Employment and Health Benefits : A Connection at Risk

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 -- Complexity -- Strengths 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 Benefits -- Social 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 Sector -- Employment-Based Benefits, Federal Regulations, and Union Policies -- Growth and Change in Health Insurance Products.