Modern Economic Problems Part 14

-- 1. #Chance, unavoidable and average.# Every action and every movement in life has in it some element of chance. There are what may be called natural chances, arising from the uncertainties of the seasons, or from rainfall, heat, hail, storm, flood, lightning, or land-slides. Such chances must be taken both by the small enterpriser and by the large. In earlier conditions of society natural chance dominated industry, and it still remains and must always remain important. There is the chance of unexpected political events, such as war, riot, and legislation on money, tariffs, credit, and business relations. These things are caused, it is true, by the action of men, but it is a collective action out of the control of the individual.

There is the chance of human carelessness causing fire, explosions, and wrecks on misplaced switches. There is the chance of physical or mental collapse, as the sudden insanity or the sudden death of one performing responsible duties. There is the chance of sickness that often wrecks the plans and the fortunes of a whole family. There is the chance of economic alterations in methods of production and of transportation, in fashions and demand in this direction or for those materials.

Some of these chances are more connected with money-lending, others with manufacturing, some with agriculture, others with commerce; but all are present in some degree in every industry. Some events are unique in nature and seem unlikely ever to occur again; others are of a kind occurring so irregularly that no reasonable prediction can be made as to the time and frequency of their occurrences. Still others occur frequently and to many different persons; but no individual can tell when and how they will occur to him. A general average of chances in different lines of business causes some to be called safe, others extra-hazardous. Chance has its favorable as well as its unfavorable aspects. Chances are averaged and added algebraically to the profit or loss in an industry, for an extra-hazardous enterprise must in general afford a higher average of profit in order to induce men to engage in it. It is folly to take a risk without ascertaining its degree so far as general experience enables one to choose. But inasmuch and in so far as the gains and losses fall unequally upon different individuals, income depends upon chance.

-- 2. #Uneconomic character of gambling.# This prevalence of chance sometimes tempts men to say that business is "a gamble." But a distinction in principle must be made between gambling and legitimate risk-taking. The chances enumerated above are not sought, but avoided as far as possible; yet they must be borne by some one if productive enterprise is to continue, and the burden must somehow be distributed throughout the community. Gambling is, however, a kind of risk-taking which has a very different economic and moral quality. Gambling creates the hazard, making the gain or loss of income depend on an event that is not a necessary part of productive enterprise. Typical gambling is the transfer of wealth on the outcome of events absolutely unpredictable, so far as the two gamblers are concerned. Examples are the shaking of unloaded dice or the honest dealing of a pack of cards, and the betting on prices in so-called "bucket-shops" by persons having no connection with the market of real things, and seeking to get something for nothing as a result of mere chance.

Cheating is not a necessary mark of gambling, altho the cruder forms of dishonesty, such as the loading of dice or the collusion of horse-owners or of horse-jockeys to deceive the betting public, are so common that they seem often to be an essential feature. Gamblers recognize fair as opposed to unfair methods. Fair gambling is a kind of minor morality within the immoral field of gambling, like the honor found among thieves. The chance-taking in gambling has no useful purpose or result outside itself. Betting and gambling do not produce wealth, but merely shift the ownership of existing wealth. The gamblers const.i.tute themselves a little fict.i.tious economic circle, and they transfer gains and losses on the turn of events that have no practical objective result within their circle except to determine the direction of the transfer. Even when fairest, gambling must, in its average results, be uneconomic. In any economic trade each trader gains by getting goods that are, on the marginal principle, to him more valuable than the other kinds of goods he gives up.[1] But in gambling the winner gets all, the loser gets nothing. If two men of like incomes gamble the additional desires that the winner is able to gratify are (by the principle of decreasing gratification) less in amount than the desires which the loser must forego. As a result the loser is often depressed and seriously injured by the loss of his income, the winner makes reckless and extravagant use of his winnings.

Easy come, easy go, is the rule of gamblers.

Moreover, gambling reduces the amount of wealth by relaxing the motives of economic activity, diverting energy from productive enterprise, tempting men into dishonesty to offset their losses, and leading them into speculation and embezzlement.

-- 3. #Borderland of gambling.# Ranging between the extremes of unavoidable risk-taking and of gambling are a number of cases of a mixed nature. In nearly all wagers, judgment in some degree influences the choice of sides. One man bets on a horse whose pedigree and performances he knows thoroly; another judges by the horse's appearance as it comes upon the track. The professional bookmakers have the latest possible and most exact information on which to base their bids.

