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Abstract:

Abstract According to official figures, in 1996, 61% of Americans received health insurance through employers.
However, this estimate includes persons who rely primarily on government insurance such as Medicare; workers whose employer contributes nothing towards their premiums; and government employees whose private coverage is paid for by taxpayers.
Methods: To estimate the number of persons whose principal health insurance was paid in whole or part by
private sector employers and the number receiving government-paid insurance we analyzed from the 1997
Current Population Survey. Approximately 130,000 persons representative of the U.S. non-institutionalized population were sampled. We considered persons to be covered principally by private sector employer-paid health insurance if they had no public coverage and were covered by insurance from a nongovernment employer who paid all or part of their premiums. Persons who received Medicaid, Medicare, insurance from former or current military service, or the Indian Health Service were considered as receiving government insurance. To this standard definition of publicly insured we added government workers and their covered dependents with employer-paid health insurance coverage.
Results: In 1996, 43.1% (C l, 42.7% to 43.5%) of the population depended principally on private sector employer paid health insurance. 34.2% (Cl, 33.8% to 34.6%) had publicly-funded insurance, 7 .1% ( Cl, 6.8% to 7.6%)
purchased their own coverage and 15.6%( Cl, 15.3% to 15.9%) were uninsured. In only six states was over half of
the population covered principally by private sector employer-paid health insurance.
Conclusions: Current definitions of health insurance overemphasize the role of private employers and underestimate government paid insurance. Less than half of the U.S. population relies for their principal health insurance coverage on policies that are paid for in part or whole by private sector employer.