I pointed out to her that most Americans are not employed by a Fortune 500 company with the infrastructure to do things like this, and that I remain unconvinced that cost shifting is dead or even nearly so.
Why? Because increasingly, it's not just large, organized entities like Lowe's or Pepsi that have discovered the problem. Small employers have too. And rather than take the paternalistic route, they've elected to let their employees feel some of the pain.
Largely, that group doesn't understand that the gobs of cash departing their bank accounts whenever they darken a hospital's front door go toward such an inefficient and unfair system. I can tell you this is true from recent personal experience.
Cost shifting over the long term doesn't work in any industry. But as I learned in economics 101, the short term can still last a very long time. I think we're far from the end of the cost shift in general, even if employers have largely gotten wise to the game.
As we chatted over email, my critic and I came to agreement on that score, at least. She conceded that her payroll deduction for healthcare costs has tripled over the past four years and her out-of-pocket costs have increased dramatically as well.
Where does she work?
A Blues plan.