McDonnell K
EBRI Issue Brief. 1995 Aug(164):1-18.
This Issue Brief addresses eight topics in the areas of health insurance and health care costs. Using a question and answer format, the discussion draws largely on EBRI research and the EBRI Databook on Employee Benefits, third edition. In 1993, U.S. expenditures on health care were $884.2 billion, and they are projected to reach $2,173.7 billion by 2005, increasing at a projected average annual rate of 7.8 percent. Health care spending accounted for 13.9 percent of Gross Domestic Product (GDP) in 1993 and is projected to reach 17.9 percent of GDP by 2005. Among the factors contributing to the increase in health care costs are the growth in the number of individuals with traditional reimbursement health insurance coverage, the rapid expansion of technology and treatment options, and demographic factors such as the aging of the population. In 1993, employers, both public and private, spent $235.6 billion on group health insurance, accounting for 6.2 percent of total compensation. Group health insurance is the fastest growing component of total compensation, increasing at an average annual rate of 13.7 percent from 1960 to 1993. An increasing number of employees are required to make a cash contribution to their health insurance plan premium. In 1993, 61 percent of full-time employees in medium and large private establishments who participated in an employee only health insurance plan were required to make a contribution to the premium, up from 27 percent in 1979. In 1993, 185.3 million persons under age 65 had health insurance coverage, while 40.9 million people--or about 18.1 percent of the nonelderly population--received neither private health insurance nor publicly financed health coverage. Of those individuals who had health insurance coverage, 60.8 percent, or 137.4 million persons, received their health insurance through an employment-based plan. In 1993, 15.2 percent of the nonelderly population without health insurance coverage were noncitizens. In six states noncitizens represented a higher proportion of the total uninsured population than individuals in the nation as a whole. An increasing number of employers are self-funding their health insurance plans. In 1994, 74 percent of employers with 500 or more employees self-funded their health insurance plans, up from 63 percent in 1993. An estimated 22 million full-time employees in private industry and state and local governments participated in a self-funded employment-based health insurance plan.(ABSTRACT TRUNCATED AT 400 WORDS)
本问题简报涉及健康保险和医疗保健成本领域的八个主题。采用问答形式，讨论主要借鉴了员工福利研究协会（EBRI）的研究成果以及第三版《员工福利EBRI数据手册》。1993年，美国的医疗保健支出为8842亿美元，预计到2005年将达到21737亿美元，预计年均增长率为7.8%。1993年，医疗保健支出占国内生产总值（GDP）的13.9%，预计到2005年将达到GDP的17.9%。导致医疗保健成本增加的因素包括拥有传统报销型健康保险覆盖的个人数量增长、技术和治疗选择的迅速扩展以及人口老龄化等人口因素。1993年，公共和私营雇主在团体健康保险上支出2356亿美元，占总薪酬的6.2%。团体健康保险是总薪酬中增长最快的部分，1960年至1993年年均增长率为13.7%。越来越多的员工需要为其健康保险计划保费支付现金。1993年，在参加仅含员工的健康保险计划的大中型私营企业中，61%的全职员工被要求为保费缴费，而这一比例在1979年为27%。1993年，1.853亿65岁以下人口拥有健康保险覆盖，而4090万人（约占非老年人口的18.1%）既未获得私人健康保险也未获得公共资助的医疗覆盖。在拥有健康保险覆盖的人群中，60.8%（即1.374亿人）通过基于就业的计划获得健康保险。1993年，在没有健康保险覆盖的非老年人口中，15.2%是非公民。在六个州，非公民在未参保总人口中所占比例高于全国总体水平。越来越多的雇主正在自筹其健康保险计划资金。1994年，在拥有500名或更多员工的雇主中，74%自筹其健康保险计划资金，高于1993年的63%。据估计，私营行业以及州和地方政府中有2200万全职员工参加了自筹资金的基于就业的健康保险计划。（摘要截选至400字）