In the bets made on one's own prowess, as on speed in running, the chance-taking is still on the uneconomic side of the borderland, certainly if the running is for the sake of the wager, not for pleasure or for a useful purpose. A premium won by a runner for speed in delivering a message of economic importance presents an essential contrast to the winnings in a wager.

Finally, the very borderland of difficulty is reached in the purchase and sale of goods in the market with a view of profiting by chance changes in price. The purchasing and holding of land, lumber, grain, cattle, and other tangible and useful things, that need to be stored, held for buyers, or taken to market, must be judged liberally. The quality of gambling depends somewhat on the motive as well as on the ability of the trader. The enterpriser dealing with real wealth, and fitted to take the risks both because of his resources and of his exceptional knowledge, needs the motive of gain in such cases, and in a sense can be said to earn socially what he gets. The motive of the uninformed must be a blind trust in luck, and a hope to gain from a rise in prices which they are quite unable to foresee or to explain.

-- 4. #Insurance: definition and kinds.# The large element of luck in industry due to unavoidable chances has something of the same evil character as gambling. It brings unearned prizes to some and to others unmerited losses. It must therefore be a benefit to the community, if this element of unavoidable chance cannot be reduced as a whole, at least to regularize it and make it exactly calculable for any individual. In this way each may be encouraged by the more certain prospect of receiving a reward proportionate to his efforts and abilities. This desirable condition has in many respects been accomplished by means of insurance.

_Insurance_ is the act of providing a guarantee of indemnity against a financial loss that will result if an event of a specified kind occurs. The person seeking some surety against the possible loss is the _insured_; the person contracting to indemnify against the loss is the _insurer_; the written contract of insurance is the _policy_; and the price paid by the insured in fulfillment of his part of the contract is the _premium_; the amount paid when a loss has been incurred is the _indemnity_; and the person to whom the indemnity is paid is the _beneficiary_ (who may or may not be the insured).

The insurance with which we are here concerned is that which gives financial indemnity. This is given for loss of expected net income, when by chance either receipts are less or costs are more than average. The two main cla.s.ses as regards kinds of loss are property insurance and personal insurance. _Property insurance_ is that which indemnifies for loss of one's possession in specified ways, such as by fire, by the elements at sea (marine), by hail, lightning, or cyclone, by death (of valuable animals), by robbery, and by breakage (of window gla.s.s). _Personal insurance_ is that which indemnifies the beneficiary for loss of income as the result of various happenings to persons, the chief being death, accident, sickness, invalidity, old age, and unemployment. The principle of insurance is being constantly extended to new subjects[2] and it is capable of further development in a variety of directions.

-- 5. #Insurance viewed as a wager.# Insurance, without question a highly useful thing, appears, paradoxically, to be in its outer form a bet. The large merchant with many vessels used in many kinds of business had in the days before marine insurance an advantage in distributing his losses over a number of voyages. Antonio, the wealthy merchant, is made thus to express his security:

"My ventures are not in one bottom trusted Nor to one place; nor is my whole estate Upon the fortune of the present year.

Therefore my merchandise makes me not sad."

In its early form marine insurance was the attempt of smaller ship-owners to distribute their losses (as could the wealthy merchant) over a number of undertakings, lucky and unlucky. It became customary for a ship-owner to bet with a wealthy man that the ship would not return. If it did come back, the owner could afford to pay the bet; if it did not, he won his bet and thus recovered a part of his loss.

Gradually there came about a specialization of risk-taking by the men most able to bear it. They could tell by experience about what was the degree of uncertainty, and could lay their wagers accordingly. When several insurers were in the same business, compet.i.tion forced them to insure the vessel and cargo of the ordinary trader for something near the percentage of risk involved. The insurance thus tended to become a mutual protection to the ship-owners; what had to be paid in premiums to cover risk came to be counted as part of the cost of carrying on that business.

Every legitimate form of insurance exhibits substantially the same characteristics; it reduces loss at the margin where it is felt most keenly. The difference between insurance and gambling, thus, lies primarily in the purpose of insurance, which is not to increase artificially the risk that any individual runs, but to neutralize or offset an already existing chance. The insurance bet is what is called a "hedge." The difference lies further in the collective method of insurance, which combines the chances scattered among a number of persons. Insurance does not increase the total of risks and of losses, but merely combines, averages, and distributes them equally among all the insured. This eliminates the chance element to the individual by converting it into a regular cost.

