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3rd Quarter 2007 Executive
Summaries
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by Jeffrey D. Munn and Lynne Wozniak, Hewitt Associates |
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Health care systems all over the world are experiencing some change as they look for a new balance between supply and demand. This article provides context for the U.S. health care financing debate by examining the health care systems of five other countries: Canada , the United Kingdom , Australia , China and India . The authors show that, with few exceptions, countries around the world have seen an increase in both government and private health care spending between 1998 and 2002.The authors also demonstrate that employers throughout most of the world are becoming more, rather than less, involved in the funding and delivery of health care to employees and their dependents—even among nations with so-called single-payer health systems.
Confronting the Fear Factor: The Coverage/Access Disparity in Universal Health Care
by Mark E. Litow, Milliman |
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Since their introduction following World War II, single-payer health care systems and universally mandated health care systems have stumbled, but in their pratfalls are many lessons that apply to the universal health care proposals currently on the table in the United States . The critical and often overlooked point is that universal coverage does not guarantee that individuals will receive needed care—In many cases guaranteed access to care is a false promise or available only on a delayed timetable. A more feasible alternative lies in providing a safety net for citizens who truly need care and financial support with an appropriate system of checks and balances—without disrupting the economic and actuarial fundamental principles of supply and demand and risk classification.
How Universal Health Care Would Influence Decisions About Work And Retirement
by Jonathan Barry Forman, University of Oklahoma College of Law |
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The current U.S. health care system distorts individual decisions about work and retirement. After a brief explanation of how the current health care system works, this article reviews those distortions and considers how individuals would respond to the implementation of a universal health care system. The author argues that the likely adverse impacts of an employer health insurance mandate on low-skilled workers could be more than offset by a well-designed system of government subsidies.
Health Care Reform: Universal Access Is Feasible and Necessary
by Eric R. Kingson, Syracuse University School of Social Work and John M. Cornman, Consultants on Purpose |
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While other industrial nations' health care systems have their own problems, they have more leeway to address those problems than does the United States, which spends twice as much on per capita health care as the average for other industrial capitalist democracies yet ranks average or below average in many comparative measures of health care quality. In fact, the authors of this article argue that international experience shows that assurance of universal access through expanded government involvement could provide savings while actually improving the quality of U.S. health care. In addition, universal access would recognize health care as a basic human right, not a commodity to be bartered in the marketplace and allocated based on class, race and social position.
A Retirement Adequacy Analysis of Default Options and Lifecycle Funds
by Jason Ellement, Capital Markets and Research Group and Lori Lucas, Callan Associates |
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Retirement income replacement analysis can assist defined contribution plan sponsors in selecting default investment options when designing an automatic enrollment program. Using quantitative analysis, this article demonstrates that the plan sponsor's default investment selection has a direct and important impact on employees' retirement income adequacy. The authors also demonstrate the importance of other automatic enrollment program design elements, such as the implication of different lifecycle paths for postretirement asset allocation and the importance of robust default contribution and escalation rates.
Employee Contributions: A Primer on Their Use, Historical Trends and Overall Fit Within Benefits Strategy
by Hudson A. Peters, CEBS, Mercer Health and Benefits LLC |
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This article focuses on the use of employee contributions as a strategic tool within employee health plans. While most employers require some form of employee contributions for health care, there is no clear “one-size-fits-all” solution. A myriad of strategies are in place, some active and some passive. This article reviews both common and emerging strategies and how they differ based on industry, employer size and region; discusses how employee contribution strategy fits within overall benefits strategy; and provides a strategic framework for approaching employee contributions in the future.
Individual Accounts for Social Security Reform: Lessons from the United Kingdom
by David Blake, Cass Business School and John Turner, Social Security, pensions and employee benefits consultant |
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To consider a Social Security reform approach that creates substantially new structures such as voluntary carve-out accounts, it is important to apply what we already know about the functioning of pension systems and their effects on workers rather than analyzing an idealized form of the proposed system. This article describes the United Kingdom 's experience with voluntary carve-out accounts, including the system's numerous difficulties. Among the many problems are “mis-selling,” high administrative costs and fundamental difficulty determining the appropriate offset between the reduction in the worker's payment to Social Security and the reduction in that person's Social Security benefits.
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