ABSTRACT
The general precepts of group insurance revolve around the law of large numbers and the fact that if you get a broad cross-section of a working population you can achieve reasonable cost results. That all worked well back in the 1950s and 1960s for the large-employer market, where the offering of medical insurance benefits was the overwhelming norm, and employer subsidies were sufficiently generous to ensure virtually universal participation by their employees. Much of this situation was related to the prevalence of collective bargaining within such industries or, in some cases, the mere threat of potential unionization. Large industrial America, as we knew it back then, was the closest thing that America has had to universal health care coverage.
