Arnold Kling  

Radical Health Care Reform

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Ezekiel J. Emanuel and Victor R. Fuchs write,


[Most health care reform plans] prop up the sagging employment-based insurance system, with all its inefficiencies and inequities, and preserve the second-class income-tested programs such as Medicaid...

The country needs comprehensive reform. Here are five essential changes:

· Get businesses out of health care...

· Guarantee every American an essential benefits package. This package -- modeled on what members of Congress get -- should be provided by qualified plans that would receive a risk-adjusted payment for each enrollee...

· The universal basic package should be financed by a dedicated tax that everyone pays, such as a value-added tax.

· Administer the program through an independent National Health Board...

· Establish an independent Institute for Technology and Outcomes Assessment to systematically evaluate new technologies and quantify their health benefits in relation to their costs.


I agree with the first idea of getting rid of employer-provided health insurance. I agree with the last idea, of conducting and disseminating research on cost-effectiveness.

However, Emanuel and Fuchs sound as though they are trying to provide equal health care to everyone. While I think that everyone could be given a decent "floor" in terms of health care, I do not see how it would be possible or desirable to enforce a ceiling as well. We are not going to shut down Canyon Ranch Health Spa, nor are we going to make it available to everyone. Inequality in health care is a reality that we will need to accept.


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TRACKBACKS (3 to date)
TrackBack URL: http://econlog.econlib.org/mt/mt-tb.cgi/643
The author at A Stitch in Haste in a related article titled Health Care Reform: Too Much of a "Good" Thing... writes:
    An op-ed in today's Washington Post provides a succinct summary of what some health care socialists have in mind:
    The [current] system ...
    [Tracked on February 7, 2007 11:51 AM]
COMMENTS (5 to date)
Randy writes:

Re; "Inequality in health care is a reality that we will need to accept."

Yes, this is the road block. If we can get past it we might actually get something done.

Nathan Smith writes:

re: "I think that everyone could be given a decent 'floor' in terms of health care..."

Who is everyone? All the American-born? Every American citizen? Everyone located on American soil? Everyone in the world?

You have to hold the line on welfare or else you hand the border-closers an argument.

EclectEcon writes:

I loved the idea of a floor when I first moved to Canada 35 years ago; unfortunately, the interventionist egalitarians are increasingly seeing that as a ceiling as well, "The rich should not be allowed to buy up all the health care in Canada," without regard for supply effects.

Jared writes:

We should give businesses incentives for high deductible health plans but not for low deductible copay plans. That would stop the high demand for health care and lower prices. Lets allow for more competition in the market - not take it all away!!

Jared writes:

Read this article to find out how to fix our health care system:
Click Here
The guy really knows what he is talking about.

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