Tabla de Contenidos:
  • Employment and Health Benefits
  • Copyright
  • Preface
  • Acknowledgments
  • Contents
  • Summary
  • EMPLOYMENT-BASED HEALTH BENEFITS IN CONTEXT
  • Historical Development
  • Key Statistics
  • International Comparisons
  • Scope and Functions
  • Access to Health Services
  • Costs in Context
  • DISTINGUISHING FEATURES OF THE CURRENT SYSTEM
  • Voluntary Group Purchase
  • Lack of Universal Coverage
  • Risk Selection and Discrimination
  • Dispersed Power and Accountability
  • Diversity
  • Innovation
  • Discontinuity
  • Barriers to Cost Management
  • ComplexityStrengths and Limitations of These Features
  • FUTURE DIRECTIONS
  • To Improve a Voluntary System
  • Reducing or Compensating for Risk Selection
  • Subsidizing Coverage
  • Other Regulatory Issues
  • The Financing Dilemma
  • Beyond Voluntary Coverage
  • Research Agenda
  • FINAL THOUGHTS
  • 1 Background and Introduction
  • EMPLOYMENT-BASED HEALTH BENEFITS IN CONTEXT
  • OVERVIEW OF REPORT
  • WHY THIS STUDY?
  • Relation to the Debate over Health Care Reform
  • Issues and Concerns
  • KEY CONCEPTS AND TERMS AS USED IN THIS REPORT
  • Employment-Based Health BenefitsSocial Insurance and Private Insurance
  • Small and Large Groups
  • Risk, Insurance, and Benefits
  • Insurable Events
  • Moral Hazard, Biased Selection, Risk Segmentation, and Underwriting
  • CONCLUSION
  • 2 Origins and Evolution of Employment-Based Health Benefits
  • THE BIRTH OF INSURANCE FOR MEDICAL CARE EXPENSES
  • Early Voluntary Initiatives
  • Early Public Action
  • THE DIVERGENT PATH OF THE UNITED STATES
  • Unsuccessful Early State Initiatives
  • Proposals for National Health Insurance in the Depression and Postwar Years
  • Innovation in the Private SectorEmployment-Based Benefits, Federal Regulations, and Union Policies
  • Growth and Change in Health Insurance Products
  • Federal Government as Sponsor of Employee Health Benefits Program
  • EARLY COST MANAGEMENT EFFORTS BY INSURERS AND OTHERS
  • Management of the Risk Pool
  • Design of the Benefit Plan
  • Controls on Payments to Providers
  • Constraints on Supply
  • Utilization Review
  • Impact of Early Cost Management Efforts
  • THE LIMITS OF VOLUNTARY HEALTH BENEFITS AND MEDICARE AND MEDICAID
  • Medicare
  • Medicaid
  • National Health Insurance RevisitedFEDERAL REGULATION AND THE EMPLOYER'S GROWING ROLE
  • Federal and State Roles Before 1974
  • The Employee Retirement Income Security Act of 1974
  • CONCLUSION
  • 3 Employment-Based Health Benefits Today
  • DATA SOURCES
  • WHO IS AND IS NOT COVERED BY EMPLOYMENT-BASED HEALTH BENEFITS?
  • Covered Workers and Family Members
  • Uninsured Workers and Family Members
  • Retirees
  • Sources of Variation in Employment-Based Coverage
  • WHAT TYPES OF COVERAGE ARE OFFERED?
  • Types of Health Plans
  • Conventional Plans