Health Insurance in an Era of Declining Social Capital. (December 2020)

• Record Type: Journal Article
• Authors: Williams, Jackson
• Is Part Of: World affairs. Volume 183:Number 4(2020)
• Page Start: 343
• Page End: 358
• Publication Date: 2020-12
• Subjects: U.S. Health Insurance -- Welfare -- Healthcare -- Health Care -- Social Policy -- United States -- Social Capital -- Robert Putnam -- Bowling Alone -- Trust -- Reduced Reciprocity -- Higher Premiums -- Affordable Care Act -- Obamacare; Seguro médico de EE. UU -- Bienestar -- Atención médica -- Atención médica -- Política social -- Estados Unidos -- Capital social -- Robert Putnam -- Confianza -- Reciprocidad reducida -- Primas más altas; 美國健康保險 -- 福利 -- 醫療保健 -- 衛生保健 -- 社會政策 -- 美國 -- 社會資本 -- 羅伯特·普特南 -- 單獨打保齡球 -- 信託 -- 降低互惠 -- 更高的保費 -- 可負擔醫療法 -- 奧巴馬醫。; International relations -- Periodicals; Peace -- Periodicals; Arbitration (International law) -- Periodicals; United States -- Foreign relations -- Periodicals; Arbitration (International law); International relations; Peace; United states; Foreign relations; Internationale politiek; Periodicals; 327.05
• DOI: 10.1177/0043820020964220
• Languages: English
• ISSNs: 0043-8200

Abstract

Putnam's seminal work on social capital focused on early forms of health insurance as both a result, and accelerator, of the norms of reciprocity and social trust that foster cooperation. Yet, while social capital has been studied as a factor supporting community-based health insurance in developing countries, there has been no analysis of its role in U.S. health insurance. With repeal of the mandate to carry health insurance, this product is once again a purely voluntary purchase, and bears analysis as a cooperation problem. Putnam later documented a sharp decline in social capital in the United States. If social capital undergirds participation in health insurance, we can expect reduced reciprocity to lower willingness to cross-subsidize the sick. Waning social capital could also manifest itself in reduced trust that other healthy people will purchase insurance and lack of trust in the providers and manufacturers who make claims on the insurance pool.