Entrepreneurial Healthcare: A Study in State Policy Arbitrage

  • Scott Jackson
Part of the International Studies in Entrepreneurship book series (ISEN, volume 17)


The author explores the relationship between entrepreneurship and health policy, specifically insurance policy, and the question of optimal design of insurance system to catalyze entrepreneurial activity in light of current policies designed primarily to address equity and cost issues. The analysis reviews the theory on the impact of social policy, specifically health insurance, upon the entrepreneur, and constructs a framework for analysis of health financing/insurance with respect to entrepreneurial activity. It presents a high level summary of current state initiatives and Health Savings Accounts (HSAs)/High-Deductible Health Plans (HDHPs) and evaluates them in light of this framework. The author finds that HSAs/ HDHPs and transitioning the insurance market to an individually oriented market remain the policy alternative most consistent with an entrepreneurial economy.


Entrepreneurial Activity Insurance Market Health Insurance Company Entrepreneurial Firm Small Business Owner 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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5.11 References

  1. Acs, Zoltan J., and Carl Schramm. 2006. A Roadmap for an Entrepreneurial Economy. Kansas City, Missouri: The E.W. Kaufman Foundation.Google Scholar
  2. AP. 2006. Doctors rip state Medicaid shift. Journal Gazette, Sept 28, 2006.Google Scholar
  3. Audretsch, David B. 1995. Innovation and Industry Evolution. Cambridge: MIT Press.Google Scholar
  4. Audretsch, David B., and A. Roy Thurik. 1998. The Knowledge Society, Entrepreneurship and Unemployment. In EIM Research Report. Zoetermeer, The Netherlands: Erasmus Institute of ManagementGoogle Scholar
  5. Audretsch, David, and Max Keilbach. 2004. Entrepreneurship Capital and Economic Performance. Regional Studies 38 (8):949–959.CrossRefGoogle Scholar
  6. Bate, Roger. 2003. Saving Lives Today and Tomorrow: Ensuring ongoing research into HIV/AIDs medicines. In Occasional Paper. Washington, DC: Africa Fighting Malaria.Google Scholar
  7. Baumol, William, Robert Litan, and Carl Schramm. 2006. Good Capitalism Bad Capitalism. Bridgeport, CT: Yale University Press.Google Scholar
  8. Blanchflower, D., and S. Oswald. 1998. What makes and entrepreneur? Journal of Labor Economics 16 (1):26–60.CrossRefGoogle Scholar
  9. Boyd, Dan. 2006. Legislature halts Medicaid reform: Kempthorne's ambitious proposal sees national interest, local concern. The Idaho State, March 1, 2006.Google Scholar
  10. Buttorff, Christine. 2006. Governor supports more at-home health services. Nashville City Paper, October 24, 2006.Google Scholar
  11. Cutler, D., and R. Zeckhauser. 1999. The Anatomy of Health Insurance. In Working Paper Washington, DC: National Bureau of Economic Research.Google Scholar
  12. Damberg, Cheryl L. 1996. Health Care Reform: Distributional Consequences of an Employer Mandate for Workers in Small Firms, Doctoral Dissertation. Santa Monica: RAND Graduate School.Google Scholar
  13. Eberstadt, Nicholas, and Sally Satel, M.D. 2004. Health and the Income Inequality Hypothesis. Washington DC: AEI Press.Google Scholar
  14. Editorial. 2006. A Runaway Drain: Texas must get a handle on Medicaid costs. The Dallas Morning News, Oct. 25, 2006.Google Scholar
  15. Foster-Higgins. 1994. National Survey of Employer-Sponsored Health Plans. New York: Foster-Higgins.Google Scholar
  16. Gruber, Jonathan, and Fames M. Poterba. 1994. Tax incentives and the decision to purchase health insurance: Evidence from the self-employed. Quarterly Journal of Economics 109 (August):707–733.Google Scholar
