Spanish legislation on insurance and reinsurance mediation stipulates that intermediary can only receive commissions and fees for the management of their policies and prohibits any other form of remuneration. However, it is possible that financial intermediaries who manage larger risks wait until the end of the legal deadline to settle with insurance companies. This common practice in the insurance market hides additional remuneration in defiance of the law. It also means that the risk is not covered within (...) the prescribed period and would, involve a commercial payment to the client, and, on the other hand, affect sustainable claims management. (shrink)

A broker’s activity is one of the elements of insurance mediation. Brokers sell property and personal as well as life insurance policies. Apart from the range of duties, the quantitative condition of distribution channels, the paper also discusses problems of a broker’s professional ethics, which include broadly understood information reliability, activation honesty and assistance in damage liquidation. Signed in 1998, the Sobieszew Charter lays out the norms of ethical broker’s activity in three dimensions: their contacts (...) with clients, mutual contacts and contacts with an insurance company. As well as that, the Charter created the Commission of Professional Ethics, the role of which is settling conflicts arising in the above-mentioned dimensions. The Charter also established seven main principles of professional ethics including the principle of a fair turnover or that of forming healthy relationships among brokers. The paper investigates the data concerning ethics in broker organizations, the major elements of which are a broker’s impartiality, conducting honest negotiations and the duty of submitting identical requests for proposal to insurance companies. The issue of insurance brokerage is not discussed. (shrink)

Relevance of the article is determined that the effective functioning of the reinsurance market greatly depends on the development of its infrastructure because it creates opportunities for implementation of reinsurance services, mediates, accelerates and facilitates placement and execution of reinsurance contracts. Given the state of the domestic insurance market mediation necessary means to enhance its development and integration into the global reinsurance market. The article is a study of measures to enhance the role of mediation in the insurance (...) market of Ukraine. The article provided a critical assessment of the legal status of insurance mediation in Ukraine. Factors that determine its role in the insurance market of Ukraine. Established quantitative and cost indicators of intermediation of brokers in insurance and reinsurance, given their logical explanation. Suggestions to create appropriate conditions for the development of mediation in the insurance and reinsurance markets in Ukraine. Mediation plays an important role in the development of the insurance market of Ukraine since: helping the participants to choose the most optimal proposal for the establishment of additional guarantees of the insurance liabilities; strengthening partnerships and trust between the reinsurer and the reinsurer; improves the quality and dynamics of sales reinsurance services; supports a healthy competitive environment in the reinsurance market. It was established that the quantitative and cost indicators of intermediation of brokers in insurance and / or reinsurance in Ukraine do not match. By number of deals leadership position with insurers-residents, the cost - non-resident reinsurers. The most attractive segment for mediation turned provision of agreements with non-resident reinsurers for property insurance. To create the appropriate conditions for the development of mediation in the insurance and reinsurance markets of Ukraine should: increase transparency of brokers to introduce their professional liability insurance and the formation of guarantee funds. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about your health might (...) end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

Commercialism first became a major problem for medicine in the decade of the 1970s, when huge quantities of new money began to flow into the healthcare system, as a result of Medicaid and Medicare, and the rapid expansion of private, employer-based insurance. Of course, physicians benefited, but most of this new money went to insurance plans and medical care delivery institutions, like hospitals, nursing homes, diagnostic services, and ambulatory care facilities of many kinds. Many of these were newly (...) established for-profit businesses. A vast number of satellite enterprises sprang up to serve the growing needs of the new businesses by providing services like marketing and advertising, brokering, consulting, information technology, financial services, case and disease management, billing and collecting, and so forth. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

