Essentials of Health Policy and Law 2nd Edition by Joel Teitelbaum,Sara Wilensky

Exercise 4

In general, people with low incomes or no health insurance (or both) tend to be less healthy than those who are financially better off or insured (or both). As a result, policy proposals that suggest including poor, uninsured individuals in already-existing insurance plans are met with resistance by individuals in those plans and by carriers or employers who operate them. Yet, if an insurance plan is created that only subscribes a less-healthy, poor, or uninsured population, it is likely to be an unattractive business opportunity because beneficiaries are likely to need a high quantity of health care that will be costly to provide. Given what you know about adverse selection and risk, what, in your opinion, is the best way to provide insurance coverage to the poor and uninsured? Should they be included in current plans? Should the government provide financial incentives for private carriers to insure them? Should a separate plan or program be created to serve them? In these various scenarios, what incentives are created for plans, current plan members, government, and so on? Can high-deductible health plans work for a low-income population?