The Market for Health Insurance - Essay Example

The Market for Health Insurance Overview It is a well known fact that most American citizens with health coverage obtaintheir insurance via health programs which are provided by the companies in which they work for. However, majority of these citizens acquire their coverage through the non-group insurance. It is projected that about 46.3 million or 15.39 percent of the people on the US lack health insurance coverage. Additionally, even homesteads with health insurance covers may be rendered susceptible as a result of financial baggage of a calamitous health positions or poor health either because of the constriction of strategy of decisions about what care is covered. Rises in health insurance covers, has besmirched access to health cover (Berkowitz 30-45). Presently 7 percent of the United States nonelderly, acquire coverage through personal strategies bought frankly from insurance providers. Numerous plans at the national state and centralized, in addition to the standard propositions using the personal health insurance market as way of growing access to reasonable health policies. States license bodies that provide health insurance coverage and have determined laws that regulate their structure, finances, and responsibilities to the people that they insure (Berkowitz 46). Introduction Health care costs in the US, which have escalated quickly in actual terms in the last few decades, have put pressure on the state and national budgets. Future expansion in health insurance costs is estimated to threaten the monetary status of state and national governments unless primary strategy transformations take place. Also, for many American citizens, the lack of health insurance coverage sophisticates access to health care. Health insurance markets are frequently focused on a single insurer accounting for over 50 percent of the market. Issues about focus on health insurance markets are connected to broader issues about the cost, value, and accessibility of health care. The market structure of the health insurance and hospital commerce may have helped is increasing health care costs and in restricting access to inexpensive health insurance and health care. Some debate market focus has amounted to higher care prices. Higher cost of health care or health insurance may then make health care less inexpensive and consequently less available for some homesteads. Patrons in the personal and small group markets characteristically face specifically challenging situations. Whilst health insurance purchased in the personal market has the advantages of being portable, and potentially being an enhanced match to an individual’s predilection for health coverage than standards purchased via group strategies, it does have elements of essential concern. Amid these issues is how regulations and edicts surrounding the personal insurance market reflects is potential to meet numerous population needs. It is needed to comprehend these concerns to establish how market transformations would interrelate with these policies (Henderson 10-15). Others, nevertheless, agree that health care givers with strong bargaining weight should assist restrict health providers’ potential to increase costs, and that the advantage of minimal premiums coming from the potential to negotiate may be passed along to patrons. Some commerce analysts have expressed competition amid primary health care providers as strong, and some pricing trends show that competing has stalwartly impacted on insurers’ market plans. Additionally, some argue that economies of scale along with state and national control have contributed to the increasing level of focus on health insurance markets. The Obama government has made transformation of the American health insurance and health care structure utmost policy precedence. Numerous congressional attempt at broadening access to health insurance by rising the number of Americans with health care coverage, by minimizing the price of insurance faced by persons, by offering sturdy incentives for persons to obtain health care coverage, and by reconfiguring parts of the health insurance market. Some of these health transformations propositions additionally contain measures intended to reduce the expansion of the health cover prices, though some principles experts are unsure whether the present propositions are probably going to achieve that goal (Berkowitz 60-75). Some contend that a more essential transformation of the health care segment and the health care insurance market would be required to transform the estimated flight of health insurance cover prices. Key Regulations affecting the markets for health insurance Over the recent decades, the number of American citizens without health coverage persists to stimulate a strong argument in policy spheres with Congress providing perceptions about how to offer reasonable health care insurance for more American citizens. Certainly, a wide range of analysts contend that for a better government involvement in health care as a means to insure a bigger percentage of its citizens. Frequently ignored is the actuality that government strategy, specifically disproportionate regulatory intercession, may charge many American citizens out of insurance and consequently lead to the rising numbers of uninsured. Health coverage is greatly controlled at the federal level. Some states need coverage programs to insure particular kinds of health care providers. Other federal controls impact on the charging laws for coverage. Yet others restrict the ability of coverage organizations to choose health care providers. These regulations protect consumers by necessitating insurers to be fiscally solvent and capable of remunerating claims, disburse claims punctually, and conform to specific market conduct needs. Control starts with the licensing of bodies that sell insurance within the state. Licensing includes appraisals