The number of uninsured Americans is about 45 million and climbing. Companies like General Motors, with large numbers of older or retired workers receiving generous benefits, are struggling under ever-higher health care bills. More companies are abandoning their role in providing health insurance to their employees, and some people worry the federal tax overhaul now being discussed could scare away even more employers. So, are we in the final days of the company health plan? Probably not. Frustrations with the status quo notwithstanding, the current system of providing insurance to most working Americans through their employers is not likely to disappear, according to policy analysts and consultants in Washington and around the country. That is mainly, they say, because none of the other possibilities, like a government-run plan or some new private-sector solution, have enough support to serve as a replacement. Employers "are not about to get out of the business of providing health insurance to employees, even though they complain so loudly about it," said Paul B. Ginsburg, the president of the Center for Studying Health System Change, an independent research group in Washington. Inspiring the latest round of debate is the proposal introduced last month by the President's Advisory Panel on Federal Tax Reform, as part of a sweeping effort to overhaul the tax system. Under the proposal, tax breaks for both employers and their workers for health benefits are limited to $11,500 of coverage for a family and $5,000 for an individual. Under current tax law, there are no limits to how much coverage is exempt from payroll and income taxes. Many say the proposal is a political nonstarter. But some critics see it as a threat to a system that is already unraveling. Only 60 percent of employers now offer coverage, compared with 66 percent as recently as 2003, according to annual survey conducted by the Kaiser Family Foundation, a nonprofit health research group in Menlo Park, Calif. In 2000, the percentage was 69 percent. If the tax advisory panel's recommendations on employer-sponsored health care went into effect, they would "dismantle our current health care system," Representative Pete Stark, a California Democrat, said in a news release. That might be an exaggeration, and the proponents of the plan assert that they are not trying to take away the entire tax advantage of providing employer-based coverage. Instead, people may view it as "a tax on excessive health plans," one of the panel members, Representative Connie Mack, Republican of Florida, said in a news conference.
