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The viability of the employer-provided health insurance system
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The viability of the employer-provided health insurance system
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Guo
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Xuguang
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Xuguang Guo
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author
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Burton
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John
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Advisory Committee
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John F. Burton
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chair
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Director
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Steven
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Steven M. Director
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Kruse
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Douglas
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Douglas L. Kruse
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Voos
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Paula
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Paula B. Voos
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Killingsworth
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Mark
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Advisory Committee
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Mark R. Killingsworth
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Rutgers University
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Graduate School - New Brunswick
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theses
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2008
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2008-10
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English
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electronic
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xiv, 152 pages
Abstract
The dissertation evaluate the viability of employer-provided health insurance (EPHI) system in the United States, using two confidential data sets that have been made available to me by the Bureau of Census, including the Medical Expenditure Panel Survey-Insurance Component and Longitudinal Business Database.
The empirical findings suggest that the current EPHI system will sustain, at least in a short period. Despite the public accusations that employers are fleeing from the insurance market, I find that dropping health insurance coverage is indeed rare. Employers are also reluctant to replace their insurance plans with HMOs, regardless of its price advantage. Once health insurance is offered, employers still make insurance plans available to most of their workers.
However, employers are controlling insurance costs in more subtle ways with some success. They transferred a significant portion of the EPHI costs to their workers through increasing their contribution to the insurance premiums or lowering their wages. Around 20 percent of the increased insurance costs were shifted to workers through employee contribution to health insurance, and at least another 20 percent was transferred through slowing down wage growth after 2001. My findings also suggest the quality for EPHI purchased by employers falls behind the advance of medical service in general. When the quality for EPHI at the market improves by 1 unit, a typical employer will only increase its quality for health insurance around 0.32 units.
Finally, the empirical results of this dissertation suggest that offering health insurance is a blessing for the business. Establishments offering EPHI were 29.2 percent more like to survive than others. Furthermore, the gap of default rate between establishments offering health and those not offering did not shrink from 1997 to 2004, despite the increase of health insurance costs.
The empirical findings suggest that the current EPHI system will sustain, at least in a short period. Despite the public accusations that employers are fleeing from the insurance market, I find that dropping health insurance coverage is indeed rare. Employers are also reluctant to replace their insurance plans with HMOs, regardless of its price advantage. Once health insurance is offered, employers still make insurance plans available to most of their workers.
However, employers are controlling insurance costs in more subtle ways with some success. They transferred a significant portion of the EPHI costs to their workers through increasing their contribution to the insurance premiums or lowering their wages. Around 20 percent of the increased insurance costs were shifted to workers through employee contribution to health insurance, and at least another 20 percent was transferred through slowing down wage growth after 2001. My findings also suggest the quality for EPHI purchased by employers falls behind the advance of medical service in general. When the quality for EPHI at the market improves by 1 unit, a typical employer will only increase its quality for health insurance around 0.32 units.
Finally, the empirical results of this dissertation suggest that offering health insurance is a blessing for the business. Establishments offering EPHI were 29.2 percent more like to survive than others. Furthermore, the gap of default rate between establishments offering health and those not offering did not shrink from 1997 to 2004, despite the increase of health insurance costs.
Note
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Ph.D.
Note
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Includes bibliographical references (p. 141-151).
Subject
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Industrial Relations and Human Resources
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Employer-sponsored health insurance
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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http://hdl.rutgers.edu/1782.2/rucore10001600001.ETD.17483
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doi:10.7282/T3RF5VCK
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ETD doctoral
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Xuguang Guo
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Rutgers University. Graduate School - New Brunswick
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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