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Key concepts and summary

Insurance is a way of sharing risk. A group of people pay premiums for insurance against some unpleasant event, and those in the group who actually experience the unpleasant event then receive some compensation. The fundamental law of insurance is that what the average person pays in over time must be very similar to what the average person gets out. In an actuarially fair insurance policy, the premiums that a person pays to the insurance company are the same as the average amount of benefits for a person in that risk group. Moral hazard arises in insurance markets because those who are insured against a risk will have less reason to take steps to avoid the costs from that risk.

Many insurance policies have deductibles, copayments, or coinsurance. A deductible is the maximum amount that the policyholder must pay out-of-pocket before the insurance company pays the rest of the bill. A copayment is a flat fee that an insurance policy-holder must pay before receiving services. Coinsurance requires the policyholder to pay a certain percentage of costs. Deductibles, copayments, and coinsurance reduce moral hazard by requiring the insured party to bear some of the costs before collecting insurance benefits.

In a fee-for-service health financing system, medical care providers are reimbursed according to the cost of services they provide. An alternative method of organizing health care is through health maintenance organizations (HMOs), where medical care providers are reimbursed according to the number of patients they handle, and it is up to the providers to allocate resources between patients who receive more or fewer health care services. Adverse selection arises in insurance markets when insurance buyers know more about the risks they face than does the insurance company. As a result, the insurance company runs the risk that low-risk parties will avoid its insurance because it is too costly for them, while high-risk parties will embrace it because it looks like a good deal to them.

Problems

Imagine that 50-year-old men can be divided into two groups: those who have a family history of cancer and those who do not. For the purposes of this example, say that 20% of a group of 1,000 men have a family history of cancer, and these men have one chance in 50 of dying in the next year, while the other 80% of men have one chance in 200 of dying in the next year. The insurance company is selling a policy that will pay $100,000 to the estate of anyone who dies in the next year.

  1. If the insurance company were selling life insurance separately to each group, what would be the actuarially fair premium for each group?
  2. If an insurance company were offering life insurance to the entire group, but could not find out about family cancer histories, what would be the actuarially fair premium for the group as a whole?
  3. What will happen to the insurance company if it tries to charge the actuarially fair premium to the group as a whole rather than to each group separately?
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References

Central Intelligence Agency. “The World Factbook.” https://www.cia.gov/library/publications/the-world-factbook/index.html.

National Association of Insurance Commissioners. “National Association of Insurance Commissioners&The Center for Insurance Policy and Research.” http://www.naic.org/.

OECD. “The Organisation for Economic Co-operation and Development (OECD).” http://www.oecd.org/about/.

USA Today. 2015. “Uninsured Rates Drop Dramatically under Obamacare.” Accessed April 1, 2015. http://www.usatoday.com/story/news/nation/2015/03/16/uninsured-rates-drop-sharply-under-obamacare/24852325/.

Thaler, Richard H., and Sendhil Mullainathan. “The Concise Encyclopedia of Economics: Behavioral Economics.” Library of Economics and Liberty . http://www.econlib.org/library/Enc/BehavioralEconomics.html.

Henry J. Kaiser Family Foundation, The. “Health Reform: Summary of the Affordable care Act.” Last modified April 25, 2013. http://kff.org/health-reform/fact-sheet/summary-of-new-health-reform-law/.

Questions & Answers

it is the situation where by im a market there is only one supplier and producer of a certain comodity that has no close substitute or competitor
Sepiso Reply
yes
Alhaji
what is demand and supply
Alhaji
what is Economics?
Pintu Reply
Is the study of human behaviour as a relationship between ends and scares mean which have alternative use
Alhaji
yes
Tawa
what is monopoly
Alhaji
what are the difficultés if retail prix index for calculating thé value of money
Oscar
hmm OK wait
Castino
what is labour
Mamudou Reply
LABOUR is a measure of work done by human being
Blessing
It is all form of human effort use to utilize in production
Alhaji
Why is scarcity a foundermental problem in economics
Alhaji
Why is scarcity a foundermental problem in economics
Alhaji Reply
scarcity occur unbalance demand and supply at this time cost goods increase then inflation very increase
Tesfaye
scarcity is a foundermental problem because its a natural situation and it affects the world at Large.in other words,it's limit in supply relating to deman
Akwosih
'Economics is about making choices in the presence of scarcity"
manoj Reply
. 'Economics is about making choices in the presence of scarcity" - Dscuss.
manoj
describe the producer's scarce resources.. I.e land,Labour,capital and enterprise
Alfhah Reply
short in supply
Charles
What are human behaviour?
Regina Reply
the rationality in decision making
Charles
how can you describe economic goods in a much better easier way?
Alfhah Reply
any thing that have utility
Charles
what is deman and supply
Aruna Reply
Demand can be defined as the ability and willingness to buy commodities in a given price of goods and services in a particular period of time
Alasana
supply refers to the ability and willingness to offered commodities for sale in a given price of goods and services in a period of time .
Alasana
Demand can refer to the ability and willingness to purchase a commodity at a giving price and time.
habib
what must the producer do if total costs exceed total revenue
Mmusi Reply
raise price
Nguyen
reduce cost
Charles
scarcity resources sample
nawala Reply
land
Charles
what's scarcity
tumelo Reply
resources short in supply
Charles
hello
Shadesch
scarcity is excess against human wants.
Kennedy
scarcity is limit in supply relating to demand
Akwosih
students
Hamdu
shortge of resources .imbalance of wants to resources .
Hamdu
hlo
Yahya
limitation of supply in relation to their demand for commodity
Prince
what are the two types of economic theory's?
Lizabeth Reply
i thick it is microeconomic theory and macroeconomic theory. or it can be normative and positive economic theories.
Deep
yes^
Nguyen
with diagrams show thé change in prices in thé different time period that can result in an increase in demande
Fankam Reply
define momentary period
Fankam
What is a monopsony?
Allan Reply
monopsony is a situation where only one buyer is available in the market
The
And with many sellers?
Allan
oligopsony
The
to be more specific, oligopsony is a situation with many sellers but few buyers
The
Thank you
Allan

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Source:  OpenStax, Principles of economics. OpenStax CNX. Sep 19, 2014 Download for free at http://legacy.cnx.org/content/col11613/1.11
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