-- 6. #Insurance as mutual protection.# Modern insurance is conducted either by enterprisers for profit, or by mutual companies; but in any case in large measure the losses in insurance are mutually shared, as the premiums (plus interest earned) equal the total losses plus operating expenses and profit, if any is made. Each insured gets a contract of indemnity for the payment of a sum that will help cover the losses of others. Such an exchange is mutually beneficial. The premium comes from marginal income; the loss if it occurs would fall upon the parts of income having higher value to the insured. The less urgent needs of the present are sacrificed in order to protect the income that gratifies the more urgent needs of the future. In insurance each party gives a smaller value for a greater; each makes a gain. The greater security in business stimulates effort. This effect is quite the opposite of that of gambling.

-- 7. #Conditions of sound insurance.# To be economically sound, insurance must have to do with real productive agents, and with a group of occurrences which, as a whole, are approximately ascertainable in advance--however irregularly they may fall upon individuals. The beneficiary must have an _incurable interest_ in the property or person insured; that is, the beneficiary must actually suffer a loss by the occurrence insured against. Finally, the amount of the indemnity must not be greater than the loss incurred. Some of the greatest difficulties in insurance arise from the absence of these essential conditions. When there is no insurable interest or when the indemnity is greater than the loss that may be incurred, the beneficiary may and sometimes does find it to his interest to bring about the socially injurious event insured against. He artificially increases the loss against which insurance was taken. When the insured sets fire to his own buildings, he makes an illegitimate use of insurance. Constant efforts are made by insurance companies to guard against these "moral risks," the least calculable of any. Merchants whose stocks have been mysteriously burned two or three times find difficulty in getting further insurance. Formerly insurance was not paid in case of death by suicide; but now usually no such limitation is contained in a policy after a period of one or more years. As men rarely plan suicide years in advance, death by one's own hand some years after taking life insurance is regarded as coming under the ordinary rules of chance. Yet it is to be feared that this liberal policy serves as a temptation at times to crime and to self-destruction.

-- 8. #Purpose of life insurance.# Property insurance is mainly an aspect of enterpriser's cost, whereas personal insurance is more closely connected with the object of saving.[3] We shall in the rest of this chapter limit the discussion to the one most important form of personal insurance, that called life insurance (sometimes called survivors' insurance).

Life insurance is that form of insurance in which partial indemnity is provided for survivors against the financial loss incurred by the death of the insured. Usually the insured is the breadwinner of the family and the beneficiary is a member of his family, but in an increasing number of cases the beneficiary is the surviving business partner, a creditor, or a business corporation with an insurable interest in the life of one of its employees.

Life insurance has been much used by persons mainly dependent on labor incomes[4] rather than on incomes from capital, by those receiving salaries, professional fees, and by active business men. It has of late been extended rapidly, as "industrial insurance" to wage earners, in policies never exceeding $1000, but averaging very much less, and often being for no more than enough to pay funeral expenses. The premiums on such policies are usually collected weekly and by agents making personal visits. The cost to the insured is, therefore, necessarily very high in proportion to the amount of insurance.

-- 9. #a.s.sessment plan.# Life insurance plans may be distinguished, with reference to the time and method of collecting the premiums, as a.s.sessment and reserve insurance.

In the simple form of a.s.sessment insurance originally the losses were paid by contributions taken after the losses occurred, each member paying an equal share without regard to age. In a slightly improved plan the a.s.sessments are made at the beginning of the year, based upon the expected mortality for the year. The sum just sufficient for this purpose (omitting expenses) is called the _natural premium_. The cost of such insurance is closely related to the average age of the members. The rates are very low in a new organization with a membership of young men; but each year the average age, and therefore the mortality of the membership, rises and the annual a.s.sessments must be increased. By constant additions of young members, this rise of cost may be r.e.t.a.r.ded. But when these members grow older, a still larger addition of young members is required to keep down the average, and the mathematically inevitable result is an increasing rate of a.s.sessment. This keeps young men from entering, and finally results in failure or in some form of "reorganization" that drives out the older members. The a.s.sessment plan carries with it the seeds of its own decay.

