You can find competing private health insurance plans with community rated premiums and government sponsored risk adjustment in Belgium, Germany, Israel, the Netherlands and Switzerland – where participation is mandatory. Ireland and Australia have voluntary enrollment, as does Medicare Advantage and the (Obamacare) marketplaces in the United States.
In all these systems, insurers have perverse incentives to attract the healthy and avoid the sick. Strangely it has taken researchers a very long time to discover what Mark Pauly and I discovered over two decades ago.
View the study or read through this Jason Shafrin Summary.
1 thought on “Managed Competition Exposed”
I told this to a team of people at the Office of Inspector General (Dallas office) when I was applying for a job many years ago. The idea surprised them and one of them said, “we will have to look at these plans.” Alas, they had hired a PhD candidate earlier that didn’t work out they were suspect of me and I didn’t get a call back. I was not exactly waiting for their call either.