We live in the era of Facebook, Fitbit, and Skype. As such, it would be unreasonable to expect that the healthcare industry would not see the same kind of globalization as do our social spheres and consumer activities. Indeed, the explosion of information technology, the ease of transcontinental travel, and the emergence of a more globally aware citizenry allows for scientific collaboration that has had many positive effects on global health. However, the economic and structural disparities between systems of healthcare (...) delivery in the industrialized world and parts of the developing world have created a monster in the form of an international medical tourism industry that endangers the health and safety of citizens of the host country as well as visiting patients. Not only does the practice of medical tourism pose a practical danger to those in direct contact with the industry, but it brings up troubling philosophical problems centering on national responsibility and the commodification of healthcare, among other important issues. In the United States, the driving force behind international medical tourism is the exorbitant cost of healthcare, particularly for the uninsured but also for the underinsured and those who experience catastrophic medical expenses from chronic illness or sudden health crises. Not only have individuals begun to look outside the U.S. for surgical procedures and other expensive therapies, but employers have begun to toy with the idea of outsourcing the medical care of the employees they insure in order to cut costs. In other industrialized nations, the issues that underpin international medical tourism are related to healthcare rationing and reflect different shortcomings in the delivery of healthcare in those nations, such as the United Kingdom and Canada, that have single-payer systems. Yet the regulatory and philosophical implications for both patients and hosts of international healthcare are largely the same. The challenge of regulating international trade in medical care is obvious and becomes particularly acute when there are insurers and employers involved. Complicating matters further, medical care that takes place outside the country of origin of the patient is often brokered by “medical concierge services,” which, though quick to claim indemnity from any harm arising from substandard or inappropriate medical care, cannot be divorced from responsibility for the health outcomes of their clients. Agreements hashed out between concierge services and patients specify that any remedy for harm stemming from their medical care must be pursued within the confines of the law of the host country, but the practical implications of this are troublesome. How can a foreign patient—often without either linguistic or cultural competency in the host country—be expected to navigate the complexity of a foreign legal system, particularly one that may be far less developed than his home country? Furthermore, if insurance companies and employers are involved with such care, who pays for an adverse result or determines responsibility for harm that may befall the patient? Under which countries’ laws? If a patient travels to Singapore for sexual reassignment surgery or a cardiac valve repair, returns to the States and suffers complications, who pays for the restoration of her health? Beyond legal standards and judicial remedies for harm to patients seeking care on the international market, there is the question of what ethical standards and norms apply to such patients. What effect does it have on American patients, for example, to receive care within a system that does not emphasize autonomy and informed consent the way they are used to? Why should foreign physicians care about the cultural mores of their patients’ country of origin? Can they be expected to grasp cultural differences between American, Canadian, and British patients? The medical concierge might respond, “Well, buyer beware!” This is unreasonable: It is nearly impossible for any patient to accurately assess the various options, risks and benefits that go with a particular medical treatment, much less the patient who is attempting to do so on the international market. And the crass invocation of the doctrine of caveat emptor betrays a view of healthcare as a commodity that is naive and inappropriate. Paramount in my mind, however, are the practical implications for the care of the citizens of developing nations that host international patients and the broader philosophical issue of what the goals of the medical profession as a whole and each country’s individual healthcare system should be. While I understand the argument that international medical tourism creates great economic gains for developing nations, which can then be channeled toward the care of their citizenry as a whole, there is much reason to doubt that this “trickle-down” model of economics provides real benefits for underserved, whether in healthcare or other arenas. What is more likely is that, while lucrative international “medi-cities” may keep bright doctors in their home countries, it is also likely to lure them away from the institutions that serve the lion’s share of their countrymen. With the concentration of talented native doctors in private hospitals that serve citizens of the developed world, the population at large is left to obtain care at institutions that suffer “brain drain” from the flight of talented local staff to more prestigious, often “brand name,” institutions that give them more Western-like salaries while allowing them to practice in their countries of origin. The very fact that citizens of the wealthiest nations in the world are forced to go abroad for life-saving care speaks to an abdication of national responsibility on the part of their home countries. The provision of health care is one of the principal responsibilities of any nation and it is unacceptable that a nation with the strength and wealth of the United States would take advantage of the weaker political and economic situations of developing nations in order to shirk its responsibility to its fellow citizens. If we take care of our countrymen and take pride in an equitable system of healthcare delivery, there will be no need to shrug our shoulders and say “Buyer beware” to the patient who heads to the Philippines for heart surgery. (shrink)

In order to assure optimal care of patients with chronic illnesses, it is necessary to take into account the cultural factors that may influence health-related behaviors, health practices, and health-seeking behavior. Despite the increasing number of Romanian Roma, research regarding their beliefs and practices related to healthcare is rather poor. The aim of this paper is to present empirical evidence of specificities in the practice of healthcare among Romanian Roma patients and their caregivers. Using a qualitative exploratory descriptive design, this (...) study is based on data gathered through three focus groups with 30 health mediators in the counties of Iasi and Cluj (Romania). We identified various barriers to access to healthcare for Roma patients: lack of financial resources and health insurance coverage, lack of cognitive resources or lack of personal hygiene, but also important cultural issues, such as the shame of being ill, family function, disclosure of disease-related information, patient’s autonomy, attitudes towards illness and health practices, that should be considered in order to create a culturally sensitive environment in Romanian medical facilities:… The role of the health mediators within the context of cultural diversity is also discussed, as cultural brokers contributing to health care quality among Romanian Roma patients Bridging cultural differences may improve patient–healthcare provider relationships, but may have limited impact in reducing ethnic disparities, unless coupled with efforts of Roma communities to get involved in creating and implementing health policies. (shrink)

