Healthy, Wealthy, and Wise 5 Steps to a Better Health Care System, Second Edition

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Edition: 2nd
Format: Hardcover
Pub. Date: 2011-03-01
Publisher(s): Hoover Institution Press
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Summary

Health care in the United States has made remarkable advances during the past forty years. Yet our health care system also has several well-known problems: high costs, significant numbers of people without insurance, and glaring gaps in quality and efficiency-and the Patient Protection and Affordable Care Act of 2010 is not the answer. This second edition of Healthy, Wealthy, and Wisedetails a better approach, offering fundamental reform alternatives centering on tax changes, insurance market changes, and redesigning Medicare and Medicaid. The book proposes five specific reforms to improve the ability of markets to create a lower-cost, higher-quality health care system that is responsive to the needs of individuals, including increasing individual involvement, deregulating insurance markets and redesigning Medicare and Medicaid, improving availability and quality of information, enhancing competition, and reforming the malpractice system. The authors show that, by promoting cost-conscious behavior and competition in both private markets and government programs such as Medicare and Medicaid, we can slow the rate of growth of health care costs, expand access to high-quality health care, and slow down runaway spending.

Author Biography

John F. Cogan is the Leonard and Shirley Ely Senior Fellow at the Hoover Institution, Stanford University. R. Glenn Hubbard is the Dean and Russell L. Carson Professor of Finance and Economics, Graduate School of Business, and a professor of economics at Columbia University. He is also a research associate at the National Bureau of Economic Research and a visiting scholar at the American Enterprise Institute. Daniel P. Kessler is a professor of economics, law, and policy at the Stanford University Graduate School of Business; a senior fellow at the Hoover Institution, Stanford University; and a research associate at the National Bureau of Economic Research.

Table of Contents

Preface to the Second Editionp. ix
Acknowledgmentsp. xiii
Introductionp. 1
The Challenge: Obtaining High-Quality, Affordable Health Carep. 9
The Good: Innovationp. 9
The Bad: High Costs and a Large Uninsured Populationp. 14
High Costs: No Easy Answerp. 14
The Uninsured Population: Many Causes, Uncertain Consequencesp. 19
The Ugly: Backlash against Markets and the Misguided Policy Responsep. 23
The Backlash against Marketsp. 24
The Misguided Policy Responsep. 25
Five Policy Reforms to Make Markets Workp. 31
Increase Individual Involvement in Health Care Decisionsp. 33
In Private Markets, Reform Taxation of Health Spendingp. 34
Increase Cost Sharing in Government Programsp. 49
Deregulate Insurance Markets and Redesign Medicare and Medicaidp. 52
Deregulate Insurance Marketsp. 52
Redesign Medicare and Medicaidp. 63
Expand Provision of Health Informationp. 66
Control Anticompetitive Behaviorp. 67
Reform the Malpractice Systemp. 69
Study the Tax Preference for Nonprofitsp. 74
Impacts of Proposals on Health Care Spending, the Uninsured, the Federal Budget, and the Distribution of Tax Burdensp. 77
Effects of Reforms on Health Care Spendingp. 78
Tax Deductibilityp. 79
Tax Creditp. 81
Insurance-Market Reformp. 81
Malpractice Reformp. 82
Summary and Discussionp. 82
Effects of Reforms on the Number of Uninsuredp. 84
Tax Deductibilityp. 85
Tax Creditp. 85
Insurance-Market and Malpractice Reformsp. 85
Summary and Discussionp. 86
Effects of Reforms on the Federal Budgetp. 88
Tax Deductibilityp. 88
Tax Creditp. 90
Insurance-Market and Malpractice Reformsp. 90
Subsidy for the Chronically Illp. 90
Summary and Discussionp. 92
Distributional Impactp. 93
Conclusionp. 97
Estimating the Impact of Policy Reforms on Health Care Spendingp. 107
Estimating the Impact of Policy Reforms on Uninsurancep. 117
Derivation of the Elasticity of Total Health Care Spending with Respect to the After-Tax Price of Out-of-Pocket Spendingp. 121
Estimating the Impact of Policy Reforms on the Federal Budgetp. 125
Notesp. 133
About the Authorsp. 147
About the Hoover Institution's Working Group on Health Care Policyp. 149
Indexp. 151
Table of Contents provided by Ingram. All Rights Reserved.

Excerpts

“In our view,the argument for increased public intervention is seriously flawed. . . . The unintended consequences of a handful of long-standing public policies are in large part responsible for the problems of the health care system.”—Introduction, pg. 4

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