Adverse selection: does it preclude a competitive health insurance market?
In sum, although fixed dollar subsidies have the great virtue of ferreting out cross subsidies, society may not be satisfied with the results. The scenario described by Marquis is only one of many. People seem to want lifetime insurance offering low premiums if things go bad rather than premiums that change annually as health outcomes are realized [see, e.g., Light (1992)]. But nondiversible risk may be too great for a market in life contracts to exist.
Department of Economics, Vanderbilt University, Nashville, TN 37235.
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Sloan
D004465:Economic Competition; D006302:Health Services Research; D015273:Insurance Selection Bias; D014481:United States