I am away from my review copy, so I am pleased that Matt Yglesias has offered ($) a good “standing on one foot” summary of the plan, as outlined in the new book We’ve Got You Covered: Rebooting American Health Care, by Amy Finkelstein and Liran Einav: They call for: A universal basic insurance system,
The post The Amy Finkelstein and Liran Einav health care plan appeared first on Marginal REVOLUTION.
I am away from my review copy, so I am pleased that Matt Yglesias has offered ($) a good “standing on one foot” summary of the plan, as outlined in the new book We’ve Got You Covered: Rebooting American Health Care, by Amy Finkelstein and Liran Einav:
They call for:
A universal basic insurance system, covering both catastrophic and routine care but at a bare bones/no frills level of service.
A global budget, set by Congress, to determine how much money the basic plan has to spend on meeting the public’s basic needs, paired with expert panels to decide which services to cover.
An additive system of private top-up insurance that people could (and they anticipate mostly would) buy into to secure access to shorter wait times and more creature comforts.
The book offers a “think it through using first principles” approach, so perhaps the authors will be frustrated by my invocation of a “how has politics been going lately?” kind of response. Nonetheless I see that Obamacare cost the Democrats dearly in more than one election, it had to be defanged (the mandate) to survive, it was supposed to be the new comprehensive framework that actually could pass (it did), and the most influential Americans just love their employer-provided private health insurance.
Whether you think those facts are good or bad, I take them as my starting point for health care reform. This book does not.
I observe also that Obamacare passed, and American life expectancy fell. I do not blame Obamacare for that, but I do notice it. As a result, I have grown increasingly interested in “how can we boost biomedical scientific progress?” and increasingly less interested in “how can we reform health insurance coverage again?” All the more because we seem to be living in a biomedical progress of science golden age.
One of the Democratic Party frustrations with conservatives during the ACA debates was witnessing them tolerate or even support Romney’s Massachusetts plan, but oppose Obamacare. That I can understand. One of the conservative frustrations with ACA was the fear that it would just be the first step in a never-ending, upward-ratcheting series of efforts to spend ever more on health insurance coverage, which has positive but only marginal implications for health itself. After all, where exactly do the moral arguments for spending more on health insurance coverage stop?
Is there a politically feasible version of the Finkelstein and Einav plan that can spend less or the same? Is there a politically feasible version of the plan period? How much trust will there be in the promise that if I give up my private health insurance coverage, it will be replaced by something better? How much trust should there be?
But again, the authors here have a very different perspective on the sector and how to do health care policy.
The post The Amy Finkelstein and Liran Einav health care plan appeared first on Marginal REVOLUTION.
Books, Medicine, Uncategorized
