This dissertation examines several key aspects regarding health insurance policies in the United States. The development of the United
States health insurance market began in the 1920s with life insurance companies selling traditional indemnity health insurance plans and
hospitals offering hospital care plans on a pre-paid basis. This market has evolved over the last century into a heavily regulated market
dominated by employer-sponsored, managed-care plans. Reviews in the introduction of this dissertation include the overall market, health
insurer evolution, the history of managed care operations, the progression of employer-sponsored health insurance plans and regulation
specific to health insurance. Analysis of health insurance market evolution can offer a better understanding of how past developments in U.S.
health care can inform and shape future policy. The second chapter of this dissertation provides an analysis of adverse selection in the U.S.
health insurance market. Adverse selection is a phenomenon inherent in insurance contracting. Using a rich, unique dataset consisting of
multiple insurers, across states for the years 2013-2015, I document a correlation between coverage and risk. Results show that adverse
selection is present both in the individual and group markets. Additionally, I test for the presence of adverse selection by state and by
insurer. I find that factors such as the health of the state population, regulatory environment, insurer competition and insurer size are not
associated with the likelihood that a state or and insurer experiences the presence of adverse selection. The third chapter of this
dissertation relates adverse selection and consumer satisfaction in health insurance plans. I exploit a dataset rich with respondent
demographics and health insurance plan information to evaluate the relationship between adverse selection and health insurance plan
satisfaction. I find that respondents who are more likely to have adversely selected into the health insurance plan are more satisfied with
their plan. This is evidence that respondents may use private information on their risk level to choose plans to their advantage. / A Dissertation submitted to the Department of Risk Management/Insurance, Real Estate and Legal Studies in
partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Fall Semester 2017. / October 18, 2017. / asymmetric information, Health insurance / Includes bibliographical references. / Patricia H. Born, Professor Directing Dissertation; Thomas Zuehlke, University Representative; Cassandra
R. Cole, Committee Member; Charles M. Nyce, Committee Member; Petra Steinorth, Committee Member.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_605015 |
| Contributors | Sirmans, Eleanor Tice (author), Zuehlke, Thomas W. (Thomas William), 1957- (university representative), Cole, Cassandra R. (committee member), Nyce, Charles M. (committee member), Steinorth, Petra (committee member), Florida State University (degree granting institution), College of Business (degree granting college), Department of Risk Management/Insurance, Real Estate and Legal Studies (degree granting departmentdgg) |
| Publisher | Florida State University |
| Source Sets | Florida State University |
| Language | English, English |
| Detected Language | English |
| Type | Text, text, doctoral thesis |
| Format | 1 online resource (135 pages), computer, application/pdf |
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