_________________________________________________________________

  E M P L O Y E E   B E N E F I T S ,   C O M P E N S A T I O N
                    &   P E N S I O N   L A W
                  Vol. 5,  No. 8: April 22, 2004
_________________________________________________________________

Publisher:     LSN Employment, Labor, Compensation & Pension Journals
               a division of
               Social Science Electronic Publishing, Inc. (SSEP)
               and Social Science Research Network (SSRN)

Editor:        PAMELA PERUN
               Urban Institute
               Mailto:pamela@planetnow.com

Copyright:     SSEP, Inc. 2004. All rights reserved.

Leading Social Science Research Delivered To Your Desktop
               http://www.SSRN.Com/

   ___________________________________________________________

                      Topic of This Issue:
                          Health Care
   ___________________________________________________________


SEARCHING THE SSRN ELECTRONIC LIBRARY
 To search the entire SSRN Electronic Library by author, title,
 JEL code, or full text of the abstracts in our database, please
 visit http://papers.ssrn.com/

 To browse all abstracts published in this journal, please visit
 http://www.ssrn.com/link/benefits-compensation-pension-law.html

REDISTRIBUTION
 Individual and professional subscriptions to the journal are for
 single users. It is a violation of copyright to redistribute
 this document electronically or otherwise without the explicit
 permission of Social Science Electronic Publishing, Inc.
 Site licenses for organizations are available by contacting
 Mailto:Site@SSRN.Com

SIGN OFF
 SUBSCRIPTION MANAGEMENT
 You can change your journal subscriptions by going to the SSRN
 User HeadQuarters at the following link: http://hq.ssrn.com
 Please enter the email address where you received this email in
 the "Your Email Address" field and click "Submit". Click on your
 name on the next screen, and your User ID and Password will be
 emailed to you. Once you have received your login information and
 successfully logged in, you will be able to change your journal
 selections. If you have questions or problems with this process,
 please email UserSupport@SSRN.com or call 877-SSRNHelp (toll free
 877.777.6435).

ALIGNMENT
 If this document is misaligned, please set type face to a
 non-proportional font such as Courier 10.

PAPER DOWNLOADS
 If you need assistance downloading papers from our web site,
 please contact Mailto:Support@SSRN.Com


T A B L E   of   C O N T E N T S
_________________________________________________________________


NEW and FORTHCOMING ARTICLES

"The Impact of the Health Insurance Market on Small Firm
 Employment"
      Journal of Risk and Insurance, Vol. 71, pp. 63-90, March
      2004
     KANIKA KAPUR
        The RAND Corporation
        Santa Monica CA Offices


"From the Tallest to (One of) the Fattest: The Enigmatic Fate of
 the American Population in the 20th Century"
      Economics and Human Biology, Vol. 2, No. 1, pp. 57-74,
      March 2004
     JOHN KOMLOS
        University of Munich
        Department of Economics
        CESifo (Center for Economic Studies and Ifo
        Institute for Economic Research)
     MARIELUISE BAUR
        University of Munich


"An Analysis of the Effect of Tax Policy on Health Insurance
 Purchases by Risk Group"
      Journal of Risk and Insurance, Vol. 71, pp. 91-113, March
      2004
     PATRICIA G. KETSCHE
        Georgia State University - Institute of Health
        Administration


"National Health Spending Rose 9.3 Percent in 2002; Sixth
 Consecutive Year of Faster Growth"
      EBRI Notes, Vol. 25, No. 3, March 2004
     RACHEL CHRISTENSEN SETHI
        Employee Benefit Research Institute (EBRI)
     PAUL FRONSTIN
        Employee Benefit Research Institute (EBRI)


"The 'Business Case' for Investing in Employee Health: A Review
 of the Literature and Employer Self-Assessments"
      EBRI Issue Brief, No. 267, March 2004
     PAUL FRONSTIN
        Employee Benefit Research Institute (EBRI)
     RAY WERNTZ
        HPN Worldwide


"Health Insurance Coverage of Individuals Ages 55-64, 1994-2002"
      EBRI Notes, Vol. 25, No. 3, March 2004
     PAUL FRONSTIN
        Employee Benefit Research Institute (EBRI)

