Download or read book Loss Coverage written by Guy Thomas and published by Cambridge University Press. This book was released on 2017-05-02 with total page 285 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most academic and policy commentary represents adverse selection as a severe problem in insurance, which should always be deprecated, avoided or minimised. This book gives a contrary view. It details the exaggeration of adverse selection in insurers' rhetoric and insurance economics, and presents evidence that in many insurance markets, adverse selection is weaker than most commentators suggest. A novel arithmetical argument shows that from a public policy perspective, 'weak' adverse selection can be a good thing. This is because a degree of adverse selection is needed to maximise 'loss coverage', the expected fraction of the population's losses which is compensated by insurance. This book will be valuable for those interested in public policy arguments about insurance and discrimination: academics (in economics, law and social policy), policymakers, actuaries, underwriters, disability activists, geneticists and other medical professionals.
Download or read book Employment and Health Benefits written by Institute of Medicine and published by National Academies Press. This book was released on 1993-02-01 with total page 381 pages. Available in PDF, EPUB and Kindle. Book excerpt: The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.
Download or read book Frontiers in Health Policy Research written by David M. Cutler and published by MIT Press. This book was released on 2004 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: Leading economists discuss current health policy challenges, including prescription drugs benefits as a component of Medicare and conversion to for-profit health plans.
Download or read book Encyclopedia of Gerontology and Population Aging written by Danan Gu and published by Springer. This book was released on 2021-11-03 with total page 5507 pages. Available in PDF, EPUB and Kindle. Book excerpt: This eight-volume encyclopedia brings together a comprehensive collection of work highlighting established research and emerging science in all relevant disciplines in gerontology and population aging. It covers the breadth of the field, gives readers access to all major sub-fields, and illustrates their interconnectedness with other disciplines. With more than 1300 cross-disciplinary contributors—including anthropologists, biologists, economists, psychiatrists, public policy experts, sociologists, and others—the encyclopedia delves deep into key areas of gerontology and population aging such as ageism, biodemography, disablement, longevity, long-term care, and much more. Paying careful attention to empirical research and literature from around the globe, the encyclopedia is of interest to a wide audience that includes researchers, teachers and students, policy makers, (non)governmental agencies, public health practitioners, business planners, and many other individuals and organizations.
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Moral Hazard in Health Insurance written by Amy Finkelstein and published by Columbia University Press. This book was released on 2014-12-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice
Download or read book Adverse Selection in Health Insurance written by David M. Cutler and published by . This book was released on 1997 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: Individual choice over health insurance policies may result in risk-based sorting across plans. Such adverse selection induces three types of losses: efficiency losses from individuals being allocated to the wrong plans; risk sharing losses since premium variability is increased; and losses from insurers distorting their policies to improve their mix of insureds. We discuss the potential for these losses, and present empirical evidence on adverse selection in two groups of employees: Harvard University, and the Group Insurance Commission of Massachusetts (serving state and local employees). In both groups, adverse selection is a significant concern. At Harvard, the University's decision to contribute an equal amount to all insurance plans led to the disappearance of the most generous policy within 3 years. At the GIC, adverse selection has been contained by subsidizing premiums on a proportional basis and managing the most generous policy very tightly. A combination of prospective or retrospective risk adjustment, coupled with reinsurance for high cost cases, seems promising as a way to provide appropriate incentives for enrollees and to reduce losses from adverse selection.
Download or read book How Adverse Selection Affects the Health Insurance Market written by Paolo Belli and published by World Bank Publications. This book was released on 2001 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: There may be a price to pay (in terms of inefficient coverage) if competition among health insurers is encouraged as a way to give patients greater choice and to achieve better control over insurance providers.
Download or read book Risk Adjustment Risk Sharing and Premium Regulation in Health Insurance Markets written by Thomas G. McGuire and published by Academic Press. This book was released on 2018-08-06 with total page 648 pages. Available in PDF, EPUB and Kindle. Book excerpt: Risk Adjustment, Risk Sharing and Premium Regulation in Health Insurance Markets: Theory and Practice describes the goals, design and evaluation of health plan payment systems. Part I contains 5 chapters discussing the role of health plan payment in regulated health insurance markets, key aspects of payment design (i.e. risk adjustment, risk sharing and premium regulation), and evaluation methods using administrative data on medical spending. Part II contains 14 chapters describing the health plan payment system in 14 countries and sectors around the world, including Australia, Belgium, Chile, China, Columbia, Germany, Ireland, Israel, the Netherlands, Russia, Switzerland and the United States. Authors discuss the evolution of these payment schemes, along with ongoing reforms and key lessons on the design of health plan payment. Provides a conceptual toolkit that describes the goals, design and evaluation of health plan payment systems in the context of policy paradigms, such as efficiency, affordability, fairness and avoidance of risk selection Brings together international experience from many different countries that apply regulated competition in different ways Delivers a practical toolkit for the evaluation of health plan payment modalities from the standpoint of efficiency and fairness
Download or read book The Theory of Demand for Health Insurance written by John A. Nyman and published by Stanford University Press. This book was released on 2003 with total page 228 pages. Available in PDF, EPUB and Kindle. Book excerpt: Why do people buy health insurance? Conventional theory holds that people purchase insurance because they prefer the certainty of paying a small premium to the risk of getting sick and paying a large medical bill. This book presents a new theory of consumer demand for health insurance. It holds that people purchase insurance to obtain additional "income" when they become ill.
