In a market where insurers are not allowed to risk rate, we find evidence of advantageous selection using observed health expenditure risk. Selection is driven by income and optimism about the future. This may explain insurers’ profitability, despite community rating.

A linkage to reconcile measurable utility derived from intensity comparisons or from probability mixtures is provided in this note. This brief note is in honor of Lloyd Shapley whose relatively unknown seminal paper on measurable utility from axioms involving the fineness of perception offered a...