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Variations in health insurance coverage: benefits vs. premiums
The Milbank Memorial Fund Quarterly. Health and Society
|January 1, 1984
Summary
Market forces in private health insurance aim for efficiency. However, legislative proposals like premium ceilings and increased plan choice present trade-offs between efficiency and equity, suggesting no single solution guarantees benefits.
Area of Science:
- Health economics
- Public policy
- Insurance market analysis
Background:
- Growing national focus on market-based healthcare reforms.
- Emphasis on promoting cost-conscious behavior among patients and providers.
Purpose of the Study:
- To analyze two key features of procompetitive private health insurance legislation.
- Evaluate the potential impacts of tax-free employer premium ceilings and expanded insurance plan choice.
Main Methods:
- Analysis of legislative proposals concerning private health insurance.
- Examination of efficiency and equity considerations in healthcare financing.
Main Results:
- Legislative proposals include tax-free employer premium caps and greater insurance plan choice.
- Efficiency and equity considerations involve distinct risks and financial transfers.
- No single policy approach is likely to achieve all intended benefits.
Conclusions:
- The structure of private health insurance benefits is central to market-driven healthcare reforms.
- Balancing efficiency and equity requires careful consideration of policy design.
- A nuanced approach is necessary, as universal solutions are unlikely to satisfy all objectives.
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