The Economic Burden of Providing Health Insurance: How Much Worse Off Are Small Firms? 2008 (Technical Report (RAND))

More than 60 percent of nonelderly Americans receive health-insurance (HI) coverage through employers. However, rising health-care costs may threaten the long-term viability of the employer-based insurance system. This report explores trends in the economic burden associated with HI provision for small and large businesses, as well as the quality of plans that small and large firms offer. More than 60 percent of non-elderly Americans receive health-insurance (HI) coverage through employers, either as policyholders or as dependents. However, rising health-care costs are leading many to question the long-term viability of the employer-based insurance system. Concerns about the economic burden of providing HI are particularly acute for small businesses, which are both less likely than larger firms to offer HI and more sensitive to price when deciding to offer insurance. Small firms may have difficulty containing costs due to their limited bargaining power and their inability to hir.

A debate will likely occur in 2009 about U.S. global national-security strategy. The authors describe and illustrate a methodology to help frame and evaluate resource-informed strategies. The core is an integrated portfolio-analysis approach that compares options by their anticipated effectiveness, risks, and resource implications, Three illustrative grand strategies are compared, which deal in different ways with the problems of our time.