Document Type
Article
Abstract
It is time we view high deductible health plans (HDHPs) as immoral hazards. While these policies can generate a pocketbook benefit for many Americans, they also impose substantial and morally reprehensible societal costs. Prior scholarship on HDHPs has focused mainly on the economic principle of moral hazard-the idea that large deductibles prevent insured patients from overconsuming medical care and driving up prices. This patient-centric, overconsumption-focused moral hazard framework, while useful for understanding how deductibles can alter patient behavior and generate patient specific harms, leaves much of the HDHP story untold. This Article moves beyond the moral hazard theoretic to critically examine the hazards of HDHPs from a societal perspective. The societal costs of HDHPs are assessed through three novel frameworks: the HDHP as (1) a political pressure relief valve that sustains a democracy deficit; (2) an insurance device that imposes a substantial public health cost; and (3) a mechanism that thins the social, economic, and moral benefits of expanded health insurance coverage through a practice of human weeding. These frameworks are not the only possible ways of viewing the social hazards of HDHPs, but they provide a starting point for moving past the dominant but limiting concept of moral hazard.
Recommended Citation
Cogan, John Aloysius Jr., "Immoral Hazards" (2025). Faculty Articles and Papers. 637.
https://digitalcommons.lib.uconn.edu/law_papers/637