Selection in Health Insurance Markets and Its Policy Remedies.

Selection (adverse or advantageous) is the central problem that inhibits the smooth, efficient functioning of competitive health insurance markets. Even-and perhaps especially-when consumers are well-informed decision makers and insurance markets are highly competitive and offer choice, such markets...

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Publicado en:Journal of Economic Perspectives Vol. 31; no. 4; pp. 23 - 51
Autores principales: Geruso, Michael, Layton, Timothy J.
Formato: Artículo
Publicado: American Economic Association Nov2017
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Selection in Health Insurance Markets and Its Policy Remedies.
      aug:
        au:
          Geruso, Michael
          Layton, Timothy J.
        affil:
          Michael Geruso is Assistant Professor of Economics, University of Texas, Austin, Texas.
          Timothy J. Layton is Assistant Professor of Health Care Policy, Harvard Medical School, Boston, Massachusetts. Both authors are Faculty Research Fellows, National Bureau of Economic Research, Cambridge, Massachusetts.
      su:
        United States
        Health insurance
        Economic competition
        Medicare
        Externalities
        Health insurance exchanges
      sug:
        subj:
          Health insurance
          Economic competition
          Medicare
          Externalities
          United States
          Direct group life, health and medical insurance carriers
          Direct individual life, health and medical insurance carriers
          Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
          Health insurance exchanges
      ab: Selection (adverse or advantageous) is the central problem that inhibits the smooth, efficient functioning of competitive health insurance markets. Even-and perhaps especially-when consumers are well-informed decision makers and insurance markets are highly competitive and offer choice, such markets may function inefficiently due to risk selection. Selection can cause markets to unravel with skyrocketing premiums and can cause consumers to be under- or overinsured. In its simplest form, adverse selection arises due to the tendency of those who expect to incur high health care costs in the future to be the most motivated purchasers. The costlier enrollees are more likely to become insured rather than to remain uninsured, and conditional on having health insurance, the costlier enrollees sort themselves to the more generous plans in the choice set. These dual problems represent the primary concerns for policymakers designing regulations for health insurance markets. In this essay, we review the theory and evidence concerning selection in competitive health insurance markets and discuss the common policy tools used to address the problems it creates. We emphasize the two markets that seem especially likely to be targets of reform in the short and medium term: Medicare Advantage (the private plan option available under Medicare) and the state-level individual insurance markets.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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