The U.S. is the only country on the planet pursuing employer-based health insurance. It was started by the labor movement as a way to increase benefits without increasing taxable wages in an era when income tax schedules were much more progressive. The U.S. was the first country to develop any mechanism for widespread health insurance, but no other country followed our now-failed model of employer-based health insurance plans.

Today, U.S. employers are at a competitive disadvantage relative to employers in other countries because of ever-rising employee health insurance costs. Virtually every other developed country taxes its citizens and businesses to subsidize health care, with modest co-payments from patients. In these countries, health care is either a citizenship right or a human right, not an employment right.

One consequence is that our manufactured goods–in particular–are relatively more expensive in international markets than comparable manufactured goods from other countries, just due to health insurance costs.

Another consequence is that U.S. residents are less-healthy than citizens in most other developing countries, and our health care costs are much higher per capita; we spend more for a lower level of health overall. In the U.S., insurance companies focus on how to off-load sick people to improve financial performance. Single-payor systems can’t off-load patients, so they soon figure out that health care prevention is cheaper than health care, and they invest significantly in preventative health care.

Employer-based health care made sense only when no other country was investing in widespread health insurance and governments were reluctant to recognize health care rights. Today, neither of these conditions exist, but we remain stuck with this failed system.