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After a California Earthquake
Attitude and Behavior Change
Risa Palm and Michael E. Hodgson
University of Chicago Press, 1992
Shortly before the Loma Prieta earthquake devastated areas of Northern California in 1989, Risa Palm and her associates had surveyed 2,500 homeowners in the area about their perception of risk from earthquakes. After the quake they surveyed the homeowners again and found that their perception of risk had increased but that most respondents were fatalistic and continued to ignore self-protective measures; those who personally experienced damage were more likely to buy insurance. A rare opportunity to analyze behavior change directly before and after a natural disaster, this survey has implications for policy makers, insurance officials, and those concerned with risk management.
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front cover of American Journal of Health Economics, volume 10 number 1 (Winter 2024)
American Journal of Health Economics, volume 10 number 1 (Winter 2024)
The University of Chicago Press
University of Chicago Press Journals, 2024
This is volume 10 issue 1 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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American Journal of Health Economics, volume 8 number 3 (Summer 2022)
The University of Chicago Press
University of Chicago Press Journals, 2022

front cover of American Journal of Health Economics, volume 8 number 4 (Fall 2022)
American Journal of Health Economics, volume 8 number 4 (Fall 2022)
The University of Chicago Press
University of Chicago Press Journals, 2022
This is volume 8 issue 4 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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front cover of American Journal of Health Economics, volume 9 number 1 (Winter 2023)
American Journal of Health Economics, volume 9 number 1 (Winter 2023)
The University of Chicago Press
University of Chicago Press Journals, 2023
This is volume 9 issue 1 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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front cover of American Journal of Health Economics, volume 9 number 2 (Spring 2023)
American Journal of Health Economics, volume 9 number 2 (Spring 2023)
The University of Chicago Press
University of Chicago Press Journals, 2023
This is volume 9 issue 2 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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front cover of American Journal of Health Economics, volume 9 number 3 (Summer 2023)
American Journal of Health Economics, volume 9 number 3 (Summer 2023)
The University of Chicago Press
University of Chicago Press Journals, 2023
This is volume 9 issue 3 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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front cover of American Journal of Health Economics, volume 9 number 4 (Fall 2023)
American Journal of Health Economics, volume 9 number 4 (Fall 2023)
The University of Chicago Press
University of Chicago Press Journals, 2023
This is volume 9 issue 4 of American Journal of Health Economics. The American Journal of Health Economics (AJHE) provides a forum for the in-depth analysis of health care markets and individual health behaviors. The articles appearing in AJHE are authored by scholars from universities, private research organizations, government, and industry. Subjects of interest include competition among private insurers, hospitals, and physicians; impacts of public insurance programs; pharmaceutical innovation and regulation; medical device supply; the rise of obesity and its consequences; the influence and growth of aging populations; and much more. The journal is published for the American Society of Health Economists (ASHEcon), which is a professional, non-profit organization dedicated to promoting excellence in health economics research in the United States.
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front cover of Assessing Alternative Modifications to the Affordable Care Act
Assessing Alternative Modifications to the Affordable Care Act
Impact on Individual Market Premiums and Insurance Coverage
Christine Eibner
RAND Corporation, 2014
This report summarizes analysis in which the COMPARE microsimulation model was used to estimate how several potential changes to the Affordable Care Act, including eliminating the individual mandate and eliminating the law’s tax-credit subsidies, might affect 2015 individual market premiums and overall insurance coverage. The report also presents estimate how changes in young adult enrollment might affect 2015 individual market premiums.
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Atlanta Life Insurance
Guardian of Black Economic Dignity
Alexa Benson Henderson
University of Alabama Press, 1990
An important and richly detailed and researched history of Black entrepreneurship in the American South, Atlanta Life Insurance Company traces the inspiring success story of Black Americans to build and sustain a thriving business and an institution important to the Black population of Georgia and surrounding states. 

Efforts to develop an economic base within the Black community began even before the Civil War. These efforts gained new meaning in the post-Reconstruction period as Blacks strove to adapt to radically changing economic circumstances and the emergence of the Jim Crow South. In Atlanta, shortly after the turn of the century, Alonzo Franklin Herndon, a former slave, joined a long line of Black entrepreneurs by creating Atlanta Life Insurance Company. More than three-quarters of a century later, it remains an important enterprise that is the nation’s largest Black-controlled shareholder insurance company. The firm is today a significant example of the efforts of Black Americans to achieve economic independence and dignity in America.
 