This paper calls for a paradigm shift in studying academic dependency, towards the paradigm of brokered dependency. Using Chinese academia as an example, I demonstrate how the neocolonial condition of academic dependency is always mediated through blockage-brokerage mechanisms. The two most salient blockage-brokerage mechanisms of dependency in the Chinese context are linguistic barrier and authoritarian malepistemization, and the effects of the latter consist of three layers: institutional, informational and incorporational. On top of their domestic impacts, those mechanisms jointly exacerbate spectacularized (...) postcoloniality in anglophone-hegemonic global academic publishing. The paradigm of brokered dependency not only represents a more nuanced approach to the study of academic dependency, but also underscores the fact that the dismantling of the neocolonial condition cannot be conceived and pursued in isolation from comprehending and confronting the authoritarian condition, especially when the latter pertains under the disguise of anticolonialism. (shrink)

Prior research suggests brokers do not always act in the best interests of clients, although morally obligated to do so. We empirically investigated this issue focusing on trades executed at best execution price, before and after the introduction of electronic limit-order trading, on the London Stock Exchange. As a result of limit-order trading, the proportion of trades executed at the best execution price for the customer significantly increased. We attribute this to a sustained increase in the liquidity of stocks as (...) a result of limit-order trading, regardless of market capitalisation. We discuss the ethical implications of our findings and conclude that market structures that enhance market competitiveness may help reconcile broker and client interests. (shrink)

Knowledge brokers are among the main channels of communication between scientists and the public and a key element to establishing a relation of trust between the two. But translating knowledge from the scientific community to a wider audience presents several difficulties, which can be accentuated in times of crisis. In this paper we study some of the problems that knowledge brokers face when communicating in times of crisis. During the first wave of the COVID-19 pandemic, we collected interviews with Italian (...) experts that played a major role as knowledge brokers in the local media. We asked them questions about five main topics: the features and role of science communicators; the use of language in communicating science; the importance of the relation of trust with the public; the peculiarity of communicating in a context of emergency; the problem of disagreement among experts, and its public perception and communication. The goal of this paper is to understand, through the words of knowledge brokers themselves, what they consider as best practices (and obstacles) to create trust between scientists and the public. Our empirical work can inform normative accounts of what knowledge brokering should be about. (shrink)

This paper explores the interactions between scientific travel, politics, instrument making and the epistemology of scientific instruments in Napoleon's Europe. In the early 1800s, the German astronomer Franz Xaver von Zach toured Italy and Southern France with instruments made by G. Reichenbach in his newly-established Bavarian workshop. I argue that von Zach acted as a broker for German technology and science and that travel, personal contacts and direct demonstrations were crucial in establishing Reichenbach's reputation and in conquering new markets. (...) The rise of German instrument making highlights the complexity of the scientific relationship between the centre and the peripheries in Napoleon's empire, and reveals the existence of diverging views on the role of instruments and of their makers. In von Zach's view, Reichenbach's instruments could not penetrate the French market because Parisian astronomers focused on mathematical astronomy and, for both political and epistemological reasons, dismissed instruments and material innovations from the peripheries. The German astronomer and his Italian colleagues, on the contrary, regarded Reichenbach's technical achievements as outstanding contributions to astronomy, and considered the political and cultural hegemony of the capital as a hindrance to the advancement of science. (shrink)

Over 1.3 billion people in the world are challenged to access good and cheap healthcare when become ill. Health insurance policies are a fantastic strategy to assist people who can't afford medical care. For middle- and low-income nations, there hasn't been much research on the ability to pay for health insurance for public employees like school teachers. Therefore, this cross-sectional questionnaire based research has been undertaken to explore the reflection of health insurance among 383 Bangladeshi school teachers (...) of 5 divisional city center primary school and were being surveyed online between 1st August to 30th August 2022. According to survey, monthly average (mean) health expenditure of respondents were 7668.93 BDT (Bangladeshi Taka equivalent to $80.72) with 95% confidence interval. Of 35% responders suffered from high blood pressure, approximately 8% people were suffering from arthritis and asthma, 7.8% people have heart disease and 8.1 % people suffer from cholesterol problem. Maximum respondents (80%) agreed that health insurance is burden for them. About 51% teachers had no idea about health insurance. However, there was no significant relation in between educational status and health insurance perception for male and female teacher respondents. Moreover, the comparative data highlighted that more awareness and more exploration might be needed in health insurance perception for primary school teachers. This result can contribute to form people’s choice-oriented health insurance policy. (shrink)

