Forbes December 20, 2024
Sachin H. Jain

The British economist Julian LeGrand suggested that public policy is grounded in a conception of humans as “knights,” “knaves,” or “pawns.” Human beings are motivated by virtue (knights) or rigid self-interest (knaves), or are passive victims of their circumstances (pawns). A society’s view of human motivation influences whether it builds public policies that are permissive, punitive, or prescriptive.

Le Grand’s observations were drawn from his studies of British social welfare policy and civil servants but could aptly be applied to health insurers and their role in the US health care system. Many health care debates-especially those relating to health care financing, quality, and education-implicitly prescribe a view of health insurers and their underlying motivations. This framework has previously been applied...

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