of finances, management, and business performances to make sure a body can offer coverage assured to policyholders. States also certify representatives and agents who sell insurance within the state (Skipper and Black 20-22). Many of these regulatory plans, specifically in the segment of health coverage funding, are devised to accomplish certain strategic objectives, such as regulating health care charges, specifically for high risk persons. Obtaining these strategic objectives consistently needs trade-offs; however the legislature hardly makes this trade-offs unequivocal. The economic impact on the federal-level health coverage controls has collectively received modest diagnostic consideration from both the conservatory and the extensive health strategy society. These non-profit companies are created by decree and funded by imposing appraisals on insurers in the market. Market conduct needs amount to claims and countersigning activities, marketing, rescissions of coverage, and imbursement of claims. These permit state to articulate iniquitous trader and claims practices, such like failure to reimburse claims fairly or promptly, and carry out market conduct assessments to ensure insurers are adhering with state rules such like explaining products precisely, avoiding illusory advertising, and utilizing sound actuarial standards to price products (Skipper & Black 23-65). Nevertheless, a more exhaustive assess of the subject should offer insights into how to minimize coverage charges and offer better health care insurance for more American citizens. . Insurers marketing help strategies in the personal market utilize approaches dissimilar from those utilized in the group insurance market to assess insurance applicants. One such method is that of medical countersigning to determine applicants according to their heath standing. Some claimants maybe classified as probable to cost the insurer more in claims than a healthier individual, amounting to insurers charging them higher premiums or limiting or revoking coverage. Other dissimilarities between the group and personal market include the application of dissimilar state versus federal laws in the marketing of products, and other accountability necessities of bodies selling personal policies (Henderson 20-25). The individual industry is productively a residual market, comprising greatly of those without access to company-funded coverage. Albeit just a comparatively diminutive number of persons acquire coverage in the non-group market, it should be noted that coverage charges in the individual industry can amount to extreme effect on the number of uninsured persons. Insurers should comply with the necessities of timely claim payment and claims appeals procedures. They are expected to have strategy transformations between the insurer and the insuree measured by the state with a view to conforming to the principles of classification and content (Henderson 26-27). Market structure The market structure of the modern United States health insurance commerce not only replicates the sophistication and qualms of health care, but also its genesis in the 1930s and the growth in the subsequent decades. Private health care providers had provided accident, sickness and burial strategies in the latter half of the 19th century. As population moved from rural agricultural localities to industrialized urban centers, employees were exposed to dangers of occupational accidents, but had less reinforcement form extended household channels that offered unofficial insurance covers. Many employee acquired accident or sickness guidelines through fraternal institutions, labor unions, or private care givers. These strategies were normally indemnity plans, which would reimburse an established cash amount in the occurrence of a grave accident or health emergency. Social investigations at the turn of century highlighted the connection between industrial calamities and poverty, amounting to progressive era transformations and labor unions to press on obligatory social insurance, which assisted lead the employees’ payment programs. The modern health insurance commerce in the U.S. was stimulated by the commencement of the Great Depression. Unlike former health insurance strategies, insurees were titled to hospital care and services rather than cash cover. Whilst the policy did not insure physician bills, it did enhance applicants’ ability to pay those costs (Robison 11-24). The health coverage market in the United States, according to many historians, was initially planned to avert competition amid cover providers. The previous polices tied before to a sole funding hospital. Each hospital policy competed with others. Classes or persons with the alternative to mediate with particular hospitals should have been able to wield pact power. Hospitals and specialist groups, nevertheless, soon pressed for combined strategies that needed free selection of physicians and hospital. Development of Insurance Industry Combined strategies dampened incentives for home hospitals to compete on the foundation of cost or munificence of policy advantages. The American Hospital Association stoutly favored combined strategies that permitted a health care beneficiary to acquire from any certified home hospice and perceived single-hospices strategies as a threat to the economic steadiness of community hospices. Additionally, in 1973, the American Hospital Association needed Blue Cross policies to have restricted terrains so that they would not compete against each other. Hospice and physician groups’ resistance to competition in health indemnity and health care merged with more collective denigrations of disparaging competition that was prevalent in the early 1930s. A wide section of economists held that measures to minimize market competition compulsory during the Great Depression in reality slowed down economic revival. Completion in health cover markets, nevertheless, increase