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May 17, 1941

Accident-and-Health Insurance

JAMA. 1941;116(20):2351. doi:10.1001/jama.1941.02820200121032

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All who have tried to apply the insurance principle to medical care have felt the need of a realistic and comprehensive treatment of the subjects discussed in this work. Hasty experimenting in the disability field brought heavy losses to New York life insurance companies. Incalculable elements are almost innumerable. Definitions of accident and disease are still many and conflicting. "Benefits provided to reimburse the insured for the costs of hospital and medical care represent the greatest variety of practice." The "moral hazard" multiplies these uncertainties. "No single factor equals it in importance in determining the acceptability of a risk." It varies according to age, sex, race, location and occupation, and it changes with the introduction of insurance and other social changes. Rates have so far been made largely by trial and error, and as a result loss ratios have been almost catastrophic. Tables of premiums and indemnities have now been

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