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Master's Professional Reports Abstract

Employer-based Health Insurance: Its Role, History, Effect on Employers, Employees, and Consumers/Taxpayers, and Reform
Calhoun, Marilyn Swayze.
REPORT 1999 C1285

In order to understand how the current system of financing health care in the United States developed and whether or not the system needs reform, this professional report examines how the employer-based system developed and how that system works from the viewpoint of employers, employees, and consumers/taxpayers. This report also looks at various approaches to reforms and draws some conclusions about reform.

The failure to fundamentally reform the current employer-based system is most often justified by the statement, "We can't afford it." This report concludes otherwise. The United States is spending a greater percentage of its gross domestic product on health care than any other country, but we fail to provide health insurance to almost one person out of five. The health financing system in the United States is a "patchwork" of public and private funding, and few participants in the system consider the macro costs or consequences of the "quilt." The United States can afford health insurance for all its citizens; but reform is ultimately a political decision--not an economic one.

The scope of this report is broad rather than deep. While an entire report could be easily written on each of the individual issues addressed in this report, I have attempted to summarize the major points of each issue in order to present a macro-view of the health insurance system.