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Health Care Turning Point: Why Single Payer Won't Work

Health Care Turning Point: Why Single Payer Won't Work

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Author: Roger M. Battistella
Publisher: The MIT Press
Category: Book

List Price: $21.95
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Rating: 5.0 out of 5 stars 1 reviews
Sales Rank: 502,681

Media: Hardcover
Edition: 1
Pages: 160
Number Of Items: 1
Shipping Weight (lbs): 0.8
Dimensions (in): 9 x 6.1 x 0.8

ISBN: 0262014076
Dewey Decimal Number: 362.10425
EAN: 9780262014076

Publication Date: March 31, 2010
Availability: Usually ships in 1-2 business days

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Product Description
The battle over health care reform has reached a turning point. We can try to fashion new policies based on old ideas—or we can acknowledge today's demographic and economic realities. In Health Care Turning Point, health policy expert Roger Battistella argues that the conventional wisdom that dominates health policy debates is out of date. Battistella takes on popular misconceptions about the advantages of single-payer plans, the role of the market, and other health policy issues and outlines a pragmatic new approach.

Few would disagree that the current system is broken. Employer-supplied health insurance no longer works; it imposes a heavy burden on American companies when they compete against international firms and creates insecurity and instability for American workers. But, Battistella asserts provocatively, a government takeover of health insurance patterned after Medicare and Medicaid won't work either. With a battered economy and an aging population, the country simply can't afford it. Battistella argues that contrary to popular belief, single-payer coverage will not lower health spending but would encourage overconsumption and drive costs up. The most efficient and affordable way to reform health care, Battistella contends, is for consumers to take ownership of it. If consumers were responsible for buying their own health insurance (as they are for buying their own car and home insurance), he argues, they'd look for value and demand greater price and quality transparency from providers. Health insurance would be more like other forms of insurance and focus on major expenses, with routine care paid for out of pocket.

The economic shibboleth that the principles of market competition don’t apply to health care is nonsense, Battistella says. We won't achieve real health care reform until policy makers adjust to this reality and adopt a more pragmatic view.

HEALTH CARE TURNING POINT'S MYTHS ABOUT HEALTH CARE REFORM
  • Health care is a social good that should be free to all.
  • Single-payer coverage lowers health spending and eliminates social and economic health disparities.
  • Prevention generates big savings.
  • More health spending will stimulate the economy and have a positive effect on health status and longevity.
  • Canada provides a desirable blueprint for U.S. health reform.
  • The principles of market competition aren't applicable to health care.



Customer Reviews:
5 out of 5 stars Quality Information   March 1, 2010
Ira E. Stoll
15 out of 16 found this review helpful

Before moving ahead any further on a health care overhaul, the president and members of Congress should stop and read Roger Battistella's new book. It won't take long; the text of the book is a slim 134 pages. But those pages are packed with facts and analysis that have the potential to change the way readers think about health care. I learned a lot from it, and I thought I already knew a lot about health care.

I was left impressed that Mr. Obama's plan has managed to get as far along as it has, given the budget constraints. Mr. Battistella essentially makes the case that America can barely afford the existing entitlements, let alone set up new ones.

The existing federal health care programs have their problems. A Harvard professor, Malcolm Sparrow, estimates that as much as 20% to 30% of federal health spending is consumed by fraud, the book says.

More generous federal health benefits, Mr. Battistella suggests, would only invite more fraud. He offers the example of Sweden: "During recent World Cup soccer finals sick leave among Swedish men rose by 55 percent." In Italy, in 2005, state employees took an average of 18 days sick leave, while workers in America average five sick days a year. The definition of "sick," in other words, is readily expandable along with government benefits.

Not that the current American system is perfect, by any stretch. Our health care system can be downright dangerous; medical errors are either the third or the eighth leading cause of death in America, some of them related to problems as simple as the continued use of hard-to-read handwriting on prescriptions and medical orders. Even the low-range estimate of medical errors places them ahead of car accidents, breast cancer, or AIDS as a cause of death, the book says.

Think the banks are the biggest lobbyists in Washington? Nope. According to Mr. Battistella, since 2006 the health industry has spent more on lobbying than any other sector of the economy.

So how to improve upon this mess? Not with central planning or control, Mr. Battistella advises: "The sheer complexity of real world conditions surpasses the capacity of experts and their analytical models, no matter how brilliant or sophisticated they are."

When dealing with obstinate interest group opposition, "improvements occur faster and with less acrimony when left to market competition than if the same objectives are sought through legislative edict or planning regulations," he writes.

Among Mr. Battistella's predictions: "employers will seek to follow the precedent established with pension benefit programs and transform health care from a defined benefit to a defined contribution plan in which vouchers are an important component." The Federal Employee Health Benefit Plan already functions somewhat like a voucher; the author explains that, "when individuals select a plan with a premium less than the government's contribution, they keep the difference. Conversely, if they chose a more expensive plan, they pay the difference out of their own pocket."

Runaway health care spending will finally be curbed, he writes, only when consumers start being "intimately involved in paying for the cost of their care rather than relegating payment to a third party." Those consumers "need access to user-friendly reliable price and quality information on specific providers to enable knowledgeable comparisons."

In the area of quality information that will help enable knowledgeable comparisons, Mr. Battistella has, with this book, made a formidable contribution of his own.

Disclosure: My father had Professor Battistella as a teacher at Cornell and they have kept up over the years.

A final note: the prose in this book is accessible enough, but a reader can tell it's by a an academic rather than someone whose primary expertise is in writing for a wide, general audience. Don't be deterred; it's only 134 pages.


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