<< Chapter < Page Chapter >> Page >

Key concepts and summary

Insurance is a way of sharing risk. A group of people pay premiums for insurance against some unpleasant event, and those in the group who actually experience the unpleasant event then receive some compensation. The fundamental law of insurance is that what the average person pays in over time must be very similar to what the average person gets out. In an actuarially fair insurance policy, the premiums that a person pays to the insurance company are the same as the average amount of benefits for a person in that risk group. Moral hazard arises in insurance markets because those who are insured against a risk will have less reason to take steps to avoid the costs from that risk.

Many insurance policies have deductibles, copayments, or coinsurance. A deductible is the maximum amount that the policyholder must pay out-of-pocket before the insurance company pays the rest of the bill. A copayment is a flat fee that an insurance policy-holder must pay before receiving services. Coinsurance requires the policyholder to pay a certain percentage of costs. Deductibles, copayments, and coinsurance reduce moral hazard by requiring the insured party to bear some of the costs before collecting insurance benefits.

In a fee-for-service health financing system, medical care providers are reimbursed according to the cost of services they provide. An alternative method of organizing health care is through health maintenance organizations (HMOs), where medical care providers are reimbursed according to the number of patients they handle, and it is up to the providers to allocate resources between patients who receive more or fewer health care services. Adverse selection arises in insurance markets when insurance buyers know more about the risks they face than does the insurance company. As a result, the insurance company runs the risk that low-risk parties will avoid its insurance because it is too costly for them, while high-risk parties will embrace it because it looks like a good deal to them.

Problems

Imagine that 50-year-old men can be divided into two groups: those who have a family history of cancer and those who do not. For the purposes of this example, say that 20% of a group of 1,000 men have a family history of cancer, and these men have one chance in 50 of dying in the next year, while the other 80% of men have one chance in 200 of dying in the next year. The insurance company is selling a policy that will pay $100,000 to the estate of anyone who dies in the next year.

  1. If the insurance company were selling life insurance separately to each group, what would be the actuarially fair premium for each group?
  2. If an insurance company were offering life insurance to the entire group, but could not find out about family cancer histories, what would be the actuarially fair premium for the group as a whole?
  3. What will happen to the insurance company if it tries to charge the actuarially fair premium to the group as a whole rather than to each group separately?
Got questions? Get instant answers now!

References

Central Intelligence Agency. “The World Factbook.” https://www.cia.gov/library/publications/the-world-factbook/index.html.

National Association of Insurance Commissioners. “National Association of Insurance Commissioners&The Center for Insurance Policy and Research.” http://www.naic.org/.

OECD. “The Organisation for Economic Co-operation and Development (OECD).” http://www.oecd.org/about/.

USA Today. 2015. “Uninsured Rates Drop Dramatically under Obamacare.” Accessed April 1, 2015. http://www.usatoday.com/story/news/nation/2015/03/16/uninsured-rates-drop-sharply-under-obamacare/24852325/.

Thaler, Richard H., and Sendhil Mullainathan. “The Concise Encyclopedia of Economics: Behavioral Economics.” Library of Economics and Liberty . http://www.econlib.org/library/Enc/BehavioralEconomics.html.

Henry J. Kaiser Family Foundation, The. “Health Reform: Summary of the Affordable care Act.” Last modified April 25, 2013. http://kff.org/health-reform/fact-sheet/summary-of-new-health-reform-law/.

Questions & Answers

what is mutation
Janga Reply
what is a cell
Sifune Reply
how is urine form
Sifune
what is antagonism?
mahase Reply
classification of plants, gymnosperm features.
Linsy Reply
what is the features of gymnosperm
Linsy
how many types of solid did we have
Samuel Reply
what is an ionic bond
Samuel
What is Atoms
Daprince Reply
what is fallopian tube
Merolyn
what is bladder
Merolyn
what's bulbourethral gland
Eduek Reply
urine is formed in the nephron of the renal medulla in the kidney. It starts from filtration, then selective reabsorption and finally secretion
onuoha Reply
State the evolution relation and relevance between endoplasmic reticulum and cytoskeleton as it relates to cell.
Jeremiah
what is heart
Konadu Reply
how is urine formed in human
Konadu
how is urine formed in human
Rahma
what is the diference between a cavity and a canal
Pelagie Reply
what is the causative agent of malaria
Diamond
malaria is caused by an insect called mosquito.
Naomi
Malaria is cause by female anopheles mosquito
Isaac
Malaria is caused by plasmodium Female anopheles mosquitoe is d carrier
Olalekan
a canal is more needed in a root but a cavity is a bad effect
Commander
what are pathogens
Don Reply
In biology, a pathogen (Greek: πάθος pathos "suffering", "passion" and -γενής -genēs "producer of") in the oldest and broadest sense, is anything that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ. The term pathogen came into use in the 1880s.[1][2
Zainab
A virus
Commander
Definition of respiration
Muhsin Reply
respiration is the process in which we breath in oxygen and breath out carbon dioxide
Achor
how are lungs work
Commander
where does digestion begins
Achiri Reply
in the mouth
EZEKIEL
what are the functions of follicle stimulating harmones?
Rashima Reply
stimulates the follicle to release the mature ovum into the oviduct
Davonte
what are the functions of Endocrine and pituitary gland
Chinaza
endocrine secrete hormone and regulate body process
Achor
while pituitary gland is an example of endocrine system and it's found in the Brain
Achor
what's biology?
Egbodo Reply
Biology is the study of living organisms, divided into many specialized field that cover their morphology, physiology,anatomy, behaviour,origin and distribution.
Lisah
biology is the study of life.
Alfreda
Biology is the study of how living organisms live and survive in a specific environment
Sifune
Got questions? Join the online conversation and get instant answers!
Jobilize.com Reply

Get Jobilize Job Search Mobile App in your pocket Now!

Get it on Google Play Download on the App Store Now




Source:  OpenStax, Principles of economics. OpenStax CNX. Sep 19, 2014 Download for free at http://legacy.cnx.org/content/col11613/1.11
Google Play and the Google Play logo are trademarks of Google Inc.

Notification Switch

Would you like to follow the 'Principles of economics' conversation and receive update notifications?

Ask