Tax subsides for employer-sponsored health insurance are the largest subsidy for private health insurance and support key mechanisms of the U.S. insurance system, but they overwhelmingly benefit high-wage employees. When employers purchase or provide insurance for their employees, their contributions to the premium are excluded from income and payroll taxes. This tax exclusion provided more than $100 billion in income and payroll tax subsidies in 2002. High-income workers benefit more from these subsidies than those with lower incomes because of their higher marginal tax rate. Applying the tax exclusion in their respective tax brackets means high-income families (those earning more than $200,000) receive a subsidy worth one-third of the premium, while the lowest income families receive a subsidy worth just 10 percent. Despite these issues, ESI is a successful mechanism in many ways, covering a significant majority of Americans and providing a good pooling mechanism.
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JAMA Health Forum
January 2025
School of Medicine, Graduate School of Business, Stanford University, Stanford, California.
Importance: Few studies have examined the extent to which employers emphasize financial over nonfinancial criteria in measurement, reporting, and decision-making about health care benefits.
Objective: To measure and identify factors associated with financial over nonfinancial emphasis in employer decision-making about health benefits.
Design, Setting, And Participants: A survey was administered to a nationally representative sample of US employers to assess the extent of employers' emphasis on benefits plans' costs over member experience, access to care, and equity, and on financial vs other considerations when choosing third-party benefits administrators.
J Am Acad Orthop Surg
January 2025
From the Holland Bone and Joint Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Boyer, Burns, Razmjou, Renteria, Sheth, Richards, and Whyne), the Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada (Burns, Sheth, Richards, and Whyne), the Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada (Boyer, Burns, and Whyne), the Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada (Razmjou), and the Sunnybrook Orthopaedic Upper Limb (SOUL), Sunnybrook Health Science Centre, Toronto, Ontario, Canada (Sheth, Richards, and Whyne).
Introduction: Exercise-based physiotherapy is an established treatment of rotator cuff injury. Objective assessment of at-home exercise is critical to understand its relationship with clinical outcomes. This study uses the Smart Physiotherapy Activity Recognition System to measure at-home physiotherapy participation in patients with rotator cuff injury based on inertial sensor data captured from smart watches.
View Article and Find Full Text PDFSoc Psychiatry Psychiatr Epidemiol
January 2025
College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Background: Limited information is available on medication adherence, depression levels, and quality of life (QoL) among young individuals with depression in Indonesia.
Objectives: This study examined factors associated with medication adherence, depression severity, and QoL in young Indonesians with depression. It also explored (1) reasons for good or poor adherence and (2) participants' perceived QoL.
Diabetes Obes Metab
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Aims: Early dipeptidyl peptidase-4 inhibitors and metformin (DPP4i-Met) combination has been shown to extend the time to treatment failure and provide better glycaemic control for newly diagnosed type 2 diabetes (T2D) patients; however, the long-term clinical and economic outcomes of early DPP4i-Met combination remain unknown. We seek to assess the comparative long-term clinical and cost-effectiveness of DPP4i-Met versus Met for treatment-naïve T2D patients with inadequately controlled HbA1c (i.e.
View Article and Find Full Text PDFHealth Econ
January 2025
RWI Essen, Essen, Germany.
We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization and diagnoses in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.
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