WORKING PAPERS

"Employer-Sponsored Disability Insurance: Where are the Gaps in
 Coverage?"
     HELEN LEVY
        University of Chicago
        Irving B. Harris Graduate School of Public Policy
        Studies
        National Bureau of Economic Research (NBER)


S S R N   I N F O R M A T I O N
_________________________________________________________________

          * Partners in Publishing
          * Administrative Information
             - Missing issues & change of address
             - Solicitation of abstracts
          * Directors
          * Subscription to SSRN Journals
_________________________________________________________________

ACQUIRING PAPERS
 Download papers directly from the included web address or contact
 the author or other contact person directly. Provide an address
 to which the author or other contact person can send a paper
 copy and mention that you saw the abstract in SSRN. Some of
 SSRN's Partners in Publishing require a subscription or charge a
 fee for electronic downloads.



EDITORIAL POLICIES
 To provide the broadest coverage of research in Employee
 Benefits, Compensation & Pension Law we do not referee working
 papers. We accept abstracts of working papers in Employee
 Benefits, Compensation & Pension Law whose topics suit the
 coverage of the journal and which are part of the worldwide
 scholarly discourse.


N E W   and   F O R T H C O M I N G   Articles
_________________________________________________________________

"The Impact of the Health Insurance Market on Small Firm
 Employment"
      Journal of Risk and Insurance, Vol. 71, pp. 63-90, March
      2004

      BY:  KANIKA KAPUR
              The RAND Corporation
              Santa Monica CA Offices

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=513688

 Contact:  KANIKA KAPUR
   Email:  Mailto:kapur@rand.org
  Postal:  The RAND Corporation
           Santa Monica CA Offices
           P.O. Box 2138
           1700 Main Street
           Santa Monica, CA 90407-2138  UNITED STATES

ABSTRACT:
 Small firms that offer health insurance to their employees may
 face variable premiums if they hire employees with high expected
 health costs. To avoid expensive premium variability, small
 firms may attempt to maintain a workforce with low expected
 health costs. This results in employment distortions. I examine
 the magnitude of these employment distortions using the 1987
 National Medical Expenditure Survey and the 1996 Medical
 Expenditure Panel Survey. Based on the underwriting behavior of
 insurance companies in 1988, I classify medical conditions into
 three categories: conditions that led to denial of coverage;
 conditions that led to exclusion restrictions; and, conditions
 that led to higher premiums. In 1987, I find that insured small
 firms were less likely to employ workers with families that had
 conditions that led to higher premiums than insured large firms.
 However, in 1996, possibly due to the passage of small group
 health insurance reforms that restrict insurers' ability to
 exclude or deny coverage, insured small firms were less likely
 to employ workers with denial conditions compared to insured
 large firms. These results suggest that the pattern of
 employment distortions in insured small firms is consistent with
 the evolving small group health insurance market.

______________________________

"From the Tallest to (One of) the Fattest: The Enigmatic Fate of
 the American Population in the 20th Century"
      Economics and Human Biology, Vol. 2, No. 1, pp. 57-74,
      March 2004

      BY:  JOHN KOMLOS
              University of Munich
              Department of Economics
              CESifo (Center for Economic Studies and Ifo
              Institute for Economic Research)
           MARIELUISE BAUR
              University of Munich

 Contact:  JOHN KOMLOS
   Email:  Mailto:JK@ECONHIST.DE
  Postal:  University of Munich
           Department of Economics
           Ludwigstrasse 28
           D-80539 Munich,    GERMANY
 Co-Auth:  MARIELUISE BAUR
   Email:  Mailto:marieluise.baur@econhist.de
  Postal:  University of Munich
           D-80539 Munchen,    GERMANY

ABSTRACT:
 Within the course of the 20th century the American population
 went through a virtual metamorphosis from being the tallest in
 the world, to being among the most overweight. The American
 height advantage over Western and Northern Europeans was between
 3 and 9 cm in mid-19th century, and Americans tended to be
 underweight. However, today, the exact opposite is the case as
 the Dutch, Swedes, and Norwegians are the tallest, and the
 Danes, British and Germans - even the East-Germans - are also
 taller, towering over the Americans by as much as 3-7 cm.
 Americans also have shorter lives. The hypothesis is worth
 considering that this adverse development is related to the
 greater social inequality, an inferior health care system, and
 fewer social safety nets in the United States than in Western
 and Northern Europe, in spite of higher per capita income. The
 Western and Northern European welfare states, with cradle to
 grave health and unemployment insurance currently seems to
 provide a more propitious environment for the biological
 standard of living than its US counterpart.