Henderson's fascinating book reveals the historic roots of Atlanta Life, its economic growth and development as a Black-owned institution, and its social and economic involvement with the challenges and progress of Black America. 
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Black Business in the New South
A Social History of the NC Mutual Life Insurance Company
Walter B. Weare
Duke University Press, 1993
At the turn of the century, the North Carolina Mutual Life Insurance Company became the "world's largest Negro business." Located in Durham, North Carolina, which was known as the "Black Wall Street of America," this business came to symbolize the ideas of racial progress, self-help, and solidarity in America. Walter B. Weare's social and intellectual history, originally published in 1973 (University of Illinois Press) and updated here to include a new introduction, still stands as the definitive history of black business in the New South. Drawing on a wide range of sources—including personal papers of the company's leaders and oral history interviews—Weare traces the company's story from its ideological roots in the eighteenth century to its economic success in the twentieth century.
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Covering Accident Costs
Insurance, Liability, and Tort Reforms
Mark C. Rahdert
Temple University Press, 1995

Over the past century, tort law and insurance have developed deeply intertwined legal and economic roots. Insurance usually determines whether tort cases are brought to trial, whom plaintiffs sue, how much they claim, who provides the defense, how the case gets litigated, the dynamics of the settlement, and how much plaintiffs ultimately recover. But to what extent should liability rules be influenced by insurance? In this study, Mark Rahdert identifies the leading arguments both in favor of and against what he terms the "insurance rationale"—the idea that tort law should be structured to facilitate victim access to assured compensation.

The insurance rationale has been a leading force in the development of product liability law and, as a component of accident compensation, has significantly influenced pro-plaintiff advances in principal areas of tort law. However, the insurance rationale is also the source of great controversy. Critics charge that liability rules deliberately set to maximize plaintiffs' access to insurance funds have corrupted the system, causing insurance costs to spiral upward uncontrollably. Considering the strengths and weaknesses of both sides of the current debate, Rahdert develops a modified version of the insurance rationale that can become a tool for evaluating future tort reform proposals.

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front cover of Economic Dimensions of Personalized and Precision Medicine
Economic Dimensions of Personalized and Precision Medicine
Edited by Ernst R. Berndt, Dana P. Goldman, and John Rowe
University of Chicago Press, 2019
Personalized and precision medicine (PPM)—the targeting of therapies according to an individual’s genetic, environmental, or lifestyle characteristics—is becoming an increasingly important approach in health care treatment and prevention. The advancement of PPM is a challenge in traditional clinical, reimbursement, and regulatory landscapes because it is costly to develop and introduces a wide range of scientific, clinical, ethical, and socioeconomic issues. PPM raises a multitude of economic issues, including how information on accurate diagnosis and treatment success will be disseminated and who will bear the cost; changes to physician training to incorporate genetics, probability and statistics, and economic considerations; questions about whether the benefits of PPM will be confined to developed countries or will diffuse to emerging economies with less developed health care systems; the effects of patient heterogeneity on cost-effectiveness analysis; and opportunities for PPM’s growth beyond treatment of acute illness, such as prevention and reversal of chronic conditions.
 
This volume explores the intersection of the scientific, clinical, and economic factors affecting the development of PPM, including its effects on the drug pipeline, on reimbursement of PPM diagnostics and treatments, and on funding of the requisite underlying research; and it examines recent empirical applications of PPM.   
 
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Embracing Risk
The Changing Culture of Insurance and Responsibility
Edited by Tom Baker and Jonathan Simon
University of Chicago Press, 2001
For much of the twentieth century, industrialized nations addressed social problems, such as workers' compensation benefits and social welfare programs, in terms of spreading risk. But in recent years a new approach has emerged: using risk both as a way to conceive of and address social problems and as an incentive to reduce individual claims on collective resources.

Embracing Risk explores this new approach from a variety of perspectives. The first part of the book focuses on the interplay between risk and insurance in various historical and social contexts. The second part examines how risk is used to govern fields outside the realm of insurance, from extreme sports to policing, mental health institutions, and international law. Offering an original approach to risk, insurance, and responsibility, the provocative and wide-ranging essays in Embracing Risk demonstrate that risk has moved well beyond its origins in the insurance trade to become a central organizing principle of social and cultural life.

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Ensuring Corporate Misconduct
How Liability Insurance Undermines Shareholder Litigation
Tom Baker and Sean J. Griffith
University of Chicago Press, 2010

Shareholder litigation and class action suits play a key role in protecting investors and regulating big businesses. But Directors and Officers liability insurance shields corporations and their managers from the financial consequences of many illegal acts, as evidenced by the recent Enron scandal and many of last year’s corporate financial meltdowns. Ensuring Corporate Misconduct demonstrates for the first time how corporations use insurance to avoid responsibility for corporate misconduct, dangerously undermining the impact of securities laws.

As Tom Baker and Sean J. Griffith demonstrate, this need not be the case. Opening up the formerly closed world of corporate insurance, the authors interviewed people from every part of the industry in order to show the different instances where insurance companies could step in and play a constructive role in strengthening corporate governance—yet currently do not. Ensuring Corporate Misconduct concludes with a set of readily implementable reforms that could significantly rehabilitate the system.

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Exposed
Why Our Health Insurance Is Incomplete and What Can Be Done about It
Christopher T. Robertson
Harvard University Press, 2019

A sharp exposé of the roots of the cost-exposure consensus in American health care that shows how the next wave of reform can secure real access and efficiency.

