Health Insurance » (1st Edition)

This book provides an overview of health insurance in the United States, with an emphasis on private insurance.

Pt. I An Introduction

1 History of Health Insurance in the United States 3

2 A Summary of Insurance Coverage 21

3 The Demand for Health Insurance 33

Pt. II Issues of Adverse Selection

4 Adverse Selection 49

5 Underwriting and Rate Making 61

6 Risk Adjustment 77

Pt. III Issues of Moral Hazard

7 Moral Hazard and Prices 93

8 Utilization Management 117

Pt. IV Managed Care and Selective Contracting

9 Selective Contracting: Managed Care and Hospitals 131

10 Managed Care and Physicians 147

11 Managed Care Backlash, Provider Consolidation, Monopsony Power, and Most Favored Nation Clauses 157

Pt. V Employer-Sponsored Health Insurance

12 Premium Sensitivity for Health Insurance 177

13 Compensating Differentials 189

14 Taxes and Employer-Sponsored Health Insurance 203

15 Employers as Agents 217

Pt. VI Special Topics in Health Insurance

16 Health Savings Accounts and Consumer-Driven Health Plans 235

17 The Small-Group Market 253

18 Health Insurance Regulation 271

19 The Individual Insurance Market 287

20 High-Risk Pools 303

Pt. VII Medicare, Medicaid, and Private Coverage

21 An Overview of Medicare 315

22 Retiree Coverage 333

23 Medicaid, "Crowd-Out," and Long-Term Care Insurance 349

An Endnote - A Course Summary 367

References 369

Name Index 393

Subject Index 399

About the Author 409