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首页> 外文期刊>International journal of health care finance and economics. >The effects of health shocks on employment and health insurance: The role of employer-provided health insurance
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The effects of health shocks on employment and health insurance: The role of employer-provided health insurance

机译：健康冲击对就业和健康保险的影响：雇主提供的健康保险的作用

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Employment-contingent health insurance (ECHI) has been criticized for tying insurance to continued employment. Our research sheds light on two central issues regarding employment-contingent health insurance: whether such insurance "locks" people who experience a health shock into remaining at work; and whether it puts people at risk for insurance loss upon the onset of illness, because health shocks pose challenges to continued employment. We study how men's dependence on their own employer for health insurance affects labor supply responses and health insurance coverage following a health shock. We use the Health and Retirement Study (HRS) surveys from 1996 through 2008 to observe employment and health insurance status at interviews 2 years apart, and whether a health shock occurred in the intervening period between the interviews. All employed married men with health insurance either through their own employer or their spouse's employer, interviewed in at least two consecutive HRS waves with non-missing data on employment, insurance, health, demographic, and other variables, and under age 64 at the second interview are included in the study sample. We then limited the sample to men who were initially healthy. Our analytical sample consisted of 1,582 men of whom 1,379 had ECHI at the first interview, while 203 were covered by their spouse's employer. Hospitalization affected 209 men with ECHI and 36 men with spouse insurance. A new disease diagnosis was reported by 103 men with ECHI and 22 men with other insurance. There were 171 men with ECHI and 25 men with spouse employer insurance who had a self-reported health decline. Labor supply response differences associated with ECHI-with men with health shocks and ECHI more likely to continue working-appear to be driven by specific types of health shocks associated with future higher health care costs but not with immediate increases in morbidity that limit continued employment. Men with ECHI who have a self-reported health decline are significantly more likely to lose health insurance than men with insurance through a spouse. With the passage of health care reform, the tendency of men with ECHI as opposed to other sources of insurance to remain employed following a health shock may be diminished, along with the likelihood of losing health insurance.
机译：雇佣应急医疗保险（ECHI）因将保险与持续就业捆绑在一起而受到批评。我们的研究揭示了与以就业为基础的健康保险有关的两个核心问题：此类保险是否将“遭受健康冲击的人”锁定在工作岗位上;以及是否因健康冲击给继续就业带来挑战，是否使人们在疾病发作时有遭受保险损失的风险。我们研究了男性对自己雇主的健康保险依赖如何对健康冲击后的劳动力供给反应和健康保险覆盖面产生影响。我们使用1996年至2008年的健康与退休研究（HRS）调查，在相隔2年的访谈中观察就业和健康保险状况，以及在访谈之间的间隔期间是否发生健康冲击。所有已雇用的已婚男性都通过其自己的雇主或配偶的雇主参加了健康保险，至少连续两次接受了HRS浪潮的采访，接受了有关就业，保险，健康，人口统计学和其他变量的数据，第二个年龄在64岁以下访谈包括在研究样本中。然后，我们将样本限制为最初健康的男性。我们的分析样本包括1,582名男性，其中1,379名在第一次面试中患有ECHI，而203名由配偶的雇主支付。住院影响了209例ECHI患者和36例配偶保险患者。 103名患有ECHI的男性和22名具有其他保险的男性报告了新的疾病诊断。自我报告的健康状况下降的有171名患有ECHI的男性和25名具有配偶雇主保险的男性。与ECHI相关的劳动力供应反应差异-患有健康冲击的男性和ECHI更有可能继续工作-似乎是由特定类型的健康冲击所驱动的，而这种冲击与未来更高的医疗保健成本相关，但与发病率的迅速上升（限制了继续就业）无关。自我报告健康下降的ECHI男性比通过配偶获得医疗保险的男性更有可能失去健康保险。随着医疗保健改革的通过，与ECHI男性相比，由于其他原因而遭受健康冲击的人继续受雇的趋势可能会减少，同时失去健康保险的可能性也可能会降低。

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