Bert,
To be or not to be that is the question, but my philosophy of a practice is to be like a lichen. The staff being the algae reducing the atmospheric CO2 to carbon sugar--feeding me patients/collection & billing. Doctors being the fungus by retaining the water/capturing nutrients--so anything I can do to help this symbiotic relationship by providing health insurance (even though it is quite costly), providing a healthy retirement fund, etc.. means more to me than working in a fancy office or owning a building.
I am unhappy if any category of my monthly statement has a higher percentage of overhead cost than my staff's salary/perks. If that changes, the lichen has trouble surviving on a rock or tombstone (Obamacare, monopolistic ACO activity, HMO's and all the like) and as long as I keep my nose to the grindstone, and my AC/Updox is working , I can survive the future--I would be happy to compare my overhead costs or my staff turnover to any group in my community-and yes the office looks like you are in the time warp of the 60's but patient don't seem to complain about their bill paying without too many frills about.
So even though your young employee doesn't want health insurance, I wouldn't give her the option and provide it for her. She may be glad you started when in 20 years she is thanking you for providing it for her.
Now that is my philosophy and I know it wasn't asked for and it is outdated, and I may be kicking myself in the pants for beholding to this principle but it has worked for the past 18 years, and I am getting too old to change.
