Health Insurance Provision and Labor Market Efficiency in the United States and GermanyHealth Insurance has claimed a prominent place on the policy agenda in the United States. Critics argue that the status quo has lead to spiraling health care costs, an inequitable distribution of quality medical care, and that employer-provided health insurance has "locked" individuals into jobs, thereby interfering with the efficient matching of employers and employees. In contrast to the United States, Germany guarantees virtually all citizens health insurance. Insurance is portable, but the cost may change when an individual changes jobs, again leading to the potential for job-lock. This paper assesses the empirical magnitude of health insurance-related impediments to job mobility in the United States and Germany, The results show little evidence that health insurance provision interferes with job mobility in either the United States or Germany, thus suggesting that these employer-based systems for providing the health insurance portion of the social safety net do not alter this aspect of labor market efficiency. |
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Alberto Alesina Angus Deaton Bill Clinton Bureau of Economic cell total Ceteris paribus change employers Change Job Change chi-square test statistic columns company funds Controls Controls Controls No Controls correlated cost denotes significant denotes the chi-square Descriptive Statistics differences discussion dummy variables Economic Research effect employer-provided health insurance employer-provided insurance employment German system Germany GSOEP health insurance provision health insurance status health status indicator variable Individuals One-Year Transition insurance coverage Insurance Lock insurance variable Insured Spouse interaction variable job mobility labor market efficiency Madrian married women medical insurance medigap National Bureau NBER non-insurance null hypothesis number of children p(change payroll tax rate pension percent level Poor Health portable premium Probit Analysis probit equation providing health insurance provision of health PSID reported sickness funds Single Women Spouse Insurance Standard Error statistically significant Table transition rates Transitions No Change United value of insurance wage workers Worse Health zero