The toxic battle over how to reshape American health care has overshadowed the underlying bipartisan agreement that health insurance coverage should be incomplete. Both Democrats and Republicans expect patients to bear a substantial portion of health care costs through deductibles, copayments, and coinsurance. In theory this strategy empowers patients to make cost-benefit tradeoffs, encourages thrift and efficiency in a system rife with waste, and defends against the moral hazard that can arise from insurance. But in fact, as Christopher T. Robertson reveals, this cost-exposure consensus keeps people from valuable care, causes widespread anxiety, and drives many patients and their families into bankruptcy and foreclosure.

Marshalling a decade of research, Exposed offers an alternative framework that takes us back to the core purpose of insurance: pooling resources to provide individuals access to care that would otherwise be unaffordable. Robertson shows how the cost-exposure consensus has changed the meaning and experience of health care and exchanged one form of moral hazard for another. He also provides avenues of reform. If cost exposure remains a primary strategy, physicians, hospitals, and other providers must be held legally responsible for communicating those costs to patients, and insurance companies should scale cost exposure to individuals’ ability to pay.

New and more promising models are on the horizon, if only we would let go our misguided embrace of incomplete insurance.

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front cover of Final Report
Final Report
Evaluation of Tools and Metrics to Support Employer Selection of Health Plans
Soeren Mattke
RAND Corporation, 2014
The Affordable Care Act places strong emphasis on quality of care as a means to improve outcomes for Americans and promote the financial sustainability of our health care system. This report attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools that can be used to evaluate plan options.
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The Financing of Catastrophe Risk
Edited by Kenneth A. Froot
University of Chicago Press, 1999
Is it possible that the insurance and reinsurance industries cannot handle a major catastrophe? Ten years ago, the notion that the overall cost of a single catastrophic event might exceed $10 billion was unthinkable. With ever increasing property-casualty risks and unabated growth in hazard-prone areas, insurers and reinsurers now envision the possibility of disaster losses of $50 to $100 billion in the United States.

Against this backdrop, the capitalization of the insurance and reinsurance industries has become a crucial concern. While it remains unlikely that a single event might entirely bankrupt these industries, a big catastrophe could place firms under severe stress, jeopardizing both policy holders and investors and causing profound ripple effects throughout the U.S. economy.

The Financing of Catastrophe Risk assembles an impressive roster of experts from academia and industry to explore the disturbing yet realistic assumption that a large catastrophic event is inevitable. The essays offer tangible means of both reassessing and raising the level of preparedness throughout the insurance and reinsurance industries.

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Free for All?
Lessons from the RAND Health Insurance Experiment
Joseph P. Newhouse
Harvard University Press
From 1971 to 1982, researchers at the RAND Corporation devised an experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge? and what are the consequences for their health? This book presents a comprehensive account of the experiment and its findings. It will be an invaluable teaching tool and reference for anyone concerned with health-care policy.
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The Future of Health Policy
Victor Fuchs
Harvard University Press

Americans are understandably concerned about the runaway costs of medical care and the fact that one citizen out of seven is without health insurance coverage. Solving these problems is a top priority for the Clinton administration, but as Victor Fuchs shows, the task is enormously complex. In this book Fuchs, America's foremost health economist, provides the reader with the necessary concepts, facts, and analyses to comprehend the complicated issues of health policy. He shows why health care reform that benefits society as a whole will unavoidably burden certain individuals and groups.

Fuchs addresses such central questions as cost containment, managed competition, technology assessment, poverty and health, children's health, and national health insurance. The future of U.S. health policy, he argues, is tightly linked to three basic questions; First, how can we disengage health insurance from employment? Second, how can we tame technological change in health care? And finally how can we cope with the runaway medical costs of an aging society?

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How Our Days Became Numbered
Risk and the Rise of the Statistical Individual
Dan Bouk
University of Chicago Press, 2015
Long before the age of "Big Data" or the rise of today's "self-quantifiers," American capitalism embraced "risk"--and proceeded to number our days. Life insurers led the way, developing numerical practices for measuring individuals and groups, predicting their fates, and intervening in their futures. Emanating from the gilded boardrooms of Lower Manhattan and making their way into drawing rooms and tenement apartments across the nation, these practices soon came to change the futures they purported to divine.

How Our Days Became Numbered tells a story of corporate culture remaking American culture--a story of intellectuals and professionals in and around insurance companies who reimagined Americans' lives through numbers and taught ordinary Americans to do the same. Making individuals statistical did not happen easily. Legislative battles raged over the propriety of discriminating by race or of smoothing away the effects of capitalism's fluctuations on individuals. Meanwhile, debates within companies set doctors against actuaries and agents, resulting in elaborate, secretive systems of surveillance and calculation.

