I remember during some townhall forum where “normal people” (i.e. handpicked by Dan Rather or the like) asked questions to GOP and the Democratic candidate. This may have been in 2004. Bush said that the biggest concern for the average American small business owner was taxes. The questioner said that his biggest concern as a small business owner was health care, and what was government going to do to make it easier. I noted back then that health care is a tax policy issue, and that Bush for all his ham-fistedness had it right. Ramesh Ponnuru highlights this fact in Time.
That’s how we ended up with the health-insurance system we have now, based on employers. You get a tax break if you get your insurance through your job. If you get a raise and use it to buy your own insurance instead, you have to pay taxes on that money. (Ditto if you use your raise to pay doctors directly.) Almost everyone takes the tax break. The market for insurance bought by individuals is, as a result, small and stunted, which is all the more reason to stay in the employer system.