upgrade

💸principles of economics review

Death Spiral

Written by the Fiveable Content Team • Last updated September 2025
Written by the Fiveable Content Team • Last updated September 2025

Definition

A death spiral refers to a situation where an insurance plan experiences a cycle of rising premiums and declining enrollment, leading to a downward spiral that ultimately results in the plan's collapse. This phenomenon is closely tied to the concepts of insurance and imperfect information.

5 Must Know Facts For Your Next Test

  1. The death spiral is often triggered by adverse selection, where healthier individuals opt out of the insurance plan, leaving a disproportionate number of high-risk individuals in the pool.
  2. As premiums rise to cover the increased costs, more healthy individuals choose to forgo coverage, further exacerbating the problem and leading to a self-reinforcing cycle of premium increases and enrollment declines.
  3. Moral hazard can also contribute to the death spiral, as insured individuals may be more likely to utilize healthcare services, driving up costs and necessitating further premium hikes.
  4. Effective risk pooling is crucial in preventing a death spiral, as it allows insurance providers to spread the risk across a larger and more diverse group of individuals.
  5. Government intervention, such as individual mandates or subsidies, can help mitigate the risk of a death spiral by incentivizing broader participation in the insurance pool.

Review Questions

  • Explain how adverse selection can lead to a death spiral in an insurance plan.
    • Adverse selection occurs when individuals with higher-than-average risk are more likely to seek out and purchase insurance coverage. This results in an imbalance in the insurance pool, with a disproportionate number of high-risk individuals. As the insurance provider raises premiums to cover the increased costs, healthier individuals are more likely to opt out of the plan, leaving an even higher proportion of high-risk individuals. This self-reinforcing cycle of premium increases and enrollment declines ultimately leads to the collapse of the insurance plan, known as a death spiral.
  • Describe the role of moral hazard in contributing to a death spiral.
    • Moral hazard refers to the tendency for insured individuals to engage in riskier behavior or utilize more healthcare services than they would without insurance. This increased utilization of services drives up the costs for the insurance provider, who then must raise premiums to cover these expenses. As premiums rise, healthier individuals are more likely to forgo coverage, leading to a disproportionate number of high-risk individuals in the insurance pool. This cycle of premium increases and enrollment declines is the hallmark of a death spiral, and moral hazard plays a significant role in exacerbating this phenomenon.
  • Evaluate the importance of effective risk pooling in preventing a death spiral, and discuss potential government interventions that could help mitigate this risk.
    • Effective risk pooling is crucial in preventing a death spiral, as it allows insurance providers to spread the risk across a larger and more diverse group of individuals. By including both high-risk and low-risk individuals in the insurance pool, the costs can be distributed more evenly, preventing the self-reinforcing cycle of premium increases and enrollment declines. Government interventions, such as individual mandates or subsidies, can help incentivize broader participation in the insurance pool, ensuring a more balanced risk distribution. These policies can help mitigate the risk of a death spiral by encouraging healthier individuals to maintain coverage, thereby stabilizing the insurance market and preventing the collapse of insurance plans.