Dan Bouk reveals how, in a little over half a century, insurers laid the groundwork for the much-quantified, risk-infused world that we live in today. To understand how the financial world shapes modern bodies, how risk assessments can perpetuate inequalities of race or sex, and how the quantification and claims of risk on each of us continue to grow, we must take seriously the history of those who view our lives as a series of probabilities to be managed.
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How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?
David I. Auerbach
RAND Corporation, 2014
This report identifies potential mechanisms through which the Affordable Care Act (ACA) might affect liability claim costs and develops rough estimates of the size and direction of expected impacts as of 2016. Overall, effects of the ACA appear likely to be small relative to aggregate auto, workers’ compensation, and medical malpractice insurer payouts, but some states and insurance lines may experience cost changes as high as 5 percent or more.
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Insurance Era
Risk, Governance, and the Privatization of Security in Postwar America
Caley Horan
University of Chicago Press, 2021
Charts the social and cultural life of private insurance in postwar America, showing how insurance institutions and actuarial practices played crucial roles in bringing social, political, and economic neoliberalism into everyday life.

Actuarial thinking is everywhere in contemporary America, an often unnoticed byproduct of the postwar insurance industry’s political and economic influence. Calculations of risk permeate our institutions, influencing how we understand and manage crime, education, medicine, finance, and other social issues. Caley Horan’s remarkable book charts the social and economic power of private insurers since 1945, arguing that these institutions’ actuarial practices played a crucial and unexplored role in insinuating the social, political, and economic frameworks of neoliberalism into everyday life.

Analyzing insurance marketing, consumption, investment, and regulation, Horan asserts that postwar America’s obsession with safety and security fueled the exponential expansion of the insurance industry and the growing importance of risk management in other fields. Horan shows that the rise and dissemination of neoliberal values did not happen on its own: they were the result of a project to unsocialize risk, shrinking the state’s commitment to providing support, and heaping burdens upon the people often least capable of bearing them. Insurance Era is a sharply researched and fiercely written account of how and why private insurance and its actuarial market logic came to be so deeply lodged in American visions of social welfare.
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The Liability Century
Insurance and Tort Law from the Progressive Era to 9/11
Kenneth S. Abraham
Harvard University Press, 2008

Kenneth Abraham explores the development and interdependency of the tort liability regime and the insurance system in the United States during the twentieth century and beyond, including the events of September 11, 2001.

From its beginning late in the nineteenth century, the availability of liability insurance led to the creation of new forms of liability, heavily influenced expansion of the liabilities that already existed, and continually promoted increases in the amount of money that was awarded in tort suits. A “liability-and-insurance spiral” emerged, in which the availability of liability insurance encouraged the imposition of more liability, and, in turn, the imposition of liability encouraged the further spread of insurance.

Liability insurance was not merely a source of funding for ever-greater amounts of tort liability. Liability insurers came to dominate tort litigation. They defended lawsuits against their policyholders, and they decided which cases to settle, fight, or appeal. The very idea behind insurance––that spreading losses among large numbers of policyholders is desirable––came to influence the ideology of tort law. To serve the aim of loss spreading, liability had to expand.

Today the tort liability and insurance systems constantly interact, and to reform one the role of the other must be fully understood.

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Making Security Social
Disability, Insurance, and the Birth of the Social Entitlement State in Germany
Greg Eghigian
University of Michigan Press, 2000
While welfare has been subject to pronounced criticism throughout the twentieth century, social insurance has consistently enjoyed the overwhelming support of European policy makers and citizens. This volume argues that the emergence of social insurance represents a paradigmatic shift in modern understandings of health, work, political participation, and government. By institutionalizing compensation, social insurance transformed it into a right that the employed population quickly came to assume.
Theoretically informed and based on intensive archival research on disability insurance records, most of which have never been used by historians, the book considers how social science and political philosophy combined to give shape to the idea of a "social" insurance in the nineteenth century; the process by which social insurance gave birth to modern notions of "disability" and "rehabilitation"; and the early-twentieth-century development of political action groups for the disabled.
Most earlier histories of German social insurance have been legislative histories that stressed the system's coercive features and functions. Making Security Social, by contrast, emphasizes the administrative practices of everyday life, the experience of consumers, and the ability of workers not only to resist, but to transform, social insurance bureaucracy and political debate. It thus demonstrates that social insurance was pivotal in establishing a general attitude of demand, claim, and entitlement as the primary link between the modern state and those it governed.
In addition to historians of Germany, Making Security Social will attract researchers across disciplines who are concerned with public policy, disability studies, and public health.
Greg Eghigian is Associate Professor of History, Penn State University.
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The Medical Malpractice Myth
Tom Baker
University of Chicago Press, 2005
American health care is in crisis because of exploding medical malpractice litigation. Insurance premiums for doctors and malpractice lawsuits are skyrocketing, rendering doctors both afraid and unable to afford to continue to practice medicine. Undeserving victims sue at the drop of a hat, egged on by greedy lawyers, and receive eye-popping awards that insurance companies, hospitals, and doctors themselves struggle to pay. The plaintiffs and lawyers always win; doctors, and the nonlitigious, always lose; and affordable health care is the real victim.