In recent years, researchers and practitioners have increasingly paid attention to food waste, which is seen as highly unethical given its negative environmental and societal implications. Waste recovery is dependent on the creation of connections along the supply chain, so that actors with goods at risk of becoming waste can transfer them to those who may be able to use them as inputs or for their own consumption. Such waste recovery is, however, often hampered by what we call ‘circularity holes’, (...) i.e., missing linkages between waste generators and potential receivers. A new type of actor, the digital platform organization, has recently taken on a brokerage function to bridge circularity holes, particularly in the food supply chain. Yet, extant literature has overlooked this novel type of brokerage that exploits digital technology for the transfer and recovery of discarded resources between supply chain actors. Our study investigates this actor, conceptualized as a ‘circularity broker’, and thus unites network research and circular supply chain research. Focusing on the food supply chain, we adopt an interpretive inductive theory-building approach to uncover how platform organizations foster the recovery of waste by bridging circularity holes. We identify and explicate six brokerage roles, i.e., connecting, informing, protecting, mobilizing, integrating and measuring, and discuss them in relation to extant literature, highlighting novelties compared to earlier studies. The final section reflects on contributions, implications, limitations and areas for further research. (shrink)

This paper examines the planning, execution, and closure of the US–Korea Cooperative Ecological Survey project in the Korean Demilitarized Zone in the 1960s. In this period, the U.S. National Academy of Sciences initiated bilateral scientific cooperation between the NAS and similar organizations in developing countries along the line of the developmental turn of U.S. foreign assistance. Working closely with the NAS, U.S. conservationists used this scheme to introduce nature conservation practices and the discipline of ecosystem ecology to developing countries. In (...) this context, by way of the NAS’s Pacific Science Board, two countries’ biologists initiated the preliminary cooperative project in the DMZ in 1966. Korean and U.S. scientists soon began to realize that their collaboration was marked by dissonance. The U.S. side attributed the cooperation failure to Korean culture while the Korean side criticized the unequal structure of their cooperation. Joining the global historiography of Cold War scientific collaboration, this paper pays particular attention to the intermediaries of the collaborative project and their rivalry. It argues that political struggles revolving around the position of go-betweens – as what I call knowledge brokers – on the recipient side provoked contestation between American and Korean scientists. The contention between the two sides played out in the collaboration coming to an end, albeit partially. Throughout this analysis, this study suggests paying more serious attention to the politics of scientific exchange among actors on the recipient side as an outset from which to analyze the heterogeneity of the Korean side without losing sight of their active role in the building process of American hegemony. (shrink)

With the rise of research impact as a ‘third’ space (next to research and teaching) within the universities in the United Kingdom and beyond, academics are increasingly expected to not only produce research but also engage in brokering knowledge beyond academia. And yet little is known about the ways in which academics shape their practices in order to respond to these new forms of institutionalised expectations and make sense of knowledge brokering as a form of academic practice. Drawing on 51 (...) qualitative interviews with researchers and research users involved in two large knowledge brokering initiatives in the UK, this study identifies four repertoires of co-production practices: (i) _Challenge_ to the existing policy framework, (ii) _Deliberation_ between diverse stakeholders, (iii) _Evidence intervention_ producing of actionable knowledge, and (iv) _Advocacy_ for specific evidence-based options. By exploring knowledge brokering as navigation of different knowledge production regimes – traditionally academic and policy-oriented – the paper contributes to the existing debates by providing insights into the nature of navigating science-policy interactions as a process of epistemological bricolage, requiring an assemblage of different meanings, values and practices into new repertoires of practice. Importantly, the choice of a repertoire is not limited to the individual choice of a researcher but rather, it is shaped by the broader institutional context of higher education, risking _instrumental bias_ in which practices oriented towards practical solutions are incentivised over critical or participatory forms of engagement. (shrink)

The paper takes a look at insurance customer dishonesty as a special case of consumer ethics, understood as a way of situation handling, as a moral choice between right and wrong, such as between self-interest vs. common-interest, in other words, a “moral temptation”. After briefly raising the question if different schools, of moral philosophy would conceptualize such moral temptations differently, the paper presents ‘moral psychology’ as a frame of reference, with a focus on cognitive moral development, moral attitude and (...) moral neutralization. Conceptualization questions can’t be answered finally without thinking at the same time of empirical research design and instrument design decisions, e.g. choosing between experiment vs. questionnaire studies, designing suitable moral temptation situations as an experiment vs. questionnaires with scenario vignettes. The paper discusses then experiences from a 2004 pilot survey, with a main focus on a few insurance dishonesty scenarios with follow-up questions. The paper has an open end, i.e. outlines desirable future theoretical, empirical and practical work with insurance customer dishonesty. (shrink)

