Pre-WW2, many unions in the US had negotiated employer-paid health insurance as a (taxable) benefit. When the government capped wages as part of wartime price controls, these unions threatened to strike, which would have gutted industrial production. To avoid a strike, the government offered to temporarily make employer-provided health insurance a tax-free benefit.
Temporarily. And here we still are.
//Hacky solution to get a working prototype, should be refactored before deployment.
Legislative and regulatory debt can be a problem just like technical debt.
I really wish there was more appreciation for this outside of tech. I'm disdainful of a lot of SV libertarianism, to say the least, but will gladly make common cause on this one point.
The healthcare situation in the US may have started out as a hacky WW2 era fix, but has been explicitly and aggressively lobbied against for years at the highests levels of government.
Framing it in a technocratic context as "technical debt, but for laws and stuff" completely misses the intense crusade against it in the US.