Download or read book Voluntary Health Insurance in Europe Country Experience written by Sagan A. and published by World Health Organization. This book was released on 2016-07-20 with total page 163 pages. Available in PDF, EPUB and Kindle. Book excerpt: No two markets for voluntary health insurance (VHI) are identical. All differ in some way because they are heavily shaped by the nature and performance of publicly financed health systems and by the contexts in which they have evolved. This volume contains short structured profiles of markets for VHI in 34 countries in Europe. These are drawn from European Union member states plus Armenia Iceland Georgia Norway the Russian Federation Switzerland and Ukraine. The book is aimed at policy-makers and researchers interested in knowing more about how VHI works in practice in a wide range of contexts. Each profile written by one or more local experts identifies gaps in publicly-financed health coverage describes the role VHI plays outlines the way in which the market for VHI operates summarises public policy towards VHI including major developments over time and highlights national debates and challenges. The book is part of a study on VHI in Europe prepared jointly by the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe. A companion volume provides an analytical overview of VHI markets across the 34 countries.
Download or read book Pooling Health Insurance Risks written by Mark V. Pauly and published by American Enterprise Institute. This book was released on 1999 with total page 120 pages. Available in PDF, EPUB and Kindle. Book excerpt: Uncertainty about risks to health virtually requires that people have health insurance. But how is the cost of premiums determined? Should rates vary according to some indicators of risk? How much do premiums vary with risk? Do the young and the healthy actually subsidize the old and the unhealthy?
Download or read book Health Insurance written by Michael A. Morrisey and published by Asociation of University Programs in Health Administration/Health Administration Press. This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: History of Health Insurance in the United States -- The Affordable Care Act -- A Summary of Insurance Coverage -- The Demand for Insurance -- Adverse Selection -- Underwriting and Rate Making -- Risk Adjustment -- Moral Hazard and Prices -- Utilization Management -- Managed Care, Selective Contracting, and the Insurance Industry -- Provider Consolidation, Monopsony Power, and the Managed Care Backlash -- Insurance Market Structure, Conduct, and Performance -- Premium Sensitivity and Health Insurance -- Compensating Differentials -- Taxes and Employer-Sponsored Health Insurance -- Employers as Agents -- Health Savings Accounts and Consumer-Directed Health Plans -- The Small-Group Market -- The Individual Insurance Market -- Health Insurance Regulation -- High-Risk Pools -- An Overview of Medicare -- Retiree Coverage -- Medicaid, Crowd-Out, and Long-Term Care Insurance.
Download or read book Coverage Matters written by Institute of Medicine and published by National Academies Press. This book was released on 2001-10-27 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers.
Download or read book Handbook of the Economics of Population Aging written by John Piggott and published by Elsevier. This book was released on 2016-11-21 with total page 1146 pages. Available in PDF, EPUB and Kindle. Book excerpt: Handbook of the Economics of Population Aging synthesizes the economic literature on aging and the subjects associated with it, including social insurance and healthcare costs, both of which are of interest to policymakers and academics. These volumes, the first of a new subseries in the Handbooks in Economics, describe and analyze scholarship created since the inception of serious attention began in the late 1970s, including information from general economics journals, from various field journals in economics, especially, but not exclusively, those covering labor markets and human resource issues, from interdisciplinary social science and life science journals, and from papers by economists published in journals associated with gerontology, history, sociology, political science, and demography, amongst others. Dissolves the barriers between policymakers and scholars by presenting comprehensive portraits of social and theoretical issues Synthesizes valuable data on the topic from a variety of journals dating back to the late 1970s in a convenient, comprehensive resource Presents diverse perspectives on subjects that can be closely associated with national and regional concerns Offers comprehensive, critical reviews and expositions of the essential aspects of the economics of population aging
Download or read book Impact of Health Insurance in Low and Middle income Countries written by Maria-Luisa Escobar and published by Brookings Institution Press. This book was released on 2010 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.
Download or read book Care Without Coverage written by Institute of Medicine and published by National Academies Press. This book was released on 2002-06-20 with total page 213 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
