Going To Extremes

Several years ago, some industry experts proposed plans in which employers would gross up employees' pay by the amount they currently were spending on health-care costs, and employees would be on their own to find the plans that fit their needs. Typically, the amount of the gross-up would be several thousand dollars per employee. That version of defined-contribution health-care didn't get very far. For one thing, grossing up employees' pay also would boost their taxable income. More importantly, the U.S. health-care system isn't set up to easily accommodate solo purchasers. "The individual marketplace, in most states, is such an ugly thing," says Scott Keyes, a Minneapolis-based senior consultant with Watson Wyatt & Co., Washington, D.C. Individuals with chronic conditions, such as diabetes, could see premiums double or triple if they tried to obtain coverage on their own, he says.