_________________________________________________________________
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
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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.
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Topic of This Issue:
Health Care
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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)
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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.