Wednesday, June 30, 2010

Good motives and unintended consequences

Facts matter. Here is an example.

Based on comments by some, you would have thought that individual and small business insurance rates have gone up because of payments to hospitals and doctors or because insurers were somehow trying to take advantage of this group. It turns out that a well-intended provision in the Massachusetts universal access law created a moral hazard, a "situation in which one person makes the decision about how much risk to take, while someone else bears the cost if things go badly."

Kay Lazar reports in today's Boston Globe:

The number of people who appear to be gaming the state’s health insurance system by purchasing coverage only when they are sick quadrupled from 2006 to 2008, according to a long-awaited report released yesterday from the Massachusetts Division of Insurance.

The result is that insured residents of Massachusetts wind up paying more for health care, according to the report.


... [T]he gaming in the system . . . is adding as much as $300 million dollars to the health care system in Massachusetts’’ each year, said Tara Murray, spokeswoman for Blue Cross Blue Shield of Massachusetts, the state’s largest insurer.

...When state lawmakers overhauled the health care system in 2006, they combined into a single insurance pool consumers who buy coverage on their own with those who get insurance through their jobs at small businesses that employ 50 or fewer people. The aim was to make insurance more affordable for the individuals buying coverage on their own, who tended to be sicker and therefore had been paying very high premiums. And the hope was that having small businesses and their workers absorb some of the cost of covering this group would raise their premiums only modestly.

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