In this article I take a poem by Lisa Bellear as a starting point for theorizing the possibility of a renovated feminism. I argue that the rhetorical questioning of the poem performs a mode of intersubjectivity in which the addressee/reader reflects upon their whiteness. The poem drives directly into the dense affect that saturates the troubled zone of cross-racial relations in contemporary Australia. If this zone is characterized by white anger and anxiety, it is also a zone of intense `feeling' (...) for the indigenous poet. Jean-Luc Nancy defines literature as the act of the `opening [of] community to itself', that is, of communicating our being-in-common. The cross-racial encounter that Bellear brokers between an indigenous and a white woman through the performance of address in this poem is not entirely comfortable or governable. I discuss how my students find this poem so confronting, and the fact that this discomfort underlines the necessity for a pedagogy that accommodates what Spivak refers to as `moments of bafflement'. (shrink)

In Roger Pielke Jr.’s The Honest Broker (2007) he discusses different roles a scientist can adopt when giving advice to policymakers. The honest broker role focuses on clarifying and expanding the scope of choice for others. This role has the virtues of being sensitive to known problems with experts being partisan by stealth, dominating policy decisions by controlling knowledge input, and reducing the scope of considerations deemed relevant to decision-making. Yet I argue that to the extent the honest (...) broker role involves expanding the scope of choice, an array of problems arises. These include ambiguity about which and whose consensus ought to guide scientists in their decisions about what role to adopt, an implicit tendency to insulate politics from science, and a possible replication of the anti-pluralism of political populism. Drawing upon Phillip Pettit’s critique of Isaiah Berlin’s account of freedom as non-interference, I argue that the honest broker role for scientists inherits the problems afflicting accounts of freedom as the non-restriction of options: namely, the problems of adaptive preference formation and ingratiation. On this basis I suggest not advising scientists to be honest brokers, because doing so might fail to help them be reflexive scientists. (shrink)

Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph Heath considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved (...) in the provision of specific insurance is explained and justified by the greater efficiency of the state, in comparison with markets, in addressing market failures such as moral hazard or adverse selection. Our argument is that while insurance, intrinsically and idealistically, may diverge from a redistributive scheme, it is nevertheless difficult to deny that insurance has nothing to do with equality. More precisely, we argue that insurance may be understood as an egalitarian tool if our understanding of equality is broadened to include relational equality. Our paper aims to briefly recap the debates surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked given the domination of luck egalitarian approaches in these debates. (shrink)

SummaryThis paper explores the interactions between scientific travel, politics, instrument making and the epistemology of scientific instruments in Napoleon's Europe. In the early 1800s, the German astronomer Franz Xaver von Zach toured Italy and Southern France with instruments made by G. Reichenbach in his newly-established Bavarian workshop. I argue that von Zach acted as a broker for German technology and science and that travel, personal contacts and direct demonstrations were crucial in establishing Reichenbach's reputation and in conquering new markets. (...) The rise of German instrument making highlights the complexity of the scientific relationship between the centre and the peripheries in Napoleon's empire, and reveals the existence of diverging views on the role of instruments and of their makers. In von Zach's view, Reichenbach's instruments could not penetrate the French market because Parisian astronomers focused on mathematical astronomy and, for both political and epistemological reasons, dismissed instruments and material innovations from the peripheries. The German astronomer and his Italian colleagues, on the contrary, regarded Reichenbach's technical achievements as outstanding contributions to astronomy, and considered the political and cultural hegemony of the capital as a hindrance to the advancement of science. (shrink)

Microinsurance is the provision of insurance services to the poor, usually in developing countries. One of the key criteria of poverty is vulnerability even to minor events. In such cases, even micro coverage can make a major difference, yet still be funded by an affordable contribution by the insured. Like any kind of insurance, microinsurance can cover different risks to life, health, farming, property among other things. Our paper sketches how one could address and develop microinsurance business ethics. (...) First, we introduce microinsurance to the business ethics community and business ethics to the microinsurance community. Our draft of microinsurance ethics is then developed from two angles: as a holistic understanding of ideals and possible ethical conflicts in key stakeholder relationships and by distinguishing eight challenges when targeting the poor and when marketing microinsurance. As an open ending, the article suggests a three-stage action research design focusing on how microinsurance could (and should) internalize ethics, respecting rather than neglecting national- and local-cultural conditions. (shrink)

