Insuring the uninsured through private action: ideas and initiatives

The growing issue of health coverage for the uninsured has no single solution, but private initiatives hold promise for some alleviation. The keys to increasing coverage are: more insurance pooling (to share risk and management); different insurance products, especially ones featuring better spending controls (to be attractive yet affordable at the low end of the market); and subsidy plus information (to encourage voluntary enrollment). Lack of insurance is not a problem for employees in large workplaces because relatively low prices and high incomes, as well as employer and tax code paternalism, assure coverage to almost 100% of workers in large groups. People on their own or in small groups, as well as increasing numbers of dependents of workers in large groups, are significantly disadvantaged in comparison. Considerable progress should be possible privately, but no one should expect large improvements without more cultural change or social intervention.