December 02, 2006

Inequities in the "skin in the game" health insurance argument

In a letter to the editor of the Wall Street Journal (subscription required), Princeton economist Uwe Reinhardt asks, "Should Corporate Chiefs Get Lifetime Health Care?" Here is the letter:

"In your Nov. 20 editorial "AHIP Hop" on the health-insurance proposal recently unveiled by America's Health Insurance Plans (AHIP), you lament the fact that "individuals generally aren't sensitive to the price of their treatment decisions." For that reason, you have long supported high-deductible health insurance that puts patients' "skin in the game," to use the colorful metaphor for "high deductibles."

Economists, who generally believe that fiscal incentives drive human behavior, can resonate with this prescription, but as one such I would ask: What does it tell us about the health-insurance coverage of highly paid corporate executives? Does it not imply that these executives should never have the corporation buy health insurance of any sort for them, lest these executives become too insensitive to the cost of their health care?

Instead, we find that corporate executives routinely insist that their companies purchase for them and their spouses generous health insurance for life, and many of them even insist that the company cover all out-of-pocket expenses built into such policies.

Is that at all defensible on the "skin in the game" theory you espouse?"


Posted by schwitz at December 2, 2006 11:05 AM | TrackBack
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