To meet these difficulties in part, various modifications of the flat-rate a.s.sessment plan are employed, such as cla.s.sification by age at entry, so that each member pays a flat-rate according to age at entry; or large initiation fees at entry which form a temporary "reserve" to offset increasing mortality in late years. Finally, the policies may be issued on the natural premium plan, by which the members of each age cla.s.s pay exactly what the insurance costs for the year. Under this plan the company will remain solvent, but with this and all the other expedients the surviving members are forced to drop the insurance in later years.

a.s.sessment insurance is sold by business companies organized for profit, by fraternal orders, and by various types of mutual organizations. The business companies have had a dismal history of hardship to surviving members and of eventual failure. They are disappearing under the influence of hostile legislation resulting from a better popular knowledge of insurance principles. The fraternal orders combine insurance with other objects of a benevolent and social character. With good management, a favorable death rate, and very low expenses, some of them have provided protection at very low rates for many years. Others have failed with disappointment and disaster to the older members. Still others are struggling with difficulties that presage dissolution. Many now have some form of reserve acc.u.mulations, and some have so improved their methods that they closely resemble reserve companies. The a.s.sets of all the a.s.sessment companies are now $1.37 per $100 of insurance in force, while the legal reserve companies have $22.66. The a.s.sessment companies now get 10 per cent of their total incomes from their funded investments, as against 24 per cent for the old-line companies. Even with the favorable conditions under which the fraternal orders conduct their insurance business they are doomed to failure unless they adopt rates and policies based upon adequate reserve acc.u.mulations. Many thousands of present members are paying for insurance at rates which will not suffice to meet the future losses. The a.s.sessment plan fails to eliminate the one great risk, that of leaving the survivors without insurance in advancing years.

-- 10. # The reserve plan.# The reserve plan, if honestly administered, gives complete protection against the difficulties just indicated. The essential purpose of the reserve plan is to collect during the earlier years of the insurance policy when the mortality is less, a sum larger than is needed to meet the current losses. This sum, the reserve, is kept invested and acc.u.mulating an income, sufficient to offset the increase in losses as years advance. In reserve insurance, therefore, the premium never increases from year to year, altho it may be so arranged as to diminish or to cease entirely sometime within the term for which the insurance continues.

The premium must always be fixed in advance. The calculations for determining the premiums on different kinds of insurance policies are many and complex, but all conform to a few general principles. The three factors a.s.sumed are an average mortality table, a rate of interest (or yield on investments), and an expense rate in proportion to the premiums or outstanding insurance. Insurance on the reserve plan is often called "scientific insurance" because, upon the basis of these a.s.sumptions resulting from experience, it makes exact mathematical calculations of the premiums and reserves needed for insurance of any particular kind in respect to age of insured, number of payments, method of paying the beneficiary, and any other conditions. The premium thus fixed is, however, only a maximum, and usually is reduced as the result of conditions more favorable than those a.s.sumed.

-- 11. #The mortality table.# When large numbers of men are taken as a group, a certain proportion of those at each age may be expected to die. A mortality table starts with a group of persons, as 100,000, at a given age, as 10 years, and shows the number who die and the number who survive at each year of age until all are dead. The table most widely used in the United States is the American Experience Table of Mortality, constructed by Sheppard Homans in 1868. The figures of this table, at different years, are given below:

Age Number Living Deaths each year Death rate per 1,000

10 100,000 749 7.49 20 92,637 723 7.80 30 84,441 720 8.43 35 81,822 732 8.95 40 78,106 765 9.79 50 69,804 962 13.78 60 57,917 1,546 26.69 70 38,569 2,391 61.99 80 14,474 2,091 144.47 90 847 385 454.54 95 3 3 1,000.00

The actual number of deaths of any group of insured will not correspond exactly with the figures of any mortality table. But this is not an essential defect of a table so long as the figures of the table are approximately correct and are at least as great in the earlier years as the actual mortality. For any excess of premium thus collected but increases the safety of the insurance and reduces later payments. In fact the mortality in nearly all companies in the United States is much below the figures of the American Experience Table, partly because of the influence of medical selection on the recently insured and partly because of the decided improvement in longevity since the table was constructed.

