One of the issues raised by the current debates over medical insurance is the issue that, in the United States, medical insurance is generally provided by employers as a benefit to their employees. While employees may have to shoulder a portion of the premium costs, the bulk is generally paid for by the employer.

The reason that things have developed this way makes sense. Because insuring a group of people allows an insurance company to spread risk out, the insurance companies are able to offer better pricing on premiums. This idea of the “group policy” is both a marketing tactic by the insurance companies to sell their policies to employers, and a practical way for the company to keep costs (and therefor premiums) down.

Over time, employers have used medical insurance benefits as a way to stay competitive in the marketplace. If a company wants the best and the brightest in a given field, they need to offer a competitive package. If the competitor down the street offers a medical insurance package, you’re going to have a harder time getting the most qualified employees if you don’t also offer a medical insurance package.

Is this a Bad Thing?

There are those that argue that this model is inefficient and even dangerous in that it leaves entire classes of people out of the medical insurance loop. People who are employed part time, or people who work in unskilled jobs may not be eligible for medical insurance through their employer.

The same holds true for self-employed people and small businesses. Because group health insurance policies require a certain number of participants, these kinds of businesses don’t qualify.

Are there Other Options?

The fact of the matter is, however, people can still buy their own medical insurance. In some cases, it is cost prohibitive. For others, it’s a matter of figuring out what’s available. For example, many local Chambers of Commerce offer group medical insurance access for local small businesses.

For those that can’t afford private insurance, there are other safety nets. The Medicaid program helps low-income families by providing medical insurance coverage. Some states offer a graduated buy-in to Medicaid or a similar program, meaning that people who don’t qualify for Medicaid still have access to insurance at a relatively low cost.

What Does the Future Hold?

It’s hard to say what’s on the horizon. Some politicians are pushing for federally-funded universal health care. Others seek to increase access to the safety net programs. Still others believe that market reforms, such as tort reform and deregulation will help make medical insurance more accessible. Which ideas will win out remains, of course, to be seen.