issues that do not pertain to most markets. If healthcare providers take on different countersigning principles, competition can enable pooling risks more challenging (Pauly 45-79). Indemnity coverage of physician services retarded the expansion of Blue Cross hospice strategies due to the hostility from the American Medical Association and preventive state regulations. In numerous states, nonetheless, medical societies established prepaid service strategies to forestall state or federal polices, which grew into Blue Shield policies. In most states, Blue Shield was integrated into Blue Cross strategies, though some maintained detached governing boards. Blue Cross stimulated their expansion during World War II and extended to nearly all states. Wartime remuneration and price regulations certified in October 1942 debarred levelheaded indemnity and pension benefits. Medical countersigning is the procedure that insurers utilize to assess an appliance for indemnity. A coverage claim is an offer, by the claimant to the insurer, to enter into a coverage contract. In states that permit medical countersigning, the insurance provider analyzes a claimant’s health position, and then accepts that offer, revoke it, or make a counter-recommendation with dissimilar advantages, a dissimilar payment, or both. These providers utilize information reported by the person, as well as medical records. Preceding health care applications are assessed to establish if premium require be modified to adequately cover anticipated applications in the future. Further, insurers are collectively forbidden from singling out policyholders for premium increments. Age is normally used in establishing premiums with providers normally charging older folk higher premiums than younger people. At times, gender is an element is some strategies with insurance providers frequently establishing higher payments for women of childbearing age that they do for men. Specific kinds of enterprise present higher or lower threat to the persons working within them. Cover providers habitually charge folk in the higher threat occupations, such like as the construction industry, higher premiums than they impose on people in lower threat careers, such like office workers. Most states have issued other kinds of controls to make sure access to the individual private health cover market. Amid the more general are pre-existing situation restrictions and medical loss ratios. Pre-existing situations are those circumstances for which the insurance cover beneficiary was diagnosed, sought consultation, or received care during a particular period of time previous to a claimant for cover (Folland et al 34-78). The prospect of the employer-offered health cover is better considered together with the prospect of sum worker payment, both in cash and fringe settlement like health indemnity. From that context, the probability that most companies will persist to provide health coverage is not necessarily good news for workers. Low-income workers will finally cost less to employers with insurance than they cost to employers with insurance. If they didn’t, low-income workers would be doing better at employers with insurance and would line up to work there. Preceding 1954, no unequivocal law provision prohibited health coverage benefits from general taxation. The IRS, nonetheless, had shown in 1943 that group health coverage premiums paid by a company for its workers would be measured by the employees. A primary overhaul of the IRC (Internal Revenue Code) of 1954 integrated Section 106, which unequivocally debarred worker contributions for health care from workers taxable revenues. The tax prohibition for worker impermanent health care made health coverage inexpensive than non-tax advantaged models of expenditure for persons. One study established that health coverage subsequent to 1954 tax alterations grew more hastily amid workers with higher incomes, who collectively had marginal tax rates, which could show that tax minimization, amounted to employees demanding more general or munificent strategies. Other elements, such like increasing income levels, completion for employees, and increasing medical costs, additionally stimulated expansion in employer-provided benefits. But before WWII, many industrial insurers suspected that hospice or medical prices were an insurable risk. Coverage providers measured a threat insurable just if the potency losses were explicit, quantifiable and not subject to regulation by the insured (Hurley 30-45). Introduction of Medicare and Medicaid At the late 1950s, health coverage benefits had become a typical ingredient of payment packages amid most primary workers. During this time, Congress enacted the Federal Employees Health Benefits Plan (FEHBP), which offered Blue Cross and Blue Shield benefits to federal employees across the country. At this time, hospice prices increased stridently in many parts of the U.S. due to new hospice construction, the rise capital power of inpatient care, the substitution of flat-rate per diem compensation for hospices with retrospective full-cost reimbursement, and the spread of health indemnity benefits that advanced patients ability to pay. Those fee increases amounted to many Blue Cross associates to demand larger premium increases, which augmented public concern and opposition from many state watchdogs. Whilst Blue Shield/Blue Cross and commercial coverage strategies insured a bigger part of the workers and their dependants at the end of the 1950s, many low-income and elderly folk faced a myriad of challenges including acquiring inexpensive health coverage or paying for health care. The legislature in the 1950s started to offer federal abet to states that selected to cover health care overheads of these groups. Social Security was extended to reimburse providers t cover specific medical overheads incurred by blind, disabled and the elderly beneficiaries