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  • Title: Employment-based health insurance: past, present, and future.
    Author: Enthoven AC, Fuchs VR.
    Journal: Health Aff (Millwood); 2006; 25(6):1538-47. PubMed ID: 17102178.
    Abstract:
    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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