Many countries have imposed strict regulations on the genetic information to which insurers have access. Commentators have warned against the emerging body of legislation for different reasons. This paper demonstrates that, when confronted with the argument that genetic information should be available to insurers for health insurance underwriting purposes, one should avoid appeals to rights of genetic privacy and genetic ignorance. The principle of equality of opportunity may nevertheless warrant restrictions. A choice-based account of this principle implies that it (...) is unfair to hold people responsible for the consequences of the genetic lottery, since we have no choice in selecting our genotype or the expression of it. However appealing, this view does not take us all the way to an adequate justification of inaccessibility of genetic information. A contractarian account, suggesting that health is a condition of opportunity and that healthcare is an essential good, seems more promising. I conclude that if or when predictive medical tests (such as genetic tests) are developed with significant actuarial value, individuals have less reason to accept as fair institutions that limit access to healthcare on the grounds of risk status. Given the assumption that a division of risk pools in accordance with a rough estimate of people's level of (genetic) risk will occur, fairness and justice favour universal health insurance based on solidarity. (shrink)

Environmental politics needs more than piecemeal institutional efforts and more than calls for a set of 'new' values. It needs a realistic, comprehensive, and effective policy programme. Such a programme can be derived from a conjunction of Hardin's work on the 'tragedy of the commons' and Beck's analysis of the 'risk society', and involves exploiting the possibilities for the internalisation of risk provided by the insurance and reinsurance industries. Such exploitation requires tailored changes to the politico-legal environment, enforcing strict (...) liability for the production of risk, permitting any and all agents adversely effected by such negative externalities to initiate action for damages. The aim is not to clog up social and economic life with endless legal disputation, but through such a threat to ensure that environmentally significant investment and productive strategies are actively constrained by actuarially calculated strategies for risk internalisation. (shrink)

This article examines how a just society must address the needs of its imprudent members. I defend compulsory insurance as an answer to this question. It has been assumed that compulsory insurance can only be justified on paternalistic grounds. I argue that this assumption is incorrect, and defend non-paternalistic compulsory insurance. To display the merits of NPCI, I identify a trilemma that arises for views about how to address the needs of the imprudent, including libertarian and so-called (...) ‘ luck -egalitarian’ views. I then suggest that NPCI enables us to escape the trilemma. (shrink)

The aim of this article is to refute Ronald Dworkin's claim that the provision of an equal opportunity to insure against risks is sufficient to render differences in people's circumstances that are the result of luck consistent with his theory of equality of resources. Section I addresses bad luck in the circumstances of individuals in the form of mental or physical incapacitation resulting from the vicissitudes of nature. Section II addresses bad luck which is the result of the choices of (...) other individuals to give or bequeath. (shrink)

Insurance fraud and abuse—international concerns—are inherent in the proposition of insurance and prevalent in insurer–insured interactions. While the subject of considerable industry and regulatory attention, this little-researched area of consumer behavior and consumer ethics represents persistent social policy questions and problems at multiple levels. This article addresses the issue by first defining insurance fraud and its origins in contract, as well as consumer- and insurer-management. The authors conclude by re-envisioning the problem as one of co-creation by the (...) consumer-insured and insurer personnel, proposing a framework for its study and resolution. (shrink)

In his final years, Josiah Royce worked to develop his theories of community and interpretation in practical directions. In particular, he developed an account of insurance as a special community of interpretation, and proposed the creation of an international board of insurance as a deterrent for war. Rather than evaluating Royce’s policy recommendations, this paper explores how his conception of insurance clarifies his account of interpretation. For Royce, insurance provides the best model for communal interpretation thus (...) far because an insurer seeks to prevent loss in the face of risky action, in addition to adjudicating between competing claims. This paper concludes with some reflections on how the problem of moral hazard can inform a Roycean conception of philosophy. (shrink)

The study of community is an integral part of pragmatist thought, as is the continual reminder to reconstruct and re-evaluate our theories in light of changing conditions. A contemporary, literal, and significant source of changing conditions is anthropogenic global climate change, conjoined with a general increase in concern for non-human life. Already, a great deal of work has been done on applying pragmatist conceptions and insights to these issues.1 However, other pragmatist resources remain to be marshaled. One such resource is (...) Josiah Royce’s philosophy of insurance, which, while primarily offered as a way of preventing international conflicts, also concerned the mitigation of natural calamities, such as.. (shrink)

