The astute Anna Wilde Mathews (a Crimson colleague of mine) has an interview with the CEO of the Cleveland Clinic, Dr. Delos "Toby" Cosgrove. It appears in the Wall Street Journal:
WSJ: Do you think employers will stop providing health insurance, even though they can pay a penalty under the health overhaul law?
Dr. Cosgrove: The first ones will be the small companies…Every CEO I've talked to knows how much he'd save between insuring his people and paying the federal penalty.
WSJ: What does that tell you?
Dr. Cosgrove: The first time some big player does that, it's going to fall like dominoes. What that does is drive everybody to the exchanges.
WSJ: What does that mean to you?
Dr. Cosgrove: It's going to be a faster move towards one payer. Increasingly, people think that in 10 years you're going to have 75% of the health-care costs paid by the federal government.
WSJ: You think we're moving toward a single-payer system?
Dr. Cosgrove: Well, the question is how long...I don't think in the next 10 years, but I think it probably is going to head in that direction.
In my view a shift from employer-provided health insurance to individually purchased health insurance wouldn't necessarily be a bad thing, but a move to the federal government as the 75% payer from the 45.3% that it was in 2007 would be a big deal for the federal budget and for the health care industry, and probably not particularly healthy for either one.