beginning in 1950. The Kerr-mill Act of 1960, a precursor of Medicaid, backed state plans that salaried providers for health care of the completely disabled, aged and blind, as well as low-income elderly persons. State governments, subject to particular federal needs, retained considerable discretion over benefit stages and income restrictions, which were characteristically connected to welfare assistance strategies (Henderson 45-65). In 1965, the Johnson Government worked with Ways and Means Committee Chairman Wilbur Mills to produce the Medicare plan, which offered health coverage for almost all American citizens over age 65. Medicare joined a mandatory hospice indemnity plan with a voluntary physician services programs. Whilst some had worried that Medicare would displace private insurers, Blue Cross company become monetary mediators for Medicare, responsible for issuing reimbursements to providers and other back office functions. Medicaid, formed in the equivalent 1965 act, is a means-tested plan bankrolled by federal and state funds (Pauly 77-89). Each state devises and manages its own plan under federal decree. Over time, Medicaid eligibility values and federal requirements have become more sophisticated. Private health coverage organizations play an essential role in numerous health plans. Many providers run Medicare Advantage and prescription drug benefit programs The Rise of Managed Care In some parts of the nation, programs joining coverage with direct stipulation of health care evolved into essential players in local markets in spite of the sturdy hostility of the AHA and AMA. A health program devised for southern California construction employees in the mid-1930s ultimately became the Kaiser Health Program. Some physician established group practices and clinics in 1920s and 1930s. Many health care companies were created by workers, employee groups, and the federal administrations during the 1930s and 19402. Whilst some of these programs thrived locally or regionally, they did not accomplish nation reach till the 1970s. In 1971, President Nixon declared a plan to motivate prepaid group programs that combined coverage and care functions as a way to restrict the development of medical care charges. Advocated suggested that health Maintenance organizations HMO, which incorporated health care and health coverage functions, would have a monetary motive to promote welfare and would lack inducement to high-priced care. The HMO Act of 1973, which then just numbered around 30, so that 90 percent of the nation would have access to Health Maintenance organizations in 10 years. Whilst this ambitious objective was not achieved in the 1970s, by the late 1980s Congress and enterprises started to perceive greater utilization of managed care companies such as HMOs and equivalent cooperatives as a major plan for regulating health care charges. In the mid-1990s, the extensive utilization of more preventive variety of administered care ignited strong patron opposition, which compelled an industry withdraw from some of those programs. A set-up of insurers, known like preferred provider organizations (PPOs), expanded quickly in the late 1980s and early 1990s Preferred provider organizations, frequently owned by hospice system and other providers, characteristically contract with the insurers organizations and provide discounted rates, commonly known as fee-for-service. PPO recruits who obtain care outside of the system characteristically should receive program authorization or pay more. Consequently, a PPO program offered patients with more elasticity than staff-paradigm HMOs, which collectively did not insure care offered outside of the HMO. As numerous forms of administered care programs such as HMOs and PPOs become widespread, more employees provided choices amid competing health programs to permit employees willing to pay higher premiums avert preventive strategies (Anne et al 997-1009). Illustration of the Health Insurance Market Persons and families characteristically purchase coverage and/or insurance to avert risks by paying an established premium in order to obtain benefits in an extreme occasion were to take place during the insurance policy’s term. Most persons are willing to pay a provider and presume the immensity of monetary risks related to impulsive health outcomes of tentative severity. Health coverage is a technique of pooling risks so that the fiscal baggage of medical care is distributed amid many individuals. Some covered individuals will become sick or injured and incur essential medical costs. Most individuals, nonetheless, will remain comparatively healthy, consequently incurring little or no medical costs. Whilst it is dissimilar to foresee who will incur high costs, the standard medical cost amid a large group of individuals is more foreseeable. Insurance e pools the medical costs of the covered, who pay for the costs through their premiums (Folland et al 86-104). The health indemnity/insurance market is firmly interconnected with other segments of the health care network. Thus, many affiliates play a role in the health coverage market. Health providers are intermediaries in the transaction of the stipulation of health care between patients and providers. In essence, health insurers are arbitrators who remunerate providers on behalf of patients. Health insurers not only remunerate providers, but additionally characteristically have some clout over the number and forms of services covered and mediate contracts with providers on the compensation for health services. The health coverage market has many features that drive it far from the economic yardstick of perfect competition. Perfectly competitive markets, according to economic hypothesis, allot goods and services effectively if specific circumstances are met. Markets allot goods and services efficiently when the social rates of the resources utilized to make final product equals the