Employment-based health insurance: past, present, and future.

نویسندگان

  • Alain C Enthoven
  • Victor R Fuchs
چکیده

We review the rise, stabilization, and decline of employment-based insurance; discuss its transformation from quasi-social insurance to a system based on actuarial principles; and suggest that the presence of Medicare and Medicaid has weakened political pressure for universal coverage. We highlight employment-based insurance's flaws: high administrative costs, inequitable sharing of costs, inability to cover large segments of the population, contribution to labor-management strife, and the inability of employers to act collectively to make health care more cost-effective. We conclude with scenarios for possible trajectories: employment-based insurance flourishes, continues to erode, or is replaced by a more comprehensive system.

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عنوان ژورنال:
  • Health affairs

دوره 25 6  شماره 

صفحات  -

تاریخ انتشار 2006