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Displaced workers and employer-provided health insurance: evidence of a wage/fringe benefit tradeoff?

Job changes that result from plant closings and mass layoffs provide an opportunity to see how workers respond to an employment shock that is arguably exogenous to individual productivity. Comparing compensation packages of displaced workers on their old and new jobs is a potentially promising method to infer a tradeoff between wages and non-wage benefits. Although displaced worker data overcomes many of the pitfalls to estimating wage/fringe tradeoffs by controlling for time-invariant unobserved productivity, time-varying unobservables could still bias estimates. In this analysis, I investigate the compensating wage differential for one particularly valuable benefit, employer-provided health insurance. I find that even after controlling for an extensive set of productivity factors, I obtain results indicating a wrong-signed tradeoff. Those who lose health insurance through the job change also lose wages relative to other displaced workers, while those who gain health insurance also gain in wages. Individuals expected to incur higher health care costs (older workers and workers who are likely to buy family coverage) do not experience steeper wage/health insurance tradeoffs as would be expected if employers were able to pass health care costs on to workers according to individual costs. Although this exercise fails to isolate a wage/fringe tradeoff, the strong correlation between changes in wages and changes in fringe benefits has important implications for public policy towards displaced workers. Further research is needed to understand the true magnitude and distribution of the costs of job displacement taking changes in fringe benefits into account.

Efficiency↗

Benefits in behavioral health carve-out plans of Fortune 500 firms.

OBJECTIVE: This study examined the prevalence and nature of behavioral health carve-out contracts among Fortune 500 firms in 1997. METHODS: A survey was conducted of 498 companies that were listed as Fortune 500 firms in 1994 or 1995. A total of 336 firms (68 percent) responded to the survey. Univariate analyses were used to analyze prevalence, types, and amounts of covered services, cost sharing, and benefit limits. A total of 132 firms reported contracting with managed behavioral health organizations; 124 firms answered benefits questions about covered services, cost-sharing levels, and annual and lifetime limits. RESULTS: Most of the plans covered a broad range of services. Cost sharing was typically required, and for inpatient care it was often substantial. Fifteen percent of the firms offered mental health benefits that were below the limits defined in this study as minimal benefit levels, and 34 percent offered substance abuse treatment benefits that fell below minimal levels. The most generous mental health benefits and substance abuse treatment benefits, defined as no limits or a lifetime limit only of $1 million or more, were offered by 31 percent and 20 percent of the firms, respectively. CONCLUSIONS: The carve-out contracts of the Fortune 500 firms in this study typically covered a wide range of services, and the benefits appeared generous relative to those reported for other integrated and carve-out plans. However, these benefits generally did not reach the level of parity with typical medical benefits, nor did they fully protect enrollees from the risk of catastrophic expenditures.

Contract Services↗

Clinton's six-point reform program.

Congressional approval of the president's ambitious plan for rebuilding the U.S. health care system will depend on creating coalition in both the House and the Senate and on modifications that preserve the program's over-arching goals while incorporating aspects of other proposed reform plans.

Cost-Benefit Analysis↗

Comparison of physical health benefits utilization. Mental and physical health claimants, 1989 and 1990.

Research has indicated an association between mental health problems and physical illness, including higher physical health benefits utilization among persons with a mental health diagnosis. We hypothesized that mental health claimants will have higher covered health benefits and be more likely to make physical health claims than physical health claimants. The data for the study included all health benefits claims for 1989 and 1990. The results indicated that mental health claimants have higher total covered benefits and higher covered benefits in a number of diagnostic categories. In addition, the findings revealed a greater likelihood to make any health claim as well as a claim for several diagnostic categories among persons with a mental health diagnosis. The study indicates the need for coordination between mental health and physical health benefits cost management.

Adolescent↗