JEL Classification: D60, I10, I31, J15, N00, P50
______________________________

"An Analysis of the Effect of Tax Policy on Health Insurance
 Purchases by Risk Group"
      Journal of Risk and Insurance, Vol. 71, pp. 91-113, March
      2004

      BY:  PATRICIA G. KETSCHE
              Georgia State University - Institute of Health
              Administration

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=513689

 Contact:  PATRICIA G. KETSCHE
   Email:  Mailto:Pketsche@GSU.edu
  Postal:  Georgia State University - Institute of Health
           Administration
           35 Broad Street
           Atlanta, GA 30302  UNITED STATES

ABSTRACT:
 There is an extensive body of literature dealing with the
 welfare loss associated with generous levels of health insurance
 as a function of the tax subsidy. The theoretical discussion in
 this study considers the effect of the tax subsidy on pooling
 within plans, and suggests the hypotheses that the tax subsidy
 will have a disproportionately positive effect on the likelihood
 that a high-risk worker will be eligible for and participate in
 employment-based coverage, while the effect of the tax subsidy
 on plan generosity will be greatest for low-risk employees. If
 coverage of high-risk individuals enhances social welfare, this
 result may offset, at least in part, the welfare loss associated
 with generous plans. Data from the 1987 National Medical
 Expenditure Survey are used to test these hypotheses. The
 results provide evidence that the subsidy works to expand risk
 pools in the employment-based health insurance market.

______________________________

"National Health Spending Rose 9.3 Percent in 2002; Sixth
 Consecutive Year of Faster Growth"
      EBRI Notes, Vol. 25, No. 3, March 2004

      BY:  RACHEL CHRISTENSEN SETHI
              Employee Benefit Research Institute (EBRI)
           PAUL FRONSTIN
              Employee Benefit Research Institute (EBRI)

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=519062

 Contact:  RACHEL CHRISTENSEN SETHI
   Email:  Mailto:sethi@ebri.org
  Postal:  Employee Benefit Research Institute (EBRI)
           Suite 600
           2121 K Street, NW
           Washington, DC 20037-1896  UNITED STATES
   Phone:  202-775-6330
     Fax:  202-775-6312
 Co-Auth:  PAUL FRONSTIN
   Email:  Mailto:FRONSTIN@EBRI.ORG
  Postal:  Employee Benefit Research Institute (EBRI)
           Suite 600
           2121 K Street, NW
           Washington, DC 20037-1896  UNITED STATES

ABSTRACT:
 National health expenditures increased 9.3 percent between 2001
 and 2002, reaching nearly $1.6 trillion. As a percentage of
 gross domestic product, national health spending rose to 14.9
 percent in 2002 from 14.1 percent in 2001 and 13.3 percent in
 2000. In 2002, private-sector health spending accounted for 54.1
 percent of national health spending, and the public sector
 accounted for 45.9 percent. The proportion paid for by private
 sources has decreased over time, while the proportion paid for
 by public sources has increased. In 1970, for example, private
 sources paid for 62.1 percent of national health expenditures,
 and public sources paid for 37.8 percent.

 The PDF for the above title, published in the March 2004 issue
 of EBRI Notes, also contains the fulltext of another March 2004
 EBRI Notes article abstracted on SSRN: "Health Insurance
 Coverage of Individuals Ages 55-64, 1994-2002."


