Feeling the squeeze of health insurance premium costs on their profits, U.S. businesses increasingly look to cost sharing with their employees to maintain their dominant status in a highly competitive global marketplace. Some industries, such as steel and car manufacturing, have worked collaboratively with workers to moderate labor costs and increase
productivity quite substantially over the past two decades. Yet there are increasing numbers of U.S. employers that cope with escalating health care costs by closing factories, buying out unions, moving operations to locations where fringe benefits for workers have not yet evolved, and reneging on commitments to health benefits for retirees to stay afloat (Schilling, 2006)