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Pure community rating: a quick fix to avoid.

Insurance coverage denial and excessive premium rates have made the small employer health insurance market a popular target for sweeping reforms. Many proponents of small market insurance reform have advocated pure community rating by requiring carriers to charge the same rate to all of their customers as a solution. But legislating the use of pure community rating could do more harm than good in solving the problems of cost and access. A more sensible approach would limit rate differences through either rating bands or community rating by class.

Actuarial Analysis↗

Risk-sharing.

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Contract Services↗

GP fundholding--half a good policy.

GP fundholding has arguably achieved more desirable changes in health provision than any other facet of the health service reforms, but as a policy it remains incomplete and deeply flawed. The challenge is to build on the policy without losing the considerable positive achievements of the scheme. Christopher Fewtrell describes how North Derbyshire Health Authority approached this complex policy dilemma.

Cost-Benefit Analysis↗