Three Models of Health Insurance: The Conceptual Pluralism of the Patient Protection and Affordable Care Act
Year: 2011
Type: article
Abstract: What risks should health insurance mitigate?American health scholars, politicians, and the public at large answer this question ambivalently.This Article defines three dominant conceptions of health insurance that weave throughout popular and academic discourse and that echoed in the 2010 health reform debates.The first conception is that health insurance should primarily serve to mitigate harms to health.This "Health Promotion" theory relies on using health insurance to pay for medical care that most cost-effectively preserves and improves health.Alternately, health insurance might primarily mitigate risks to wealth from high medical care costs.This "Financial Security" theory demands that health insurance limit financial insecurity from these costs.Finally, the "Brute Luck" theory, highly sensitive to the possibility of adverse-incentive effects arising from moral hazard, demands that health insurance protect primarily against unavoidable or "chance" health risks that do not arise from individual behavior.This last theory thus seeks to preserve incentives for insureds to prevent risk themselves, while insurance neutralizes harms from random poor health.Each theory implies distinct principles to guide premium pricing and allocation of premium dollars toward medical care.
Author: Allison K. Hoffman
Institution: University of California, Los Angeles
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W3125542281