JEL Classification: H51
______________________________

"The 'Business Case' for Investing in Employee Health: A Review
 of the Literature and Employer Self-Assessments"
      EBRI Issue Brief, No. 267, March 2004

      BY:  PAUL FRONSTIN
              Employee Benefit Research Institute (EBRI)
           RAY WERNTZ
              HPN Worldwide

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=519043

 Contact:  PAUL FRONSTIN
   Email:  Mailto:FRONSTIN@EBRI.ORG
  Postal:  Employee Benefit Research Institute (EBRI)
           Suite 600
           2121 K Street, NW
           Washington, DC 20037-1896  UNITED STATES
   Phone:  202-775-6352
     Fax:  202-775-6312
 Co-Auth:  RAY WERNTZ
   Email:  Mailto:ray.werntz@comcast.net
  Postal:  HPN Worldwide
           Washington DC Regional Office
           11909 Champion Lake CT
           Herndon, VA 20170  UNITED STATES

ABSTRACT:
 This paper reports on the findings from interviews with six
 large employers to learn more about what these employers
 actually do to promote employee health beyond offering health
 plans, why they do what they do, how they financially justify
 what they do to their peers and superiors, and what the
 prospects are for their more expansive and longer-term approach
 to health benefits costs in the current general economic climate
 and in the face of sustained health care inflation.


JEL Classification: J32
______________________________

"Health Insurance Coverage of Individuals Ages 55-64, 1994-2002"
      EBRI Notes, Vol. 25, No. 3, March 2004

      BY:  PAUL FRONSTIN
              Employee Benefit Research Institute (EBRI)

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=519065

 Contact:  PAUL FRONSTIN
   Email:  Mailto:FRONSTIN@EBRI.ORG
  Postal:  Employee Benefit Research Institute (EBRI)
           Suite 600
           2121 K Street, NW
           Washington, DC 20037-1896  UNITED STATES
   Phone:  202-775-6352
     Fax:  202-775-6312

ABSTRACT:
 Employee Benefit Research Institute estimates from the March
 2003 Current Population Survey reveal that children and adults
 ages 55-64 were the most likely age groups to have health
 insurance coverage in 2002. The likelihood of individuals ages
 55-64 being uninsured (12.9 percent) in that year was no greater
 than it was in 1994. However, future retired adults in this age
 group may be more likely to be uninsured if employer cutbacks to
 retiree health benefits affect them and they have no other means
 of obtaining health insurance.

 The PDF for the above title, published in the March 2004 issue
 of EBRI Notes, also contains the fulltext of another March 2004
 EBRI Notes article abstracted on SSRN: "National Health Spending
 Rose 9.3 Percent in 2002; Sixth Consecutive Year of Faster
 Growth."


JEL Classification: J32
______________________________

W O R K I N G   P A P E R   Abstracts
_________________________________________________________________

"Employer-Sponsored Disability Insurance: Where are the Gaps in
 Coverage?"

      BY:  HELEN LEVY
              University of Chicago
              Irving B. Harris Graduate School of Public Policy
              Studies
              National Bureau of Economic Research (NBER)

Document:  Available from the SSRN Electronic Paper Collection:
           http://papers.ssrn.com/paper.taf?abstract_id=524122

Paper ID:  NBER Working Paper No. W10382
    Date:  March 2004

 Contact:  HELEN LEVY
   Email:  Mailto:HLEVY@UCHICAGO.EDU
  Postal:  University of Chicago
           Irving B. Harris Graduate School of Public
           Policy Studies
           1155 East 60th Street
           Chicago, IL 60637  UNITED STATES

Paper Requests:
 Full-Text downloads are available from SSRN Online for $5.

ABSTRACT:
 I use data from the Current Population Surveys and Employee
 Benefits Surveys to analyze employer-sponsored disability
 insurance coverage. There does not appear to be a systematic
 trend from 1980 to 2000 in the fraction of workers with
 coverage. Disability insurance coverage rates are lower than
 health insurance coverage rates; low-skill, low-wage,
 low-tenure, part-time and small establishment workers are all
 less likely to have either of these fringe benefits. Public
 policy debates about workers without health insurance fail to
 consider an important economic risk these workers face in the
 event of an illness or injury: the risk of lost wages.