-- 12. #The single premium for any term.# It is evident that the natural a.s.sessment premium payable at the beginning of the year for $1000 of insurance for that year is expressed by the death rate, e.g., at age 35, the payment of $8.95 by each of the 81,822 living at the beginning of the year will provide the $732,000 needed to pay the losses.[5]

In the same manner would be determined the natural a.s.sessment premium for each year of insurance. Now, when it is possible to invest the premiums so as to yield a minimum rate of income it is a simple matter to determine the amount of a single premium, at any age, that is adequate to pay for insurance covering any selected number of years (term insurance) up to the entire period of each insured person's life (full life). It is necessary only to apply the formula of present worth and that of compound interest on investments.[6] Thus the expected losses of any year according to the table of mortality, divided by 1 + rate of yield on investments raised to the power of years distant, equals the present worth of insuring the entire group for that year. The sum of the discounted cost of insurance for all the years of the term divided by the number living at the beginning of the period, gives the single premium for each of the insured. Let P be the present worth of all the policies for a group of the same age, p the present worth of one policy, X the total insured at the beginning of the period, f the natural a.s.sessment premium this year, or the natural premium required for any year. Then

f f1 f2 fn P = __________ + _________ + ________ + _________ (l + r) (l + r)^2 (l + r)^3 (l + r)^n

P p = _________ X

The payment in advance of the single premium for any selected period provides a reserve fund sufficient, on the a.s.sumptions made, to carry all the insurance without further payments. Each year there is added to the fund the income earned on investments, and there is subtracted the amount of the losses for the year, until the death of the last member of the insured group. If the deaths in the earlier years are fewer than were expected in the mortality table, this will be offset eventually by more deaths at the advanced years; but in the meantime a reserve larger than was expected is yielding income, thus providing a larger sum than is needed to pay all the policies at maturity. This surplus might be distributed as so-called "dividends" from time to time to those surviving, or be added pro-rata, at intervals, to the amount of the policies as acc.u.mulated dividends.

-- 13. #Level annual premiums and reserves.# It is a matter of no very abstruse mathematics (in principle) to find the equivalent of this single premium in any one of many other forms of premium payment.

The processes are mainly but variations of present worth and compound interest calculations. Such calculations, however, lead into many complexities of practical detail difficult to explain in brief compa.s.s, and are the special task of the actuary (the mathematical expert dealing with such problems in the insurance business). The most useful actuarial equivalent of the single premium is the level annual premium for any period (term or life). Almost all policies now written have the level annual premium as a feature. The amount of the level annual premiums at first is greater than the losses; this causes for a time the steady acc.u.mulation of a reserve which yields income. Then, as the losses grow, they overtake and finally surpa.s.s the amount of the annual premiums. Therefore, the total reserve for any group of insured increases year by year to a maximum and then declines until it reaches zero with the payment of the last claim. The individual reserve for each policy not yet matured increases steadily the longer it is in force. The total reserve is essential to the solvency of the company and the payment of all the policies as they fall due. The companies which issue policies on the level premium plan or reserve plan are known as "old line" companies, or as "legal reserve"

companies, because the state laws require every company of this type to maintain the reserves calculated on the basis of a certain rate of yield. The growth of the legal reserve companies in recent times const.i.tutes one of the financial marvels of the age.

-- 14. #Different features of policies.# The premiums thus far discussed are "net premiums" estimated as just sufficient to meet the actual payments required by the contracts in the policies. To provide for the expenses of management an addition is made to the net premium called the "loading." The entire premium is called the "gross premium."

Reserve insurance is still carried on by a few stock companies, but of late some stock companies have been transformed into mutual companies, which are the prevailing type. The mutual company legally belongs to the policyholders. The gross premiums in reserve insurance are, for the purpose of safety, fixed at a figure larger than the expected cost of the insurance, and normally the earnings from interest are higher, the mortality is lower, and expenses are less than those on which the calculation of rates is based. From the excess of income resulting, the company sets aside a surplus and then divides the rest among the policyholders. These returns, virtually but the refund of excess premiums, are called "dividends" (a somewhat misleading term, not to be confused with dividends on corporate stock). The policies that receive dividends are called "partic.i.p.ating" and are said to partic.i.p.ate in the earnings. Formerly the majority of policies paid "deferred" dividends after 5, 10, or 20 years, according to various tontine and semi-tontine plans, the survivors to these periods receiving their dividends plus those of the other policyholders who had died or had withdrawn from the company. This form of payment having been found objectionable, it was made illegal in New York and other states, and in most cases dividends are now paid annually. The stock company, organized for profit, frequently charges lower premiums for "non-partic.i.p.ating" policies, and then retains such profits as may result from keeping expenses below receipts.

