Comment on "The employed uninsured and the role of public policy"

Monheit, Hagan, Berk, and Farley, in an earlier issue of this journal, made a major contribution to our understanding of health system problems of access and uncompensated care by correcting the widespread misimpression that lack of health insurance coverage is predominantly related to unemployment. Their research, based on the 1977 National Medical Care Expenditure Survey, indicated that 75% of the uninsured were workers and their dependents. The authors observed that industry, unionization, full- or part-time status, and geographic region are among the interrelated factors that influence the availability of employment-related health insurance coverage. This comment augments their findings through an examination of U.S. employment trends since 1977 as well as projections of future employment.