This paper draws on a study of numeracy coordinators in primary schools in the UK in the second year of the implementation of the National Numeracy Strategy (NNS). It identifies them as working between three main tasks: embedding the Strategy, sustaining teacher collegiality and auditing accountability. We identify tensions in 'being a coordinator' in relation to these tasks, especially for discourse and identity. We assess the usefulness of the metaphor of 'brokering' in 'communities of practice' (Wenger, 1998) to theorise such (...) tensions. We conclude with some reservations about the metaphor, especially in the way the tensions are discursively performed in relation to the rate of change, complexity of notions of professional identity, and the problematic 'community' status of audit in the educational context. (shrink)

Catastrophe insurance differs from regular insurance in that individual claims are correlated and insurers have to pay more clients at once, which creates a liquidity strain. In this paper, I show two related findings: first, that when customers know their claims are correlated, this correlation can cause positive-sloping demand at low prices, and second, that because of this, a catastrophe insurance market can fail. Market failure is a stable equilibrium, which provides a better understanding of the frequent (...) failures in catastrophe insurance markets. (shrink)

Madison Kilbride recently argued that insurance ) should cover in vitro fertilisation with preimplantation genetic testing services for couples at high risk of having a child affected with a genetic condition. She argues that IVF-PGT meets CMS’s definition of ‘medically necessary care’, where such care includes ‘services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms’. Kilbride argues that IVF-PGT satisfies this definition in two ways: as a diagnostic tool and as a treatment. (...) Contradicting Kilbride, however, I argue that IVF-PGT provides neither diagnosis nor treatment under CMS’s definition. Thus, as long as we accept CMS’s definition of medically necessary care—which Kilbride does, explicitly—it follows that IVF-PGT does not count as medically necessary care. Still, there may be other reasons to conclude that IVF-Preimplantation genetic testing should be covered, and so, it would be a mistake to reject Kilbride’s conclusion altogether. The problem is simply that Kilbride’s argument—that the procedure should be covered because it is medically necessary per CMS’s definition—is not sound. I conclude by discussing a number of other genetic services that are not currently being covered despite the fact that they do seem to satisfy CMS’s definition of ‘medically necessary diagnosis or treatment’. These services, I argue, should be provided under CMS before we consider expanding coverage to include elective procedures such as IVF-PGT. (shrink)

Insurance claim fraud costs insurance companies, policymakers, and taxpayers billions of dollars every year and has been described as the second largest white collar crime. The most common insurance fraud activity and one that contributes a significant portion of dollar losses is the practice of padding claim amounts in the event of a loss. One of the largest issues insurance companies face is that policyholders often do not perceive insurance claim padding as an unethical behavior. (...) However, very little research has examined the factors that contribute to such perceptions. Considering how consumers often attempt to justify fraudulent behavior from a fairness perspective, the present work examines how the amount of the deductible in an insurance claim situation can influence feelings of fairness and ethicality. The results of an experimental study show that higher deductible amounts result in stronger perceptions that insurance claim padding is fair to the insurance company, weaker perceptions that the behavior is unethical, and higher proposed claim award amounts. The study also shows, however, that the deductible amount effects are attenuated for consumers who display higher ethical standards as reflected by their scores on the consumer ethics scale. Implications are discussed with respect to the insurance industry, deviant consumer behavior, and general business ethics theory. (shrink)

This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the United States. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupations, and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations (...) include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the United States, and regional differences in safety-net coverage. Policy implications are discussed. (shrink)

While a number of jurisdictions internationally prohibit insuring companies to be able to use genetic information in their risk classification, a voluntary code of practice permits insurers the limited use of predictive genetic test results in the UK. Jonathan Pugh1 offers a pluralist justice-based argument in support of the UK practice. Pugh’s position is developed to avoid what he sees as flaws with the current debate on insurers’ access to genetic information, including an alleged reliance on idealised assumptions about the (...) predictive power of genetic test results, revisionary implications for the provision of insurance suggested in the debate and failings of commentators to engage adequately with a conception of justice that undergirds the status quo approach in the UK. Pugh suggests that a quasi-libertarian approach to justice is implicit within the terms of the present Code and should be phrased as a principle of equity. Further, he argues that basic egalitarian and non-comparative concerns should be captured in broad principles: equal access and need. This leaves him with three principles that should be balanced in order to guide protection insurance policy. When the argument is applied to review …. (shrink)

