Aspects of Health Reform: Introduction

By McLaughlin, Catherine; Levy, Helen et al. | Inquiry, Summer 2009 | Go to article overview

Aspects of Health Reform: Introduction


McLaughlin, Catherine, Levy, Helen, Quinn, Brian, Inquiry


From 2001 to 2008, the Robert Wood Johnson Foundation funded the Economic Research Initiative on the Uninsured (ERIU), housed at the University of Michigan. The goals of ERIU were to increase, diversify, and improve the quality, and quantity of economics research on the uninsured, and to translate that research Otto the type of resources that are useful to policymakers, policy analysts, researchers, and members of the media.

One of the primary objectives of ERIU was to fund research projects that explored economic issues about the uninsured in new, yet rigorous and interesting ways. ERIU began by commissioning six critical syntheses of the existing research. These syntheses were intended to inform researchers of what we know and what we don't know about the uninsured. (1) In eight years, ERIU funded more than 50 new research projects on a variety of coverage topics aimed at addressing the gaps in knowledge highlighted in these syntheses. These projects, involving more than 100 researchers, resulted in over 70 conference and seminar presentations worldwide and approximately 40 articles published in peer-reviewed journals. (2)

**********

After the failure of the Clinton health reforms 15 years ago, the research that has come out of the Economic Research Initiative on the Uninsured (ERIU), and the field of health economics more generally, has greatly increased our understanding of why individuals become uninsured and the negative impact of becoming uninsured. This work has laid the foundation for the current debate by under scoring the need for reform. Over this period, the research community has also helped to shape the contours of the debate by providing insight into the dynamics of public and private insurance and developing solutions to help make them work better.

As health care reform again grabs headlines in Washington, familiar themes are sounding. The efficiency-equity trade-off,

central to any allocation decision, and the issues of adverse selection and moral hazard underlie current debates over how reform should be structured. Four papers commissioned by ERIU in this volume of Inquiry highlight these core economic principles that health care policymakers should understand as they grapple with these issues that are critical to effective reform of our health care system.

Efficiency

For a variety of historical reasons, employer-sponsored health insurance (ESI) has long been the mainstay of coverage in the United States. As we enter another round of debate over health care reform, there is a fundamental difference of opinion over what role employers should play in a reformed system. Employers are central to some reform proposals, such as those built around a mandate on employers to provide insurance. Other proposals establish incentives that could, over time, weaken the link between employment and insurance. As we debate different options for reform, one question that must be addressed is whether we should shore up the system of ESI or whether it may be time to move away from this system.

Economists Thomas Buchmueller of the University of Michigan and Alan Monheit of the University of Medicine and Dentistry of New Jersey discuss how we arrived at an employment-based system and the efficiency gains and losses of keeping it. Buchmueller and Monheit provide a conceptual framework for evaluating the impact on ESI of different approaches to health reform. Key to that evaluation is recognizing the effect of ESI on labor market outcomes, including decisions about whether and when to enter the labor force, whether to work full or part time, what type of job to look for, and when to retire.

Buchmueller and Monheit summarize the pros and cons of the link between employment and health insurance as follows:

* Advantages of ESI. There are notable economies of scale resulting from ESI. Having one large purchaser reduces the insurer's administrative costs and the average fixed cost of buying insurance. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Aspects of Health Reform: Introduction
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.