This, according to Tom Baker, is the myth of medical malpractice, and as a reality check he offers The Medical Malpractice Myth, a stunning dismantling of this familiar, but inaccurate, picture of the health care industry. Are there too many medical malpractice suits? No, according to Baker; there is actually a great deal more medical malpractice, with only a fraction of the cases ever seeing the inside of a courtroom. Is too much litigation to blame for the malpractice insurance crisis? No, for that we can look to financial trends and competitive behavior in the insurance industry. Are these lawsuits frivolous? Very rarely. Point by point, Baker—a leading authority on insurance and law—pulls together the research that demolishes the myths that have taken hold about medical malpractice and suggests a series of legal reforms that would help doctors manage malpractice insurance while also improving patient safety and medical accountability.

President Bush has made medical malpractice reform a priority in his last term in office, but if history is any indication, legislative reform would only worsen the situation and perpetuate the gross misunderstanding of it. The debate surely will be transformed by The Medical Malpractice Myth, a book aimed squarely at general readers but with radical conclusions that speak to the highest level of domestic policymaking.
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front cover of Navigating the Cultures of Health Care and Health Insurance
Navigating the Cultures of Health Care and Health Insurance
Highly Skilled Migrants in the U.S.
Nina Zeldes
University College London, 2023
A qualitative and quantitative approach to the study of foreign patients’ utilization and assessment of health care in the United States.

What are the barriers preventing migrants from accessing and successfully using health care in their new home country? Do these barriers vary based on the migrants’ country of origin? And are they a problem for highly skilled migrants, who often have well-paid jobs and health insurance provided by their employers? Based on field research conducted in the Washington DC area, Navigating the Cultures of Health Care and Health Insurance brings together mixed methods, qualitative, and quantitative approaches to the study of foreign patients’ utilization and assessment of health care in the United States. Through interviews with both health care providers and patients, attitudes toward health insurance and medical treatment are compared for migrants from three countries with very different cultural backgrounds and health insurance systems: Germany, India, and Japan. 
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front cover of Perceptions of Technological Risks and Benefits
Perceptions of Technological Risks and Benefits
Leroy C. Gould
Russell Sage Foundation, 1988
The election of Ronald Reagan in 1980 was said to herald a new mood of opposition to government regulation. But at the same time, large and vocal segments of the population have been demanding that corporations and regulatory agencies address public concerns about technological safety. What do we really know about people's perceptions of technological risk and their judgments about appropriate levels of technological regulation? Perceptions of Technological Risks and Benefits analyzes the results of a unique body of survey data—the only large-scale, representative survey of public attitudes about risk management in such technologies as nuclear power, handguns, auto travel, and industrial chemicals. The findings demonstrate that public judgments are not simply anti-technological or irrational, but rather the product of a complex set of factors that includes an awareness of benefits as well as a sensitivity to the "qualitative" aspects of risk (how catastrophic, dreaded, or poorly understood a hazard seems to be). This volume offers striking evidence that whatever Americans may think about government regulation in general, they are remarkably consistent in desiring stricter regulation of technological safety. These conclusions suggest that the current trend away from regulation of technology reflects a less than perfect reading of public sentiment.
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Probable Justice
Risk, Insurance, and the Welfare State
Rachel Z. Friedman
University of Chicago Press, 2020
Decades into its existence as a foundational aspect of modern political and economic life, the welfare state has become a political cudgel, used to assign blame for ballooning national debt and tout the need for personal responsibility. At the same time, it affects nearly every citizen and permeates daily life—in the form of pension, disability, and unemployment benefits, healthcare and parental leave policies, and more. At the core of that disjunction is the question of how we as a society decide who should get what benefits—and how much we are willing to pay to do so.

