The individual market: a delicate balance.
In our voluntary insurance market, the greatest challenge is maintaining a balance between "healthy" and "sick" enrollees. Affordable coverage is possible only if many healthy persons purchase insurance, thereby cross-subsidizing high-risk persons. This is a particular challenge in the individual market, where healthy enrollees have no employer or tax subsidies to lower their premium costs. A successful individual market requires a delicate balance regarding the risk level of enrollees, the rates charged, and the regulations adopted. Small miscalculations in any of these areas can quickly result in spiraling premiums and plummeting coverage rates.
Serota
Scott
S
BlueCross BlueShield Association, Chicago, USA.
D004465:Economic Competition / Q000331:legislation & jurisprudence; D019981:Health Care Sector; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000191:economics* / Q000331:legislation & jurisprudence; D011907:Rate Setting and Review; D012306:Risk; D014481:United States