social profit of consuming that product. Competitive markets may allot goods wastefully if those circumstances are not met. Most of these situations frequently fail to hold in the health coverage market. Take offs from these situations can hinder markets and amount to unproductive outcomes. Transformations are most likely to be productive, according to some economists, when they are knotted to the fundamental structural essential role in the health insurance market. The lack of balanced information plays a specifically essential role in the health coverage market. In effect, most patrons depend extremely on the specialized understanding and professionalism of intermediaries such as workers, insurers, physicians, labor unions, amid others (Folland et al 105-112). Intermediaries Play Major Roles in Health Care Superiority of health care is difficult to examine. Thus far, consumers characteristically establish relations with numerous intermediaries in advance. This can offer benefits as well as restrict consumer preference. Health insurers make the immensity of health care payment. How insurers devise health care systems influences how patrons use health care. Patrons characteristically select a major physician who chooses tests and treatments and make recommends to medical experts. Employers mediate with insurers on the behalf of their employees, and labor unions arbitrate contracts with providers and handle remunerations for personal services. The United States virtually alone amid leading industrialized countries in it heavy and expanding dependence on the private insurance segment to mediate healthcare for its citizens. The perception underlying this network is that fierce competition amid private insurers produces more productive results, extensively writ. In the meantime, continued faith in competitive markets manifest in the fast rise in outsourcing of public insurance to the private segment, as well as negligent antitrust enforcement during two decades of widespread insurer consolidation (Robison 11-24). To establish why insurance carriers are able to extract higher prices from profitable organizations in focused insurance markets, it is important to join insights from field interview with a paradigm of bilateral bargaining, as many employers and insurers bargain yearly over insurance contracts. The proof claims employers are unwilling to lever health plans during good times, that is, profits shoot up willingness to pay for existing health programs. The truth that, conditional on the equivalent profit shock, premiums rise the most in marked served by a focused insurance industry that could be defined a larger profit-stimulated rises in levering charges in concerted insurance markets. In concerted markets the strong bargaining position of insurers facilitates their capturing more of the extra surplus induced by profit shocks. Nevertheless, consumers maintain some of the superfluous of each consumer. In the case of a monopoly supplier, buyer superfluous is entirely extracted. The outcomes provide the strongest confirmation to date connecting private health insurance payments to the market power of insurers. Many large companies select to self-insure, outsourcing benefits managements but reimbursing established charges of care (Robison 11-24). Payments for fully-insured programs rely on the actuarial health risk of workers, details of strategic design and collective carrier traits. The employers characteristically importune bids annually one or more health programs in all of the markets in which their activities take place. Many utilize benefits consults to serve as agents in this procedure. Eventually, after some back-and-forth on program details, an ultimate round of negotiation over the payment for a fixed program design may occur. The disposable result is that pricing of fully-insured health programs is anything but transparent, rendering the setting seasoned for disparity charging transversely employer groups, ceteris paribus. Contracts are signed three to six months to kick off the benefit year, which is collectively the calendar year. Consequently, an employer will characteristically start choosing programs prior to the preceding years. The degree the organization profits impacts these agreements; the germane profit figure will normally reflect data for each year (Hurley 99-105). Types of Health Plans The predominant kind of health coverage has transformed radically over the past 25 years. Over 90 percent of the privately insured were covered by an insurance or customary unmanaged health indemnity program in 1980. As of today, the share is less 10 percent. Today most folk insured by private indemnity are covered by some form of administered care program ranging from an administered insurance program. For instance, the PPOs, where the insurers mediate fees with providers to a personnel HMO; the insurer and the provider are equivalent, and patients consult doctors who are on payment. With administered care, the health insurers and the providers are perpendicularly incorporated to some degree (Anne et al 997-1009). Types of Insurance Companies Health insurers are a varied group of firms. Health Insurers may be commercial insurance organizations, for profits or non-profit Blue Shield/Blue Cross programs, HMO-kind firms such as Kaiser Permanente. Successful health coverage organizations can be either non-profit companies or for-profit organizations. These non-profit companies have restricted benefits and regularly face less state control than their for-profit competitors. The Blues have been most outstanding example of non-profit health insurers, though Blue Shield/Blue Cross companies have been permitted to transform to for-profit standing since 1994. These firms were originally managed on a state position. Which many have restricted them from taking advantage of probable economies of scale that bigger multi-state insurers get hold of. Self insuring