by Don Fredrick, The Complete Obama Timeline, ©2025
(Nov. 18, 2025) — Company X has 1,000 employees. They all work together in one large office building, and they all currently receive comprehensive, employer-paid health insurance — with an annual deductible of $7,500. Let us assume the company pays $8,000 per employee per year for that health insurance. The annual insurance costs of the employer would therefore be $8 million. The annual out-of-pocket costs of the employees would be anywhere from zero to $7,500. Why is this expensive and impractical practice standard among large companies? Are there not better alternatives?
Would it perhaps make more sense for the company (and for the employees) to cancel the expensive, comprehensive group insurance policy and instead have several full-time doctors on staff to deal with routine health care for the employees and their dependents, and have employer-paid, catastrophic-only insurance only for non-routine care for broken bones, heart attacks, and cancer?
To deal with all standard, routine health care, the employer’s on-site doctors would be paid directly by the company. Their examination rooms would be in the same office building where the 1,000 employees work. Those doctors would not be in a group practice, or employees of a clinic or a hospital. They would not be required to follow the “standard protocols” put in place by the bureaucrats of a multibillion-dollar conglomerate. They would be free to be doctors caring for patients, not beholden to penny-pinching accountants.
The company might need five doctors to care for 1,000 employees, their spouses, and children. Five doctors would possibly be enough to ensure that three would always be on duty during the company’s operating hours and weekends. Three doctors, each seeing up to four patients per day, would provide 84 patient visits per week, or 4,368 per year — which could be enough care for 1,000 employees and their dependents.
When one of the 1,000 employees of that company needs a routine exam, he would visit whichever of the on-site doctors happened to be on duty. If the employee needs a blood test, his blood draw could be quickly done on-site. The on-site care could also include treadmill stress tests, ultrasounds, and EKGs. If the employee needs x-rays or more elaborate tests done off-site, the company would pay cash for those services — with no insurance company red tape or involvement. If the employee needed to see a specialist, the employer would pay the bill.
The employer would pay directly for all routine care, whether done on-site or provided by an off-site facility. The employee would never see a bill. The employee would never need permission from an insurance company for a referral. The employee would never have to worry about deductibles and out-of-pocket limits.
Assume the company hired five doctors to care for all its employees and their dependents — during the week and even on the weekends. If they were each paid $150,000 per year, the cost to the employer would be $750,000 per year. The employer would also have a one-time initial cost to set up exam rooms and offices for the doctors, and to purchase equipment like treadmills, etc. The employer would obviously also have routine expenses for medical supplies.
The employer would pay directly for all outside specialist services that are not covered by catastrophic insurance, but which are recommended by the in-house doctor. (That would include visits to dermatologists, heart specialists, etc.)
The employer would cancel the comprehensive coverage for all 1,000 employees and instead provide catastrophic-only insurance. That might cost about $3,000 per employee per year. The total cost for the company to care for its employees would be $4.85 million:
Cost of five full-time doctors $750,000
Cost of annual supplies, etc. $100,000
Cost of outside specialist services $1,000,000
Cost of catastrophic insurance $3,000,000
Total annual cost to employer $4,850,000
The company’s annual cost to insure its employees would fall from $8 million to $4.85 million, a savings of $3.15 million. That could be given to the employees in salary increases. Every employee could be paid an additional $3,150 per year. Because the cost of outside specialist services would be unpredictable, the additional payment to each employee could be in the form of a year-end bonus, rather than a weekly salary increase. In other words, if outside specialist services cost less than $1 million per year, the employee bonus could be larger. If those services cost more, the bonus would be smaller.
Why would the company make such a change if its total expenses were still $8 million? Employee productivity and satisfaction would increase! Employees would not have to use an entire sick day for a visit to the doctor. They would simply see an on-the-premises doctor and then hop in the elevator and return to work. If an employee has a sore throat, the on-site doctor could quickly administer a strep throat test. If the test is positive, that doctor could give the employee antibiotics from the company’s own supply and send the employee home for a day or two. If the test is negative, the employee avoids losing a day’s pay just to make an appointment with a doctor on the other side of town.
What employee would not be happy to receive a wage increase or year-end bonus and, at the same time, not have to worry about bills for routine annual care, not have to worry about deductibles and out-of-pocket limits? What employee would not like to take a brief break from his desk to see a doctor rather than waste an entire sick day? What employee would not like to have an hour or more with a doctor, instead of the mere minutes of attention he might currently get from one of today’s assembly-line facilities? What employee would not like to see a doctor when he needs one, rather than waiting weeks or months for an appointment?
If the concept of on-site doctors in your office seems unreasonable, there is another option. Partly following the above example, the employer could cancel the comprehensive policy that costs $8 million per year, replace it with a catastrophic-only policy that costs $3 million per year, and give the $5 million in savings to the employees in the form of a $5,000 salary increase — with the expectation that those employees would be responsible for their own routine care. They would have insurance only for catastrophic events (cancer, heart attack, etc.), but they would have an extra $5,000 per year in their salary to allow them to pay cash for routine care. That amount is more than enough to cover an annual physical for each family member and an occasional visit to a specialist.
Americans need to stop demanding that health insurance cover everything. Insurance was, after all, designed to cover only non-routine events! Multiple people contribute to a pool of money, and that money covers rare emergency expenses that are too great for the average person to deal with. Multiple drivers pay car insurance premiums so that the money in that pool can help the few drivers whose cars are stolen or destroyed in an accident. If every car were stolen or destroyed every year, the car insurance industry would obviously collapse. Insurance spreads the risk, but it works only if most customers do not have claims to file. If, for example, car insurance covered biannual oil changes for every car, it would be impossible to “spread the risk” because every driver would have two oil change claims each year!
We need to think creatively when addressing the issue of health care. Everyone seems to want excellent, comprehensive care paid for by someone else, and everyone seems to believe that the government (that is, the taxpayers) must pay for everything. But there are other viable solutions. The “company doctor” proposal presented above is one suggestion. It would obviously not work for a small company, or the local dry-cleaning business, but there is no reason why it could not work for a large company. Why not at least try it? One size does not fit all. Let the free market operate without government interference!