Sperling Kenneth L, Shapira Oren M
Aon Hewitt, Norwalk, CT, USA.
Benefits Q. 2011;27(1):42-8.
The Patient Protection and Affordable Care Act includes provisions to make the individual health insurance marketplace one where all Americans, including those with preexisting health conditions, can obtain affordable coverage. At the same time, the act has failed to address, in any significant way, many of the underlying flaws in the current U.S. health care system that have caused costs to spiral out of control. The combination of persistent U.S. health care cost increases and a viable individual health insurance marketplace will cause a sea change in employer-sponsored health care offerings that is similar to that seen among employer-sponsored retirement benefit plans: movement away from defined benefit approaches and toward defined contribution designs. Although the authors show parallels between the evolution of employers' health care and retirement offerings, they explain why certain key developments will need to occur before defined contribution approaches become as prevalent in employer-sponsored health care plans as they are in today's employer-sponsored retirement plans.
《患者保护与平价医疗法案》包含多项条款，旨在使个人医疗保险市场成为一个所有美国人，包括那些有既往健康状况的人，都能够获得负担得起的保险的市场。与此同时，该法案未能以任何显著方式解决当前美国医疗保健系统中导致成本失控的许多潜在缺陷。美国医疗保健成本持续上涨与一个可行的个人医疗保险市场相结合，将导致雇主提供的医疗保健服务发生巨变，这类似于雇主提供的退休福利计划中所发生的变化：从固定福利方式转向固定缴款设计。尽管作者展示了雇主提供的医疗保健和退休福利的演变之间的相似之处，但他们解释了为什么在固定缴款方式在雇主提供的医疗保健计划中变得像在当今雇主提供的退休计划中那样普遍之前，某些关键发展需要发生。
