Delivering Public Health Insurance Through Private Plan Choice in the United States
Name
jep.31.4.3.pdf
Size
1.17 MB
Format
Adobe PDF
Checksum (MD5)
7c89e3e20786d64820d85fb9d9a6aae1
Author(s)
Gruber, Jonathan
Date Issued
2017
Journal
Journal of Economic Perspectives
Publisher
American Economic Association
Citation
Gruber, Jonathan. “Delivering Public Health Insurance Through Private Plan Choice in the United States.” Journal of Economic Perspectives 31, no. 4 (November 2017): 3–22. © 2017 American Economic Association
Version
Final published version
Abstract
The United States has seen a sea change in the way that publicly financed health insurance coverage is provided to low-income, elderly, and disabled enrollees. When programs such as Medicare and Medicaid were introduced in the 1960s, the government directly reimbursed medical providers for the care that they provided, through a classic "single payer system." Since the mid-1980s, however, there has been an evolution towards a model where the government subsidizes enrollees who choose among privately provided insurance options. In the United States, privatized delivery of public health insurance appears to be here to stay, with debates now focused on how much to expand its reach. Yet such privatized delivery raises a variety of thorny issues. Will choice among private insurance options lead to adverse selection and market failures in privatized insurance markets? Can individuals choose appropriately over a wide range of expensive and confusing plan options? Will a privatized approach deliver the promised increases in delivery efficiency claimed by advocates? What policy mechanisms have been used, or might be used, to address these issues? A growing literature in health economics has begun to make headway on these questions. In this essay, I discuss that literature and the lessons for both economics more generally and health care policymakers more specifically.
MIT Department
Massachusetts Institute of Technology. Department of Economics
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
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DOI of Published Version
https://doi.org/10.1257/jep.31.4.3
