Why do you go to work?

If you ask most people, they’ll say they need the money. But the answer expands a bit if you ask people who work for a large company or the government. Dig a little deeper, and you’ll find many people work for big organizations simply because they need the health insurance.

Lots of entrepreneurs are only able to be entrepreneurs because their spouse carries health insurance. I was one of them for a decade. My husband’s job provided affordable insurance for our family while I was building my business. If I’d had to self-pay the insurance for our family of four, it’s likely I would still be working for a big company.

But what if everyone had health insurance that wasn’t tied to their employer, like they do in many other countries? What if health insurance no longer played a part of the employer/employee relationship?

In her LinkedIn piece, “What Would Medicare for All Mean for Talent Retention?,” my business partner Elizabeth Lotardo writes that “Medicare for All would fundamentally change talent retention in the United States. In a Medicare for All world, employment decisions won’t be based on the need for medications, the ability to see a specialist or the access to primary care for employees and their families.”

Lotardo cites five big changes that will likely ensue if everyone – no matter what his or her job – has access to affordable health coverage:

  • Disengaged employees will leave quickly. Employees checking the box in the name of keeping their health insurance will rapidly depart.
  • The gig economy will spike. Newfound flexibility will give rise to a new wave of consultants, freelancers and solopreneurs.
  • Interviews will become more transparent (on both sides). For employers, the likelihood of getting an honest answer to “Why do you want to work here?” increases. For employees, comparing offers gets easier without reading the fine print of 74-page health benefit packages.
  • Small businesses will become more competitive. Small businesses will be able to compete with their giant corporate counterparts for top talent.
  • Workplace culture will matter even more. When employees aren’t bound to employers out of necessity, personal fulfillment, learning and development opportunities and establishing a positive culture will carry even more weight.

In short, if everyone has health insurance, the employee/employer relationship becomes more about the work and less about people trying to protect their family from the financial ruin of illness.

When my husband left his big company job, and we had to self-fund our insurance, it was more than $2,500 a month. No, there’s not an extra zero on there. For the past decade, we’ve paid more than $25,000 a year for health insurance to cover our relatively healthy family of four with the most basic of policies.

We’re lucky. We’ve made enough money to pay it. But having just added this up, and realizing I’ve spent more than a quarter of a million dollars on health insurance in the past decade, it’s a tough lump to swallow.

I don’t know where we’ll go with health insurance as a nation, nor do I profess to have perfect solutions for this complex issue. I do, however, see the groundswell of support for a system that provides more people more access to affordable health care.

Employers who provide great health insurance are wonderful. Employers who can retain employees when they don’t need health insurance are poised for the future.

– Lisa Earle McLeod is a leadership consultant and the author of several books. For more information on her company, visit McLeodandMore.com.

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