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Employment and Health Benefits - A Connection at Risk (Hardcover, New)
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Employment and Health Benefits - A Connection at Risk (Hardcover, New)
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The United States is unique among economically advanced nations in
its reliance on employers to provide health benefits voluntarily
for workers and their families. Although it is well known that this
system fails to reach millions of these individuals as well as
others who have no connection to the work place, the system has
other weaknesses. It also has many advantages. Because most
proposals for health care reform assume some continued role for
employers, this book makes an important contribution by describing
the strength and limitations of the current system of
employment-based health benefits. It provides the data and analysis
needed to understand the historical, social, and economic dynamics
that have shaped present-day arrangements and outlines what might
be done to overcome some of the access, value, and equity problems
associated with current employer, insurer, and government policies
and practices. Health insurance terminology is often perplexing,
and this volume defines essential concepts clearly and carefully.
Using an array of primary sources, it provides a store of
information on who is covered for what services at what costs, on
how programs vary by employer size and industry, and on what
governments do?and do not do?to oversee employment-based health
programs. A case study adapted from real organizations' experiences
illustrates some of the practical challenges in designing,
managing, and revising benefit programs. The sometimes unintended
and unwanted consequences of employer practices for workers and
health care providers are explored. Understanding the concepts of
risk, biased risk selection, and risk segmentation is fundamental
to sound health care reform. This volume thoroughly examines these
key concepts and how they complicate efforts to achieve efficiency
and equity in health coverage and health care. With health care
reform at the forefront of public attention, this volume will be
important to policymakers and regulators, employee benefit managers
and other executives, trade associations, and decisionmakers in the
health insurance industry, as well as analysts, researchers, and
students of health policy. Table of Contents FRONT MATTER SUMMARY 1
BACKGROUND AND INTRODUCTION 2 ORIGINS AND EVOLUTION OF
EMPLOYMENT-BASED HEALTH BENEFITS 3 EMPLOYMENT-BASED HEALTH BENEFITS
TODAY 4 WHATD DOES EMPLOYER MANAGEMENT OF HEALTH BENEFITS INVOLVE?
OVERVIEW AND CASE STUDY 5 RISK SELECTION, RISK SHARING, AND POLICY
6 HEALTH CARE COSTS: MORE QUESTIONS THAN ANSWERS 7 FINDINGS AND
RECOMMENDATIONS REFERENCES APPENDIXES A OPINION SURVEYS ON
EMPLOYMENT-BASED HEALTH BENEFITS AND RELATED ISSUES B REGULATION OF
EMPLOYMENT-BASED HEALTH BENEFITS: THE INTERSECTION OF STATE AND
FEDERAL LAW C PARTICIPANTS IN MEETINGS HELD IN CONJUNCTION WITH
PROJECT D BIOGRAPHIES OF COMMITTEE MEMBERS GLOSSARY AND ACRONYMS
INDEX
General
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