The problem of the uninsured

Author / Creator

Ehrlich, Isaac

Available as

Online

Summary

The problem of the uninsured -- those eschewing the purchase of health insurance policies -- cannot be fully understood without considering informal alternatives to market insurance called "self-in...

The problem of the uninsured -- those eschewing the purchase of health insurance policies -- cannot be fully understood without considering informal alternatives to market insurance called "self-insurance" and "self-protection", including the publicly and charitably-financed safety-net health care system. This paper tackles the problem of the uninsured by formulating a "full-insurance" paradigm that includes all 4 measures of insurance as interacting components, and analyzing their interdependencies. We apply both a baseline and extended versions of the model through calibrated simulations to estimate the degree to which these non-market alternatives can account for the fraction of the non-elderly adults who are uninsured, and estimate their behavioral and policy ramifications. Our results indicate that policy analyses that do not consider the role of self-efforts to avoid health losses can grossly distort the success of the ACA mandate to insure the uninsured and to improve the health and welfare outcomes of the previously uninsured.

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