  17. Helms, Robert. 2001. Positive Economics and Dismal Policies: The Role of Tax Policy in the Current Health Policy Debate. In The Political Economy of Healthcare Reform, edited by H. Zhou. Kalamazoo: W. E. Upjohn Institute for Employment Research.Google Scholar
  18. Herrick, Devon M. 2006. Crisis of the Uninsured: 2006 Update. In Brief Analysis. Dallas, TX: National Center for Policy Analysis.Google Scholar
  19. Highfield, R., and R. Smiley. 1987. New Business Starts and Economic Activity. International Journal of Industrial Organization 5:51–66.CrossRefGoogle Scholar
  20. Klick, Jonathan, and Sally Satel, M.D. 2006. The Health Disparities Myth. Washington DC: AEI Press.Google Scholar
  21. Monheit, Alan C., and P. Holly Harvey. 1993. Sources of health insurance for the self employed: Does differential taxation make a difference? Inquiry (Rochester) 30 (3):293–305.Google Scholar
  22. Moon, Marilyn, Len M Nichols, and Susan Wall. 1996. Medical Savings Accounts: A Policy Analysis. Washington DC: Health Policy Center of the Urban Institute.Google Scholar
  23. Morgan-Chase, J.P. 2004. Chase Health Savings Account (HSA): 2006 Individual Participant HSA Enrollment Package: J.P. Morgan-Chase.Google Scholar
  24. Moritz, Robert. 2006. Officials say Medicaid drug evaluation plan saving state money. Arkansas News Bureau, Sunday, Oct 1, 2006.Google Scholar
  25. Morrisey, Michael A. 2003. Health Insurance. In National Small Business Poll, edited by J. W. J. Dennis. Washington, DC: National Federation of Independent Businesses.Google Scholar
  26. Ohsfeldt, Robert L., and John E. Schneider. 2006. The Business of Health. Washington DC: AEI Press.Google Scholar
  27. Perry, Charles W., and Harvey S. Rosen. 2004. The Self-Employed Are Less Likely to Have Health Insurance Than Wage Earners. So What? . In Public Policy and the Economics of Entrepreneurs, edited by D. Holtz-Eakin and H. S. Rosen. Cambridge: MIT Press.Google Scholar
  28. Robinson, James C. 2001. The End of Asymmetric Information. Journal of Health Politics, Policy and Law 26 (5):1045–1053.CrossRefGoogle Scholar
  29. Robinson, W. S. 1950. Ecological Correlations and the Behavior of Individuals. American Sociological Review 15 (3):351–357.CrossRefGoogle Scholar
  30. Medicaid Spending Growth Hits New Record Low for States. Improving economy allows many to leave this safety net for the poor. New Tech Media 2006 [cited October 11, 2006. Available from http://www.
  31. Shane, Scott. 2003. A General Theory of Entrepreneurship. Cheltenham: Edward Elgar.Google Scholar
  32. Tahmincioglu, E. 2006. Health Care at a Premium. New York Times, November 30, 2006.Google Scholar
  33. Vock, Daniel C. Patients Key to Latest Medicaid Reforms as States Roll Out Money-Saving Plans ‘Healthier beneficiaries are cheaper than sick-lier ones’ is the theme. New Tech Media 2006 [cited October 3, 2006. Available from
  34. Wahlberg, David. 2006. Extend SeniorCare, Doyle urges. Wisconsin State Journal, Tuesday, Oct. 24, 2006.Google Scholar
  35. Wolf, Charles Jr. 1997. Markets or Governments: Choosing Between Imperfect Alternatives. 2 ed. Cambridge: MIT Press.Google Scholar
  36. Zuckerman, Stephen, Jennifer Haley, and Matthew Fragale. 2001. Could Subsidizing COBRA Health Insurance Coverage Help Most Low-income Unemployed? In Health Policy Online: Timely Analysis of Current Trends and Policy Options. Washington, DC: Urban Institute.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Scott Jackson
    • 1
  1. 1.School of Public PolicyThe George Mason UniversityFairfaxUSA

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