Tag: insurance

  • When social policy goes wrong

    When social policy experts create a new intervention to solve some social problem or make people’s lives better, there’s two possible outcomes they’re expecting: either the intervention works, or it doesn’t. But what we forget is that there’s a third option – that our well-meaning intervention actually makes people’s lives worse. This isn’t just an […]

  • “Remedy and Reaction”: Reactions

    Generals are always fighting the last war is a standard political cliché, meaning that politicians have a tendency to overgeneralize from previous experience. Democrats who lost the 1993 health care reform fight vowed not to repeat the same apparent mistakes again when the window for reform opened again in 2008. For example, conventional wisdom argued […]

  • National Salary Insurance – the wrong solution to the right problem

    It’s become fashionable among the British left to describe social security as broken – a cornerstone of the original welfare state that not only has lost its political support, but now actively causes worklessness and ‘dependency’.  In a revealing sign of the Labour Party’s direction of travel, the most influential and well-connected think-tank on the […]

  • Does Health Insurance Prevent Poverty? Evidence from OHIE

    The early results from the Oregon Health Insurance Experiment (OHIE), a natural experiment in the state of Oregon that provided previously ineligible poor adults with the chance to lottery for coverage in Medicaid (public insurance for the poor), are astounding. (The paper is here, a NYT article is here, great blog posts are here). In […]

  • Revisiting American Inequality: Did the Poor Really Get Poorer?

    American income inequality is commonly told as a story of divergence: since the 1970s, the share of income going to the top of income distribution has skyrocketed, while the share of income going to the bottom of the income distribution has seen large declines. Even in absolute terms, there is evidence that incomes for low-wage […]

  • The UK Budget: the end of National Insurance?

    Budget day is always a classic piece of British political theatre. The magic of the ‘red box’ held by the Chancellor, the routines and rituals at the Palace of Westminster, the near-impossibility of actually taking in this myriad of policy details at the time, followed by the scramble to figure out what they really mean over […]

  • The UK’s recession safety net: not as stingy as you thought

    UK unemployment benefits are known for being pretty stingy.  I’ve previously mentioned how they have fallen behind living standards since the early 1980s, and put us towards the bottom end of the OECD table of generosity. But there’s a problem in just looking at ‘unemployment benefits’ – we now increasingly rely on a complex array […]

  • The Consequences of Health Care Design for Equity and Access: Cross-National Evidence

    A few days ago Ben (channeling Paul Pierson) posed the provocative question: does the welfare state still matter? Because welfare states are so complex in structure and function, it’s unlikely that there is a single answer across all domains of policymaking. But at least in one domain – the provision of health care – the […]

  • Is health insurance like a television? (or, What is the point of health insurance?–Part 2)

    In my last post I identified an argumentative move that has been used to defend reforms like the Affordable Care Act. The move goes like this: “The whole point of health insurance is that it’s a vehicle to redistribute funds from the healthy to the sick. Virtually everyone wants health insurance of some kind. So […]

  • What is the point of health insurance? (Part 1)

    When discussing the politics and ethics of health care policy and reform, one often hears claims or suspicions about the “special importance” of health care. To my mind, the strongest suspicion can be expressed thus: health care is of special importance because of the special importance of health; health is important because of all the […]