This is a followup to the previous post about health insurance elaborating on the fact that it can be bad to let individuals make choices about their insurance policy. I stated without much detail that “assuming sufficient options and perfect competition, the result of this individual choice would be exactly the same as if the insurers were allowed to use knowledge of $K$.” The “sufficient options” assumption is important (and not necessarily realistic), so more explanation is warranted.

Yes, it’s an extreme title, but it’s true. The idea of insurance is to average risk over a large group of people. If advance information exists about the outcomes of individuals, it’s impossible for a fully competitive free market to provide insurance. In particular, free markets cannot provide health insurance. To see this, consider a function $u : S \to R$ which assigns a utility value to each point of a state space $S$.