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# Adverse selection may be making health insurance prohibitively

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Senior RC Moderator
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01 Apr 2015, 05:21
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Question 1
00:00

Question Stats:

57% (01:22) correct 43% (01:00) wrong based on 116

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Question 2
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45% (00:12) correct 55% (00:25) wrong based on 166

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Question 3
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47% (00:21) correct 53% (00:23) wrong based on 166

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Adverse selection may be making health insurance prohibitively expensive for the unemployed. In this negative feedback loop, rising insurance premiums cause the healthiest consumers to opt out of their plans, increasing the average risk of the pool. Insurers raise prices to offset that increased risk and the cycle begins again. Health insurance companies typically establish a standard rate, based on the average risk of the group, for a particular segment of the population. Among those who purchase individual insurance, consumers in poorer health are more willing to pay for such insurance because they have higher-than-average health care costs. Healthier consumers however, often forgo such insurance, reasoning that it is cheaper to pay directly for their lower-than-average health care costs. Among employers that offer health insurance, most obligate all employees, healthy or otherwise, to enroll in the employer’s group plan.

Further, because a minimum health level is often required in order to fulfill job requirements, employer group insurance plans effectively pre-screen for a minimum level of health. Insurance companies can typically charge a lower premium to these groups, based on the lower average risk of the entire employee pool, without worrying that healthy employees will opt out of the plan as individual consumers might.

1. The passage suggests that which of the following would be most likely to reduce the occurrence of adverse selection in the health insurance industry?

A. Higher insurance rates for employers with older-than-average employees
B. Protection from lawsuits alleging discrimination against consumers in poor health
C. Legislation requiring the healthiest consumers enrolled in a given insurance plan to pay premiums comparable to those of the unhealthiest members
D. Individual insurance rates that are affordable enough to persuade healthy consumers to purchase health insurance
E. Legislation requiring all employers to provide health insurance to their employees

[Reveal] Spoiler:
D

2. The “negative feedback loop” mentioned in the second sentence can best be described as a situation in which

A. those affected by that situation intentionally created the situation in the first place
B. opposing parties cannot come to consensus or solve a problem
C. the affected groups can no longer afford to participate in that situation
D. companies make decisions based upon business interests as opposed to employee interests
E. a series of understandable decisions continually escalates in a damaging manner

[Reveal] Spoiler:
E

3. The passage states which of the following about the cost of health care?

A. It is generally higher for people with poor health.
B. It is generally higher for full-time workers.
C. It is not fairly priced in the current market.
D. It has been rising in recent years.
E. The lower the average risk of the employee pool, the less it costs.

[Reveal] Spoiler:
A

[Reveal] Spoiler: Question #1 OA
[Reveal] Spoiler: Question #2 OA
[Reveal] Spoiler: Question #3 OA

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02 Apr 2015, 07:31
Thanks for the passage. Answered all correctly. Took me 5 minutes.
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24 Apr 2015, 05:13
easy passage. Took 6:45 .
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05 Aug 2015, 06:06
I have a question concerning q. number two:

Why is "E. a series of understandable decisions continually escalates in a damaging manner" correct? Where does it say that the decisions are "understandable"?

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05 Aug 2015, 10:11
can anyone explain Q 2 & 3 ?? I got both of them wrong. i mean why not Option A for Q2???

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05 Aug 2015, 22:44
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Option A uses the word "intentionally" which is not the case.
There is compulsion on Insurance companies to raise the insurance rates ( read below line)
" Insurers raise prices to offset that increased risk and the cycle begins again"
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06 Aug 2015, 05:26
can some one tell the answers of above questions

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06 Aug 2015, 05:27
can some one tell the answers of above questions

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10 Aug 2015, 12:19
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Can anyone explain question 1

1. The passage suggests that which of the following would be most likely to reduce the occurrence of adverse selection in the health insurance industry?

A. Higher insurance rates for employers with older-than-average employees
B. Protection from lawsuits alleging discrimination against consumers in poor health
C. Legislation requiring the healthiest consumers enrolled in a given insurance plan to pay premiums comparable to those of the unhealthiest members
D. Individual insurance rates that are affordable enough to persuade healthy consumers to purchase health insurance
E. Legislation requiring all employers to provide health insurance to their employees

I marked E because if all employers provide health insurance then as per effects given in 2nd para and 1st para last line adverse selection will reduce.

I eliminated D because no where mentioned whether current prices are affordable enough or not ? The issue is that health insurance is not cost effective, that's why they opt out. Its not that the insurance is not affordable
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09 Dec 2015, 16:03
Thanks for the passage & questions. Definitely a good passage to breakdown.

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04 Jan 2016, 20:42
Why is it not E.

The passage clearly states at multiple places that when the average risk increases, the cost increases.
Cant we assume by this fact that if the average risk decreases, the cost decreases?

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04 Jan 2016, 20:49
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noTh1ng wrote:
I have a question concerning q. number two:

Why is "E. a series of understandable decisions continually escalates in a damaging manner" correct? Where does it say that the decisions are "understandable"?

