year for the last decade, you hear about insurance companies raising individual and small business rates.
For profit companies managing what ostensibly a shared risk pool is another bone of contention for me. I can't find the actual reference at the moment (typing on iPhone) but legislation has been put in place requiring minimum percentages of premiums that must be spent on coverage rather than "overhead".
Also, a minor nit, not all companies offer up bad 401k plans. As an early employee at a couple of startups, I've helped hr pick the better options given rather than the first one peddled.
This is a social and financial engineering problem - change the tax structure to encourage people to get private insurance. Make the cost of private insurance 150% deductible for one year, then 140% deductible the second year, etc. for 5 years to encourage more people to do it. As more people have private insurance vs employer provided, the market economics would shift.
Sure, not all companies offer bad 401k plans. Enough do that it's not something that we should continue to encourage though - pay people more and let them make their own decisions. That money for 'benefits' isn't freely coming from nowhere - it's the cost of employing you, and it could just as easily go in to your pocket vs the pockets of plan administrators that you didn't get to choose.
>benefits tied to employment [...] is also the only economical path currently for medical insurance.
It's the least economical path ever come up with for the financing of health care. No one has ever come up with a more expensive way. All other ways that have ever been implemented have been cheaper.
For profit companies managing what ostensibly a shared risk pool is another bone of contention for me. I can't find the actual reference at the moment (typing on iPhone) but legislation has been put in place requiring minimum percentages of premiums that must be spent on coverage rather than "overhead".
Also, a minor nit, not all companies offer up bad 401k plans. As an early employee at a couple of startups, I've helped hr pick the better options given rather than the first one peddled.