In the Spotlight
The Adverse-Selection Problem
Current Democratic health-care proposals will have unintended consequencesbad ones
Scott Harrington, Medical Progress Today, 10-30-09
As the Senate prepares to consider health-care reform legislation, a key policy issue remains unsolved: how to prevent what industry insiders call "adverse selection." The bills under consideration, including the one that the Senate Finance Committee recently approved, would impose major restrictions on insurance companies—forcing them to cover anyone, regardless of preexisting health conditions; barring them from setting premiums based on policyholders' health; and limiting how much they could increase premiums because of policyholders' age. These restrictions would lead to a disproportionate number of older, sicker people buying coverage, while the young and healthy delayed buying it until they needed it. That, in turn, would drive up the cost of insurance and threaten one of the legislation's key goals: reducing the number of uninsured. And pricier insurance would doubtless lead to pressure for still more government intervention.
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