Abstract
Jonathan Gruber was a key architect of Massachusetts’ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. He delivered this lecture on October 2, 2009, and his references are to Congressional bills that were under consideration on that date. He laid out the universal coverage debate that’s gone on for a long time in the United States; described a new solution that he think they found for Massachusetts; described how the Massachusetts reform works; and how it can be extended nationally. Finally he spent time on the key issues that Congress is facing in fall 2009 trying to take this model to the national level.
Highlights
Jonathan Gruber, PhD, is a Professor of Economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is a Research Associate and the Director of the Health Care Program at the National Bureau of Economic Research. He is a co-editor of the Journal of Public Economics and an associate editor of the Journal of Health Economics
Dr Gruber’s research focuses on the areas of public finance and health economics. He has published more than 125 research articles, edited six research volumes, and written Public Finance and Public Policy, a leading undergraduate text
Dr Gruber received his BS in Economics from MIT and his PhD in Economics from Harvard
Summary
They don’t want to pick a side; they just want to make their profit off the top. They want a nice even distribution of risks with a big risk pool; that’s when insurance works best. Insurance only works well when there are large, well integrated pools of individuals who come together not on basis of health but the basis of something else, like where they work. States is that the pooling mechanism doesn’t work for individuals who can’t get workplace insurance. About two-thirds of the uninsured don’t get offered insurance at work, so they have to go to the non-group market, which is a harsh, unforgiving place to try to buy health insurance. You can be fine buying non-group insurance for ten years; one day you get cancer and the insurance carrier just yanks your non-group insurance away or raises your premiums through the roof
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