For years, a central goal of the free market health care community has been to alter the tax code’s treatment of health insurance so that it no longer gives an unfair advantage to employer-based coverage. But now that President Obama’s national health care law is starting to get implemented in earnest, this has become a much trickier proposition.

Under the current tax regime,  individuals who pay for insurance on their own don’t get to exclude those expenditures from their taxes, whereas those who obtain their health coverage through employers can. Having an employer-based insurance market means that individuals cannot take their insurance with them from job to job in an increasingly mobile workforce and it makes it harder for individuals who work on their own to get insurance. It means that there’s less choice, because people who obtain insurance through their employers are stuck with whatever policies they’re offered by their companies. And also, the perpetuation of a third party buyer system in which individuals are more insulated from the cost of their health care provides them with less incentive to shop for the best deal, thus making it harder to foster a functioning competitive market that controls the growth of costs.