Here’s a pretty simple point but one that seems to be getting lost in the “discussion.”
Insurance is plagued by an incentive problem. In an ideal insurance contract the insuree receives, in the event of a loss or unanticipated expense, a payment that equals the full value of that loss. This smooths out risk and improves welfare. The problem is that by eliminating risk the contract also removes the incentive to take actions that would reduce that risk. This lowers welfare.
In order to combat this problem the contracts that are actually offered are second-best: they eliminate some risk but not all. The insured is left exposed to just enough risk so that he has a private incentive to take actions that reduce it. The incentive problem is solved but at the cost of less-than-full insurance.
But building on this idea, there are often other instruments available that can do even better. For example suppose that you can take prophylactic measures (swish!) that are verifiable to the insurance provider. Then at the margin welfare is improved by a contract which increases insurance coverage and subsidizes the prophylaxis.
That is, you give them condoms. For free. As much as they want.
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March 5, 2012 at 9:40 am
am-cb
Thanks for posting this entry, which draws theory from Ehrlich and Becker’s 1972 work. Part of Ehrlich and Becker’s argument about self-insurance and self-protection is that if the insurer could verify the preventative activities, the premiums could be lowered. However, just giving away condoms doesn’t mean the insurer can observe whether the person is actually using them, or using them correctly. Thus, other forms of contraception such as birth control pills or IUD’s may be a better option. This is of course, assuming that pregnancy is the outcome you are trying to reduce. Prevention of STD’s may require other forms of prevention.
March 5, 2012 at 9:47 am
jeff
Thanks. I would add that just making sure you have condoms handy in case they are needed is a moral hazard problem that is solved by giving the condoms away for free.
March 5, 2012 at 10:51 am
David Pinto (@StatsGuru)
Aren’t condoms so cheap that they are essentially free? I see them as low as $0.20 per condom on Amazon.
March 5, 2012 at 1:44 pm
Daniel
Many health insurance plans give gym discounts, but I’ve never heard of condom discounts. If the effect is significant, why don’t insurance companies do it voluntarily?
April 4, 2012 at 2:08 pm
An Odyssey in Health Insurance: Can a Guy Get Some Free Condoms Already? « Playpen Report – The Sexiest Blog on the Planet!
[…] It shouldn’t be this hard for someone in a 1st world country, with insurance, to get the most common sense type of preventative care, that is to say, free-fucking-condoms. If spreading STIs and teen […]