[acituan]

Employers paid for healthcare in 1970s too, and even for higher percentages of the workforce. If there is a premium inflation surpassed the CPI, that is still inflation, not real growth. If there’s an inflation problem in delivering a temporally comparable service, that is not a “real wage” item for the employee [1]. So what the nominal figure today shouldn’t be relevant.

I agree it shouldn’t be an employer item too, but whatever employers lose on premiums, they get more on an overall stickier and cheaper labor supply.

[1] one could argue the productivity of healthcare increased, and the data indeed supports this with the overall life expectancy increase from 70s to now mid 70s plus quality of life treatments. But again most of the spend is actually on the tail end at this age group, which raises the workers’ premium without delivering the benefit. Therefore not much structural gain for the actual working age employee.

[nradov]

I don't understand your point. Very few people in their 70s have employer sponsored group health insurance. Most are only on Medicare, perhaps with a commercial Medicare Advantage or Medicare Supplement plan.

[acituan]

My bad, skipped a chain of thought there. Since medicare pays less than private insurance, hospitals can and do shift costs (which in reality is "opportunity cost of profit") to the latter, which pushes to private premiums up. Regardless, this is a minor effect. Very little of the inflation is justified with productivity gains, as you said it is a very inefficient healthcare system. US prices clock 2x-4x of comparable OPEC peers, admin percent is higher etc.