Health Insurance: Employers Still In The Game, But What About Patient Health Engagement?

U.S. employers’ health insurance-response to the nation’s economic downturn has been to shift health costs to employees. This has been especially true in smaller companies that pay lower wages. As employers look to the implementation of health reform in 2014, their responses will be based on local labor market and economic conditions. Thus, it’s important to understand the nuances of the paradigm, “all health care is local,” taking a page from Tip O’Neill’s old saw, “all politics is local.”

The Center for Studying Health System Change (HSC) visited 12 communities to learn more about their local health systems and economies, publishing their findings in an October 2011 Issue Brief, Employer-Sponsored Health Insurance: Down But Not Out.

Overall, metropolitan areas with over 400,000 residents had a 15.5% rate of uninsured in 2010, and nearly 10% unemployed. The chart illustrates O’Neill’s paradigm: from a health insurance standpoint, it’s good to live in Boston, given its 4.4% uninsured rate and 8.4% level of unemployment — both low levels compared with the 11 other communities analyzed by HSC. In 2010, Miami had an uninsured rate of 31.8% – double the national rate — and an unemployment rate of 12.4%. Orange County CA had an 18% level of uninsured, but an average level of unemployment...