cos: (frff-profile)
cos ([personal profile] cos) wrote 2014-07-02 02:24 am (UTC)

In your diner example, the employer is directly paying for the lunch, but giving the employee a choice of what lunch to order. If they choose to do that - for example, paying a per diem for a traveling employee - they can either tell the employee "we'll only pay for meals meeting these characteristics" or alternately decide make limits by choosing which establishments the employees can be reimbursed for meals at. If the employer is directly contracting with a diner *and* directly paying for the meals, I think people would be quite understanding if they chose a diner that doesn't serve pork; that's rather unobjectionable.

But this comparison is pretty far from health insurance. With health insurance, the employer is *not* directly paying for any services the employee gets reimbursed for. The employer is paying a health insurance premium, which is used to purchase insurance. Later on, the employee gets benefits from the insurer. It's not a case of oh, Sarah's employer paid $N dollars for Sarah so we'll reimburse her for $N worth of services; insurance doesn't work that way. Someone's premiums aren't directly transferred to the services they buy, nor do the premiums directly correspond to any particular health services.

When a company pays a salary, they don't get to say "we'll give you special money that can't be spent on certain things". This is the same thing. Just as the government can set standards for wage & salary compensation (such as minimum wage, rules about back pay for vacation, etc.) it can also set standards for health insurance compensation. If a company chooses to hire people and provide health insurance as compensation, it needs to buy something that legally qualifies as health insurance. But that doesn't mean that the company is now paying for all of the health services their covered employees get from that insurance.

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