The most popular policies are term policies (usually for 5, 10, 15, or 20 years); ordinary life policies with annual premiums; limited payment life policies (the policy payable at death, with premiums fully paid up after 10, 15, or 20 years); and endowment policies (the face of the policy payable after 10, 15, or 20 years if the insured is still living). An endowment policy must be understood to be a regular term policy of insurance for the specified number of years, plus a plan of regular annual savings, which at compound interest, acc.u.mulate to the face of the policy. Many persons are attracted to endowment insurance by the oft expressed thought that "you don't have to die to beat it." But this is a mistaken thought. For the premium in endowment insurance is much higher than that for life insurance alone during the same period, so that the endowment is merely a pretty convenient but somewhat costly plan of saving, hitched on to an insurance policy, with which "actuarially," it has no essential connection. In "scientific"

insurance the insured pays its full actuarial cost for each additional feature of the policy that he buys. The various policies issued by a company are approximately equivalent actuarially, on the basis of the a.s.sumptions made, but they are of very different degrees of desirability, in view of the circ.u.mstances of the insuring individual. The choice of policies deserves a more careful investigation than it usually received.

Moreover, carelessness and ignorance in the choice of a company is responsible for widespread loss and suffering.

Policies differ in respect to the mode of payment. The payment usually takes the form of a lump sum payment at death or at the maturity of the endowment. In recent times there has been a growing use of optional forms of payment which give to the beneficiary annual or monthly installments for a definite number of years or for life.

-- 14. #Insurance a.s.sets and investments as savings.# The discussion of savings inst.i.tutions in the last chapter left unmentioned insurance, which probably is destined to be the most important of all. The a.s.sets of life insurance companies in the United States have already attained the enormous sum of $5,000,000,000, a sum equal to the reported savings bank deposits. In the last twenty years life insurance a.s.sets have more than doubled in each decade, and are now increasing by about a quarter of a billion dollars every year.[7] These great funds, which in equity nearly all belong to the policyholders, form already approximately one thirtieth of all the private capital of the country.

They are invested in many ways, in real estate, in loans secured by mortgages on real estate, in bonds--munic.i.p.al, railroad, and industrial. The problem of wise legislation for these organizations, of their competent and honest management, and of their relation to the social, business, and political life of the nation, is certain to be of ever-increasing importance. We are hardly more than emerging from the experimental stage of life insurance, hardly more than at the beginning of its development.

The premium in personal insurance (life, accident, sickness, invalidity, old age pensions) is in almost all cases paid out of some current income. The premium paid is just so much subtracted from the amount available for present direct use and applied to the purchase of future incomes for one's self or family. The insurance method differs from the method of depositing savings by its contingent nature, the resulting income of any individual being possibly much greater than the amounts actually saved (e.g., when the insured dies or is injured soon after taking insurance), and possibly less or nothing at all. A very desirable kind of insurance which is yet little developed is that for a term ending with the usual retirement age (say 65 years) combined with an old-age pension for life thereafter.

It is probable that abstinence will more and more express itself not in acc.u.mulating large capital sums to provide for one's old age or for survivors, but in providing insurance for survivors, and invalidity and old-age pensions for the insured and others, payable as terminable annuities. In any case the results to be expected in the changing forms and magnitude of private fortunes are certain to be great.

-- 15. #Excessive costs of insurance operation.# So beneficent is insurance that the enormous cost of transacting the business under present methods is much to be regretted. A very large part of the premiums paid by the insured is retained by the companies.[8] In the case of reserve life insurance a considerable part of what is not returned is, however, set aside as reserve virtually held in trust for the policyholders. In the case of the other kinds of insurance, nearly all of the amount not returned is either cost of operation or profits, tho it must be recognized that a part of the cost of some kinds of insurance is for real services, such as inspection and fire prevention. It is remarkable that the percentage returned by the life insurance companies, acc.u.mulating, as they do, large reserves in trust for the policyholders, is greater than it is for the other kinds of companies (fire, marine, casualty, surety, liability, accident, and health insurance).