Probable Justice​ traces a history of social insurance from the eighteenth century to today, from the earliest ideas of social accountability through the advanced welfare state of collective responsibility and risk. At the heart of Rachel Z. Friedman’s investigation is a study of how probability theory allows social insurance systems to flexibly measure risk and distribute coverage. The political genius of social insurance, Friedman shows, is that it allows for various accommodations of needs, risks, financing, and political aims—and thereby promotes security and fairness for citizens of liberal democracies.
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Reinsuring Health
Why More Middle-Class People Are Uninsured and What Government Can Do
Katherine Swartz
Russell Sage Foundation, 2006
America's current system of health insurance, which relies almost exclusively on employer-sponsored coverage, is in danger of collapse, and this problem is not limited to the poor and working class. An increasing number of middle class Americans do not have employer-provided insurance and—due to skyrocketing premiums—cannot afford to purchase coverage for themselves. Reinsuring Health, by economist Katherine Swartz, examines this growing national crisis and outlines a concrete plan to make health insurance accessible and affordable for all Americans. Reinsuring Health documents why the number of uninsured Americans—now 45.5 million people—has grown in the last twenty-five years. Swartz focuses on how labor market changes—such as the decline of domestic manufacturing, decreased unionization, and the growth of non-standard work arrangements—have led U.S. employers to retreat from providing health insurance for their workers. These trends, combined with the increasing costs of medical care, have led to an explosion in health insurance premiums and a decline in coverage, particularly among the middle-class. Since those who seek insurance as individuals are generally most likely to need health care, private insurers charge higher premiums in the individual (non-group) markets than to people who obtain group insurance. This makes individual health insurance less attractive to the young and increasingly unaffordable for middle-class Americans. Similarly, insurers charge higher per person (or per family) premiums to small firms than to large companies, so many small firms do not sponsor coverage for their employees. Reinsuring Health shows how these problems can be overcome if the federal government provides a new reinsurance program which would protect insurance companies that provide small group and individual health insurance against the possibility that their policy-holders will incur very high medical expenses. By assuming some of the risk that people will face extremely costly medical bills, the government will make insurers less hesitant to offer coverage to high-risk individuals, and will help drive down premiums for others. Reinsuring Health demonstrates that this form of government reinsurance has worked in the past, helping to establish smooth running private markets for catastrophe insurance and secondary mortgages. Today, growing numbers of middle class Americans lack health insurance. Protection against the possibility of falling ill or getting hurt and having to pay extraordinary health care bills should not be a luxury available only to the very rich and the very poor. Reinsuring Health proposes a straightforward solution that would bring health insurance back within the reach of the increasing ranks of the uninsured, particularly those who are in the middle class.
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Reporting on Risk
How the Mass Media Portray Accidents, Diseases, Other Hazards
Eleanor Singer
Russell Sage Foundation, 1993
After acts of airline terrorism, air travel tends to drop dramatically—yet Americans routinely pursue the far riskier business of driving cards, where accidents resulting in death or injury are much more likely to occur. Reporting on Risk argues that this selective concern with danger is powerfully shaped by the media, whose coverage of potentially hazardous events is governed more by a need to excite the public than to inform it. Singer and Endreny survey a wide range of print and electronic media to provide an unprecedented look at how hundreds of different hazards are presented to the public—from toxic waste and food poisoning to cigarette smoking, from transportation accidents to famine, and from experimental surgery to communicable diseases. Their investigations raise thought-provoking questions about what the media tell us about modern risks, which hazards are covered and which ignored, and how the media determine when hazards should be considered risky. Are natural hazards reported differently than man-made hazards? Is greater emphasis placed on the potential benefits or the potential drawbacks of complex new technologies? Are journalists more concerned with reporting on unproven cures or informing the public about preventative measures? Do newspapers differ from magazines and television in their risk reporting practices? Reporting on Risk investigates how the media place blame for disasters, and looks at how the reporting of risks has changed in the past twenty-five years as such hazards as nuclear power, birth control methods, and industrial by-products have grown in national prominence. The authors demonstrate that the media often fail to report on risks until energized by the occurrence of some disastrous or dramatic event—the Union Carbide pesticide leak in Bhopal, the Challenger explosion, the outbreak of famine in Somalia, or the failed transplant of a baboon heart to "Baby Fae." Sustained attention to these hazards depends less on whether the underlying issues have been resolved than on whether they continue to unfold in newsworthy events. Reporting on Risk examines the accuracy and the amount of information we receive about our environment. It offers a critical perspective on how our perceptions of risk, as shaped by the media, may contribute to misguided individual and public choices for action and prevention in an increasingly complex world. The authors' probing assessment of how the media report a vast array of risks offers insights useful to journalists, policy analysts, risk specialists, legislators, and concerned citizens.
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Risk Acceptability According to the Social Sciences
Mary Douglas
Russell Sage Foundation, 1985
Every day, it seems, we become aware of some new technological or chemical hazard. Yet it is also possible that this very awareness is new, or at least newly heightened. Why are certain kinds of risks suddenly so salient? Are public perceptions of risk simply the sum of individual reactions to individual events, or do social and cultural influences play a role in shaping our definitions of safety, acceptable risk, and danger? Prompted by public outcries and by the confusion and uncertainty surrounding risk management policy, social scientists have begun to address themselves to the issue of risk perception. But as anthropologist Mary Douglas points out, they have been singularly reluctant to examine the cultural bases of risk perception, preferring to concentrate on the individual perceiver making individual choices. This approach leaves unexamined a number of crucial social factors—our concepts of what is "natural" or "artificial," for example; our beliefs about fairness, and our moral judgements about the kind of society in which we want to live. This provocative and path-breaking report seeks to open a sociological approach to risk perception that has so far been systematically neglected. Describing first some exceptions to the general neglect of culture, Douglas builds on these clues and on her own broad anthropological perspective to make a compelling case for focusing on social factors in risk perception. She offers a challenge and a promising new agenda to all who study perceptions of risk and, by extension, to those who study human cognition and choice as well. "An altogether brilliant piece of writing—far-reaching and a joy to read." —Amartya Sen, Oxford University A Volume in the Russell Sage Foundation's Social Science Frontiers Series
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Risk and Insurance Management Manual for Libraries
American Library Association
American Library Association, 2005

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Risk and Insurance Management Manual for Libraries, Updated
Sally Alexander
American Library Association, 2021

