HOW DOES HEALTH INSURANCE REDUCE RISK?
Health
Insurance seems like a simple exchange. You pay an
insurance company a premium and insurance pays your bills. You
get rid of risk and the insurance company takes your risk.
However, there is more to it that this. What does the insurance
company do with your risk? Do they keep it? Do they also get rid
of it somehow? When you understand what the insurance company
does with your risk, then you can better evaluate your options
and perhaps get a better deal on health insurance.
One measure of risk is the potential for ups and downs. Having a
stock that pays $100 in dividends each year and seldom changes
in price is not very risky. Having a stock that goes up or down
wildly from one period to another is risky. The same is true for
health care costs. Paying $100 each year for eyeglasses is not
risky. Having a chance of winding up in the hospital and having
to pay $100,000 is risky.
"Risk Pooling" happens when many people get together and share
their losses by averaging them together. Risk pooling works
because of the "law of large numbers." As you average together
more and more numbers in a certain range, the average becomes
more and more stable. Unusually high or low numbers tend to
cancel each other out. For example, if you roll dice once, the
result can be anywhere from 2 to 12. If you roll dice more and
more, the average will get closer and closer to 7. By the time
you roll the dice 1,000 times, the average will be very stable
around 7.
Health Insurance
companies use risk pooling to get rid of the risk they take
from you. They charge you a premium based on average cost plus
their administrative cost. When they pool many people, the
average cost is very stable and they have little risk
themselves. Risking pooling is also used in finance. When people
buy a bunch of different stocks in a diversified portfolio,
their average return from the portfolio is more stable and less
risky than the return from a single stock.
In order for risk pooling to work, the individual risks that are
pooled must be independent. "Independent" risks go up and down
at different times, not together. When risks go up and down at
different times, they tend to cancel each other out. If they go
up and down together, the do not cancel out. For example, it is
less risky to provide accident insurance for 100 people
traveling on 100 different boats than for 100 people traveling
on the same boat. Health care risks for individuals are
generally independent, although contagious diseases or
widespread disasters can change that. This is one reason why
many life and property insurance policies exclude losses from
catastrophic events such as war.
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