The Erosion of Purchased Health Insurance (original) (raw)

This paper traces the decline of purchased health insurance in the United States, specifically examining the rapid growth of self-insurance from 1981 to 1985. It highlights a significant shift in financial risk for health care from commercial insurers and Blue Cross to employers. The study analyzes the changing content and costs of self-insured plans compared to conventional fully insured plans, noting that self-insured plans, despite costing more, offer less in terms of fringe benefits and require higher cost-sharing from employees.