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Risk Management and Political Culture
Sheila Jasanoff
Russell Sage Foundation, 1986
This unique comparative study looks at efforts to regulate carcinogenic chemicals in several Western democracies, including the United States, and finds marked national differences in how conflicting scientific interpretations and competing political interests are resolved. Whether risk issues are referred to expert committees without public debate or debated openly in a variety of forums, patterns of interaction among experts, policy makers, and the public reflect fundamental features of each country's political culture. "A provocative argument....Poses interesting questions for the sociology of science, especially science produced for public debate."—Contemporary Sociology A Volume in the Russell Sage Foundation's Social Science Frontiers Series
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The Risk Professionals
Thomas Dietz
Russell Sage Foundation, 1987
In the two decades since a new social movement put environmental issues high on the national policy agenda, Washington has become home to a small group of people—the risk professionals—whose careers center on the identification, assessment, and management of risks to public health and safety. These men and women, experts working in federal agencies, Congress, activist organizations, and corporations, help transform mass concern into government policy, shaping the way our society responds to environmental and technological hazards. Based on nearly 230 interviews, The Risk Professionals provides the first comprehensive sociological analysis of our "danger establishment." Dietz and Rycroft explore the social, educational, and career profiles of risk professionals; their worldviews and ideologies; their networks and norms. Not content to view risk professionals from a single perspective, the authors build an integrated description that considers commonalities in their subjects' backgrounds, interests, values, and communication patterns. The result is a uniquely revealing look into the heart of the risk policy system, and a broader illumination of the social structures and dynamics that will influence environmental policy for years to come. A Volume in the Russell Sage Foundation's Social Science Frontiers Series
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Risk Taking
A Managerial Perspective
Zur Shapira
Russell Sage Foundation, 1995
Classical economic theory assumes that people in risk situations follow a course of action based on a rational, consistent assessment of likely outcomes. But as Zur Shapira demonstrates in Risk Taking, corporate managers consistently stray from the prescribed path into far more subjective territory. Risk Taking offers a critical assessment of the relationship between theory and action in managerial decision making. Shapira offers a definitive account of the classical conception of risky decision making, which derives behavioral prescriptions from a calculation of both the value and the likelihood of possible outcomes. He then demonstrates how theories in this vein have been historically at odds with empirical observations. Risk Taking reports the results of an extensive survey of seven hundred managers that probed their attitudes and beliefs about risk and examined how they had actually made decisions in the face of uncertainty. The picture that emerges is of a dynamic, flexible process in which each manager's personal expertise and perceptions play profound roles. Managerial strategies are continually modified to suit changing circumstances. Rather than formulating probability estimates, executives create potential scenarios based not only on the possible outcomes but also on the many arbitrary factors inherent in their own situations. As Shapira notes, risk taking propensities vary among managers, and the need to maintain control and avoid particularly dangerous results exercises a powerful influence. Shapira also examines the impact of organizational structure, long-term management objectives, and incentives on decision making. With perceptive observations of the cognitive, emotional, and organizational dimensions of corporate decision making, Risk Taking propels the study of managerial risk behavior into new directions. This volume signals the way toward improving managerial decision making by revealing the need for more inclusive choice models that augment classical theory with vital behavioral observations.
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Social Security and Retirement around the World
Edited by Jonathan Gruber and David A. Wise
University of Chicago Press, 1998
What accounts for the striking decline in labor force participation at increasingly younger ages? Social Security and Retirement around the World examines one explanation: social security programs actually provide incentives for early retirement. This volume houses a set of remarkable papers that present information on the social security systems, and labor force participation patterns, in Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Spain, Sweden, the United Kingdom, and the United States.
 
"This book is highly recommended for the serious student of retirement age trends and social security old-age pension policies of industrial nations in a cross-national context." Martin B. Tracy, Journal of Sociology and Social Welfare
 
“A path-breaking public-policy study. The authors consistently use a new methodology to evaluate the consequences of retirement systems on the behavior of older workers in eleven industrialized countries. In doing so, the book passes a major test of any conference volume the whole greatly exceeds the sum of its parts. This book without question provides the most consistent cross-national analyses of the work disincentives of retirement programs ever produces. Moreover it will serve as the model for all future efforts of this kind.” Journal of Economics
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Total Cure
The Antidote to the Health Care Crisis
Harold S. Luft
Harvard University Press, 2008

Proposals to reform the health care system typically focus on either increasing private insurance or expanding government-sponsored plans. Guaranteeing that everyone is insured, however, does not create a system with the quality of care patients want, the flexibility clinicians need, and the internal dynamics to continually improve the value of health care.

In Total Cure, Hal Luft presents a comprehensive new proposal, SecureChoice, which does all that while providing affordable health insurance for every American. SecureChoice is a plan that restructures payment for medical care, harnessing the flexibility and responsiveness of the market by aligning the incentives of clinicians, hospitals, and insurers with those of the patient. It uses the accountability of government to ensure transparency, competition, and equity.