I got this right and will try to explain it to you.
The negative feedback loop causes
a) the healthy customers to opt out.
b) insurance companies to increase cost
c) unhealthy , unemployed to suffer the damage.

Now, all these decisions are logical and understandable because the first step causes the second and second causes the third. The logic for this is given in the first paragraph.
The less than average costs for health care causes the healthy customers to opt out. It seems logical, isint it?

So, that's why these decisions add up to create a negative loop.

Consider kudos if this helps.!

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04 Jan 2016, 20:51
PUNEETSCHDV wrote:
Can anyone explain question 1

1. The passage suggests that which of the following would be most likely to reduce the occurrence of adverse selection in the health insurance industry?

A. Higher insurance rates for employers with older-than-average employees
B. Protection from lawsuits alleging discrimination against consumers in poor health
C. Legislation requiring the healthiest consumers enrolled in a given insurance plan to pay premiums comparable to those of the unhealthiest members
D. Individual insurance rates that are affordable enough to persuade healthy consumers to purchase health insurance
E. Legislation requiring all employers to provide health insurance to their employees

I marked E because if all employers provide health insurance then as per effects given in 2nd para and 1st para last line adverse selection will reduce.

I eliminated D because no where mentioned whether current prices are affordable enough or not ? The issue is that health insurance is not cost effective, that's why they opt out. Its not that the insurance is not affordable

I got this right and will try to explain it to you.
The negative feedback loop causes
a) the healthy customers to opt out.
b) insurance companies to increase cost
c) unhealthy , unemployed to suffer the damage.

Now, lets say that the individual insurance rates are affordable. This will let the healthy consumers to pay for insurance and hence not opt out. So this loop wont start.

Hence, D is the correct choice.

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04 Jan 2016, 22:04
neha, the passage doesn't state anything about the cost of employee pooled insurance other than that is helps bundle the risk, pooling high and low risk patients. It would take outside knowledge to know if employee pooled insurance comes at different prices vs one price or to know if it is based on the average employee age, tenure, industry etc.

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09 Jan 2016, 19:47
1. The passage suggests that which of the following would be most likely to reduce the occurrence of adverse selection in the health insurance industry?

D. Individual insurance rates that are affordable enough to persuade healthy consumers to purchase health insurance
E. Legislation requiring all employers to provide health insurance to their employees

In this question, we can remove choice A, B and C easily. As the passage mentioned that "Health insurance companies typically establish a standard rate, based on the average risk of the group, for a particular segment of the population." This sentence showed how the health insurance companies can handle their problems, including 3 parts "1) poorer health are more willing to pay. 2) Healthier consumers however, often forgo such insurance. and 3) Among employers that offer health insurance, most obligate all employees"

You can see that Choice E is just one of 3 parts of the standard rate's purpose.
So choice D is correct since it covers all parts.

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15 Sep 2017, 18:47
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Gnpth wrote:

Adverse selection may be making health insurance prohibitively expensive for the unemployed. In this negative feedback loop, rising insurance premiums cause the healthiest consumers to opt out of their plans, increasing the average risk of the pool. Insurers raise prices to offset that increased risk and the cycle begins again. Health insurance companies typically establish a standard rate, based on the average risk of the group, for a particular segment of the population. Among those who purchase individual insurance, consumers in poorer health are more willing to pay for such insurance because they have higher-than-average health care costs. Healthier consumers however, often forgo such insurance, reasoning that it is cheaper to pay directly for their lower-than-average health care costs. Among employers that offer health insurance, most obligate all employees, healthy or otherwise, to enroll in the employer’s group plan. Further, because a minimum health level is often required in order to fulfill job requirements, employer group insurance plans effectively pre-screen for a minimum level of health. Insurance companies can typically charge a lower premium to these groups, based on the lower average risk of the entire employee pool, without worrying that healthy employees will opt out of the plan as individual consumers might.
3. The passage states which of the following about the cost of health care?

A. It is generally higher for people with poor health.
B. It is generally higher for full-time workers.
C. It is not fairly priced in the current market.
D. It has been rising in recent years.
E. The lower the average risk of the employee pool, the less it costs.

[Reveal] Spoiler:
A

The majority of the passage concerns health insurance costs, which are distinct from the costs of the underlying health care itself. The author discusses the cost of health care only in the middle of the paragraph, explaining that healthy consumers incur lower-than-average health care costs, while consumers in poor health incur higher-than-average costs.

(A) CORRECT. The fifth sentence of the passage states that “consumers in poorer health…have higher-than-average health care costs.

(B) The passage does not compare the cost of health care for full-time workers to that for any other segment of the population. The only distinction made in the passage is between the employed and the unemployed, and then only in terms of health insurance costs.

(C) Although the passage does discuss the potentially high cost of health care insurance for the unemployed, the passage does not assert that the cost of health care itself is unfair.

(D) The passage does not discuss any changes in health care costs over time; the only rising costs discussed have to do with insurance.

(E) Though we are specifically told that insurance premiums are lower if the average risk of the employee pool is lower, we are told nothing about the cost of health care.
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Re: Adverse selection may be making health insurance prohibitively   [#permalink] 15 Sep 2017, 18:47
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# Adverse selection may be making health insurance prohibitively

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