Most consumer morality studies focus on consumer immorality, i.e. different types and degrees of consumer dishonesty or deviance. This paper follows this tradition, by looking at insurance customer dishonesty. For looking at insurance customer dishonesty in a wider perspective, the paper drafts a sociology of insurance customer morality, including outlines of micro-level, meso-level and macro-level moral sociologies of insurance fraud, as well as a discussion of moral heterogeneity and a critical understanding of deviance. As a next (...) step a few empirical rsearch questions are formulated and illustrated with data from a Norwegian-German pilot study. (shrink)

We examine the relationship between social insurance contributions and earnings management for publicly listed firms in China. Our empirical results show that the social insurance contributions burden significantly reduces the degree of earnings management by reducing the level of free cash flow. Additionally, the negative relation between social insurance contributions burden and earnings management is more pronounced when the internal and external social insurance pressures are high and when the firms are large non-state-owned enterprises. We also (...) discuss the heterogeneity among firms for different financing constraints, external financing environment, regional marketization, and internal and external corporate governance. Finally, we further find that under the dual collecting system, although the social security administration is a better collecting agency, the local tax bureau acting with full responsibility is more effective than the collecting system. (shrink)

Beginning with the seminal work by Williams and Nagel, moral philosophers have used auto accident hypotheticals to illustrate the phenomenon of moral luck. Moral luck is present in the hypotheticals because two equally careless drivers are assessed differently because only one of them caused an accident. This Article considers whether these philosophical discussions might contribute to the public policy debate over compensation for auto accidents. Using liability and insurance practices in the United States as an illustrative example, the Article (...) explains that auto liability insurance substantially mitigates moral luck and argues that, as a result, the moral luck literature is unlikely to make a significant contribution to this public policy debate. The debate would benefit more from philosophical analysis of victims’ luck, which is not as substantially mitigated by liability insurance. (shrink)

The power of some new entrants to the music industry derives from their position as brokers in computer-mediated environments. Brokers act instrumentally to exploit their position within a network which, in turn, depends on their ability to build and sustain links (and, in computer-mediated environments, hyperlinks). Bricolage in computer-mediated entrepreneurship refers to the intuitive manipulation of resources in order to achieve (perhaps tacit) goals. Without careful stewardship of the new intellectual wealth thus created, bricolage may profit neither the individual nor (...) the wider community. (shrink)

Intermediaries are social agents who can be found in all types of different environments, cultures, and organizations. More often than enough, intermediaries are middlepersons between two power centers, yet their agency is precarious due to their position as brokers who gain from bridging otherwise unconnected parties, or marginalized vulnerable individuals who suffer from the invasion of the neighboring power holders. How can these two different perspectives of the intermediaries be reconciled? Under what conditions do they shift from one type of (...) agency to another? Previous scholarship attributes the agency of intermediaries to static positionality. This paper treats the position of the intermediary as an opportunity structure, which is shaped by multi-level relational dynamics. We show the changing agency of three intermediary tribal groups (i.e. the Tibetans in northwestern China, Uriyangqad Mongols, and Jurchens) who were situated between the sedentary Chinese and nomadic Mongols during the Ming dynasty (1368–1644) through a systematic study with horse trade data. The group-based and officially-regulated horse trade constituted the most important linkage between the intermediaries and these two power centers. We study the changes in the dynamics of their contact during trade, and explain why these intermediaries became client, client to two patrons, and broker in their trade with the Chinese and Mongols in different eras. We argue that the position of the intermediaries did not provide definite advantages for their exploitation, nor did it paralyze them with any concrete disadvantages. Rather, their position offered them unpredictable opportunities that arose from their relational dynamics with the power centers. Moreover, the self-serving and local interests of the intermediaries, and the strategies and tactics that they used, determined their capacity to respond to emerging and unpredictable opportunities and capitalize on them. (shrink)

Reviews issues in the ethics of access to health insurance based on health problems due to genetic inheritance.

Public insurance is both everywhere and nowhere. It is everywhere in the sense that it is omnipresent in industrialised societies: public health insurance, unemployment benefits and pensions. It is a sizeable part of modern nations’ public budget . It has permeated our understanding of societal institutions to the extent that now access to public insurance coverage is understood as being a struggle for equality and equal citizenship .Public insurance is only one aspect of a broader phenomenon: (...) the transformation of modern societies into insurance societies, i.e. societies that are orientated toward risk-management . Nevertheless, public insurance is at the core of the welfare state as insurance system. Paul Krugman once said of the modern state that it is ‘an insurance company with an army’ while David Moss argues that government is the ultimate risk manager ( .. (shrink)