SecureChoice has two major components. A universal pool covers the major risks of hospitalization and chronic illness, which account for almost two-thirds of all costs. Everyone would be in the pool, irrespective of employment, income, or health status. The second component emphasizes choice, flexibility, and responsibility. People will be able to choose any physician to serve as their “medical home,” to keep track of their health records, provide much of their care, and suggest referrals. Clinicians will have the information and incentives to continually enhance quality. SecureChoice also facilitates improvements in areas ranging from malpractice to pharmaceuticals and establishes new roles for key stakeholders such as health insurers.

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The Transformation of Old Age Security
Class and Politics in the American Welfare State
Jill Quadagno
University of Chicago Press, 1988
Why did the United States lag behind Germany, Britain, and Sweden in adopting a national plan for the elderly? When the Social Security Act was finally enacted in 1935, why did it depend on a class-based double standard? Why is old age welfare in the United States still less comprehensive than its European counterparts? In this sophisticated analytical chronicle of one hundred years of American welfare history, Jill Quadagno explores the curious birth of old age assistance in the United States. Grounded in historical research and informed by social science theory, the study reveals how public assistance grew from colonial-era poor laws, locally financed and administered, into a massive federal bureaucracy.
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Unaffordable
American Healthcare from Johnson to Trump
Jonathan Engel
University of Wisconsin Press, 2018
Written for nonexperts, this is a brisk, engaging history of American healthcare from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Step by step, Jonathan Engel shows how we arrived at our present convoluted situation, where generic drugs prices can jump 1,000 percent in a day and primary care physicians can lose 20 percent of their income at the stroke of a Congressional pen.

Unaffordable covers, in a conversational style punctuated by apt examples, topics ranging from health insurance, pharmaceutical pricing, and physician training to health maintenance organizations and hospital networks. Along the way, Engel introduces approaches that other nations have taken in organizing and paying for healthcare and offers insights on ethical quandaries around end-of-life decisions, neonatal care, life-sustaining treatments, and the limits of our ability to define death. While describing the political origins of many of the federal and state laws that govern our healthcare system today, he never loses sight of the impact that healthcare delivery has on our wallets and on the balance sheets of hospitals, doctors' offices, government agencies, and private companies.
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Understanding Disaster Insurance
New Tools for a More Resilient Future
Carolyn Kousky
Island Press, 2022
The frequency and intensity of natural disasters—such as wildfires, hurricanes, floods, and storms—is on the rise, threatening our way of life and our livelihoods. Managing this growing risk will be central to economic and social progress in the coming decades. Insurance, an often confusing and unpopular tool, will be critical to successfully emerging from the effects of these crises. Its traditional role is to protect us from unforeseen and unanticipated risk, but as currently structured, insurance cannot adequately respond to these types of threats. How can we improve insurance to provide consistent and sufficient help following all disasters? How do we use insurance not just to help us recover, but also to help us prevent disasters in the first place? And how can insurance help us achieve broader social and environmental goals?

Understanding Disaster Insurance provides an accessible introduction to the complexities—and exciting possibilities—of risk transfer markets in the U.S. and around the world. Carolyn Kousky, a leading researcher on disaster risk and insurance, explains how traditional insurance markets came to be structured and why they fall short in meeting the needs of a world coping with climate change. She then offers realistic, yet hopeful, examples of new approaches. With examples ranging from individual entrepreneurs to multi-country collaborations, she shows how innovative thinking and creative applications of insurance-based mechanisms can improve recovery outcomes for people and their communities. She also explores the role of insurance in supporting policy goals beyond disaster recovery, such as nature-positive approaches for larger environmental impact. The book holds up the possibility that new risk transfer markets, brought to scale, could help create more equitable and sustainable economies.  

Insurance and risk transfer markets can be a powerful tool for adapting to climate change, yet they are frequently misunderstood. Many find insurance confusing or even problematic and ineffective. Understanding Disaster Insurance is a useful guidebook for policymakers, innovators, students, and other decision makers working to secure a resilient future—and anyone affected by wind, fire, rain, or flood. 
 
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When All Else Fails
Government as the Ultimate Risk Manager
David A. Moss
Harvard University Press, 2004

One of the most important functions of government—risk management—is one of the least well understood. Moving beyond the most familiar public functions—spending, taxation, and regulation—When All Else Fails spotlights the government’s pivotal role as a risk manager. It reveals, as never before, the nature and extent of this governmental function, which touches almost every aspect of economic life.

In policies as diverse as limited liability, deposit insurance, Social Security, and federal disaster relief, American lawmakers have managed a wide array of private-sector risks, transforming both the government and countless private actors into insurers of last resort. Drawing on history and economic theory, David Moss investigates these risk-management policies, focusing in particular on the original logic of their enactment. The nation’s lawmakers, he finds, have long believed that pervasive imperfections in private markets for risk necessitate a substantial government role. It remains puzzling, though, why such a large number of the resulting policies have proven so popular in a country famous for its anti-statism. Moss suggests that the answer may lie in the nature of the policies themselves, since publicly mandated risk shifting often requires little in the way of invasive bureaucracy. Well suited to a society suspicious of government activism, public risk management has emerged as a critical form of government intervention in the United States.

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