employers typically contract with a successful indemnity firm for management services. The Worker Retirement and Income Security Act of 1974 offers some advantages to large multi-state organizations that self-cover by obstructing state control and determining federal principles, which make sure that the company’s worker benefits are subject to the equivalent decree across all states (Skipper & Black 85-96). On the other hand, for-profit insurers play a progressively critical role in the health coverage market. Many provide an extensive assortment of programs devised for varied organizations or market sectors. These insurers have a responsibility to their shareholders to capitalize on profits. Many operate in numerous states and frequently provide other lines for coverage, such like life or disability indemnity. Furthermore, selection of coverage alternatives also varies by organization size. Amid small companies providing health benefits, 86 percent provide just one program to their workers. Amid very large companies, 73 percent provide two or more programs alternatives to their workers (Skipper & Black 101-109) Market Concentration and Market Power Market concentration should translate into the ability to utilize market power to increase charges or minimize productivity for numerous reasons. The first one is that concentration procedures may be calculated in ways that ignore the scope of options access to patrons and employers. Second, prospective entrants may hamper existing organizations’ potential to increase prices. For example, other forms of insurers with wide-ranging contacts with companies could potently enter the health coverage commerce, and some organizations may select to provide health coverage benefits via self-insured programs. Market concerted could be overvalued in fields where employer self-insured programs not incorporated in AMA data have essential recruitments (Anne et al 997-1009). Third, companies in concerted markets might select not to carry out what industry power they may possess, maybe since their domination and managerial configuration is devised to pursue other objectives and goals. For example, some agree that non-profit health insurers behave in a different way than for-profit insurers and may select not to implement their market clout. Conversely, others have articulated cynicism that non-profit and for-profit health care providers and insurers behave in considerably unusual ways. Whether market concentration permits organizations to facilitate productivity by carrying out market clout has stimulated debate amid economists and trade analysts. Many economists have singled out sturdy connection between market concentration positions and raised profit levels across industries. Those interactions led some economists to debate that market concentration facilitates organizations to implement market authority via advanced pricing power. Whereas a price raised above competitive degrees raises organizations’ productivity, they minimize economic effectiveness by minimizing productivity levels below most favorable levels (Anne et al 997-1009) Conclusion Confirmation suggests that health coverage markets in many local areas are exceedingly concentrated. Many big organizations have responded to market situations by self-insuring, which may offer some rivalry strain on insurers, though this is implausibly to advance market conditions for other patrons. The carrying out of market clout by companies in concentrated markets collectively amounts to increased prices and minimized productivity. High payments and restrictive access to health coverage: joined with elevated profits. Many other traits of the health coverage markets, nevertheless, also contribute to increasing charges and restricted access to reasonable health coverage. Some confirmation advocates that indemnity firms’ profits are not big, particularly during the present economic depression; though some of those projections eliminate investment income. Better still, if health insurers were exceedingly productive, it is vague how much minimizing coverage industry proceeds would do to minimize overall health care charges (Henderson 100) The Unites States healthcare system depends exceedingly on private coverage companies to administer healthcare consumption and premiums to providers. Private insurers’ split of health expenses in the U.S. was projected at 35 percent in 2003. In 2007, the expenses by private insurers were projected at $676 billion. Conversely, federal and state administrations may want to carefully analyze the extent of rivalry in the germane coverage markets before expanding the responsibility of the private segment health-coverage provision. Consequently, policies concentrated on health coverage segment may produce some results; however there are doubtfully to solve large rate growth and challenges of restricted admittance to health coverage if other measurements of the health are left unaltered (Henderson 103). Work Cited Anne, Gron & Michael, Mazzeo. “Differentiation and Competition in HMO Markets.” Journal of Political Economy 99.5 (1991): 977-1009. Print. Berkowitz, Erick. Essentials of Health Care Marketing. New York: Basic Books, 2010. Print. Folland, Sherman, Goodman, Allen & Stano, Miron. The Economics of Health and Health Care. (7th Edition). New Jersey: Prentice Hall, 2012. Print. Henderson, James. Health Economics and Policy. Boston, Massachusetts: South-Western College, 2011. Print. Hurley, Jeremiah. Health Economics. New York: Scribner, 2010. Print. Pauly, Mark. Health Benefits at Work: An Economic and Political Analysis of Employment- based Health Insurance. Ann Arbor: University of Michigan Press, 1997. Print. Robison, Jamie. “Consolidation and the Transformation of Competition in Health Insurance.” Health Affairs 23.6 (2004): 11-24. Print. Skipper, Harold & Black, Kenneth. Life and Health Insurance. New Jersey: Prentice Hall, 1999. Print. Read More