BUT ARE YOU...

BUT ARE YOU REALLY SURPRISED? New data out of the Agency for Health Care Quality and Research shows that though the nation's largest employers -- those with over 1,000 employees -- still overwhelmingly offer access to health benefits, fewer and fewer of their employees are able to afford the options. Between 1996 and 2004, megafirm workers purchasing their employer's health insurance dropped from about 88 percent to about 81 percent -- a seven percent decrease in eight years. The most significant drops came in the retail (Wal-Mart) sector, where participation plummeted by 16 percent, but numbers were down across all industries.

The number may not seem large, but we're peering into the most protected, rarified realm of health insurance here. Massive employers can bargain down health costs far better than small employers or individuals, and their ability to spread risk across a large pool ensures fair pricing for all and relatively smooth cost growth. That health inflation is nevertheless driving them to pass costs onto their employees, and the employees to give up on insurance coverage, is very worrisome -- it means that no area of the system remains protected. On that note, you really should read Maggie Mahar's just-posted piece detailing how Lenin would fix our health care system.

--Ezra Klein

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