Size matters : the health insurance market for small firms

著者

書誌事項

Size matters : the health insurance market for small firms

Jill Mathews Yegian

Ashgate, c1999

大学図書館所蔵 件 / 全2件

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注記

Includes bibliographical references and index

内容説明・目次

内容説明

There is a large and growing interest among health policy and research circles on the use of purchasing alliances to leverage change in health care. This book aims to presents detailed and useful specifics on how a leading alliance has fared in California, the most competitive health care market in the United States. Although it is generally accepted that large organizations are more effective purchasers of health insurance, little work has been done to carefully examine the reasons that underlie that phenomena. Yet, creating interventions and designing potential solutions requires a thorough understanding of the issues. The econometric analysis adds to the limited literature on the influence of premium on choice behaviour for employees of small firms, and introduces an analysis of choice behaviour in a purchasing co-operative setting. The political section of this book presents a much more detailed historical account and analysis of California's small group market reforms, the most significant health-related legislation in the state in the prior decade, than has been previously available. The conclusions are becoming particularly relevant in California and elsewhere, as the issues of reform of the individual market for health insurance comes to the forefront.

目次

  • Introduction: a brief historic sketch
  • overview of employment-based coverage
  • the health insurance market for small firms. Part 1 The small firm as a purchaser: variability, information asymmetry, and differentiation
  • the firm as a governance structure for health insurance transaction
  • neoclassical approach - contracts and lump sum transfers
  • mechanisms for improving on the small firms as governance structure
  • comparative assessment of market structures
  • refutable implications
  • the case of California
  • conclusion. Appendix: risk variability and firm size. Part 2 The political history of California's reforms: the access issue
  • the focus shifts to small group market reform
  • the failure of comprehensive reform
  • implementation
  • market forms of alliance
  • the potent combination of policy entrepreneurship and anxiety
  • overcoming obstacles to the passage of small group market reforms
  • extent of the reforms
  • sustainability of the reforms
  • future prospects. Part 3 Effect of premium on health plan choice in a purchasing alliance: literature review
  • data
  • model
  • variables
  • results
  • discussion and conclusion.

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