Acs G
Urban Institute, Washington, DC 20037, USA.
Inquiry. 1995 Spring;32(1):102-10.
This paper uses regression-based decompositions to examine the downward trend in insurance coverage between 1988 and 1991. I find that falling family incomes account for much of the decline in overall insurance coverage, while a secular decline in insurance coverage across all industries, firm sizes, employment statuses, income levels, and demographic groups accounts for most of the decline in employer-sponsored insurance among workers. Rising unemployment and changing patterns of industrial employment explain little of the decline in coverage across the entire population. Taken together, these results suggest that fewer employers are offering health coverage, workers are finding it difficult to pay their share of the premiums, and those without access to employer-sponsored plans are finding it harder to purchase nongroup insurance. Thus, it appears that the rising cost of health insurance coupled with falling incomes and profits during the recession account for the fall in health insurance coverage between 1988 and 1991.
本文运用基于回归的分解方法来考察1988年至1991年间保险覆盖范围的下降趋势。我发现家庭收入下降是总体保险覆盖范围下降的主要原因，而所有行业、企业规模、就业状况、收入水平和人口群体的保险覆盖范围长期下降则是工人雇主赞助保险下降的主要原因。失业率上升和工业就业模式变化对整个人口保险覆盖范围下降的解释作用不大。综合来看，这些结果表明，提供医疗保险的雇主减少，工人难以支付其保费份额，而那些无法获得雇主赞助计划的人更难购买非团体保险。因此，1988年至1991年间医疗保险覆盖范围的下降似乎是由于医疗保险成本上升，再加上衰退期间收入和利润下降所致。
