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The health care debate over the last year has included massive attacks by President Barack Obama and his administration against the practices of health insurance companies, particularly those selling policies to individuals. Is this criticism valid? At a time when the much-debated legislation has become a reality, Mark V. Pauly, a health economist at the University of Pennsylvania’s Wharton School, raises serious issues about the premises of the president’s criticism and the likely effects of the new legislation. In his book, Health Reform without Side Effects: Making Markets Work for Individual Health Insurance (Hoover Press, 2010), Pauly offers a realistic assessment of how much improvement can be demanded and expected. Pauly observes that the most frequently discussed alternative reforms reflect an excessively simplistic view of insurance markets, which leads to policies likely to drive out some of the beneficial features of the present market. He discusses how individual insurance markets currently fit into the overall pattern of health insurance markets, identifies what is distinctive about current performance in that market in comparison to the proposed reforms, and suggests that taking into account the current strengths of the individual market would yield much higher net benefits.

Responding to Pauly were actuary Tom Wildsmith, a senior consultant at the Hay Group, and John A. Nyman, a health economist and professor of health policy and management at the University of Minnesota School of Public Health. AEI resident fellow Thomas P. Miller moderated. This event was cosponsored with the Hoover Institution.


Agenda




Speaker biographies

Thomas P. Miller is a resident fellow at AEI, where he focuses on health policy with particular emphasis on information transparency, health insurance regulation, and consumer-driven health care. He is a member of the National Advisory Council for the Agency for Healthcare Research and Quality. Before joining AEI, Mr. Miller served for three years as a senior health economist for the Joint Economic Committee, where he organized a series of hearings focusing on promising reforms in private health care markets. He also has been director of health policy studies at the Cato Institute and director of economic policy studies at the Competitive Enterprise Institute. Mr. Miller’s writing has appeared in publications such as Health Affairs, the Wall Street Journal, the New York Times, the Washington Post, the Los Angeles Times, Reader’s Digest, National Review, the Journal of Law and Contemporary Problems, Regulation, and Cato Journal. Before coming to Washington to work on public policy, he was a trial attorney, a journalist, and a radio broadcaster.

John A. Nyman is a health economist and professor in the division of health policy and management in the School of Public Health at the University of Minnesota. His research interests include the analysis of nursing home care markets and long-term care policy, health insurance theory, the theory and practice of cost-effectiveness analysis, analysis of physician behavior, and most recently, the theory of demand for gambling and the analysis of gambling as a public-health issue. Mr. Nyman teaches courses in health economics, health insurance and cost-effectiveness analysis, and he is the recipient of the 2006 Leonard M. Schuman Excellence in Teaching Award. He is author of the book, The Theory of Demand for Health Insurance (Stanford University Press, 2003).

Mark V. Pauly is Bendheim Professor in the department of health care management, professor of health care management, insurance and risk management, and business and public policy at the Wharton School, and a professor of economics at the University of Pennsylvania. He is a member of the Institute of Medicine, an adjunct scholar at AEI, and an advisory committee member for the National Institutes of Health and the National Academy of Sciences. Mr. Pauly is coeditor in chief of the International Journal of Health Care Finance and Economics and associate editor of the Journal of Risk and Uncertainty.

Tom Wildsmith is a consulting actuary in the Hay Group’s Arlington, Virginia, office. He has over twenty-seven years of experience dealing with all aspects of health insurance policy and financing, including twelve years of operational experience with a commercial carrier and nine years of advocacy experience with a major health insurance trade association. Mr. Wildsmith’s operational experience includes pricing, product development, systems development and management, and actuarial support for small and large groups on all group products, including managed care, life insurance, long-term disability insurance, and ancillary group products. Mr. Wildsmith is a fellow of the Society of Actuaries and serves on the board of directors of the American Academy of Actuaries.

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