Health Alert | The Demand-Side Approach to Changing What Doctors Do
In many ways health care is like education. In both fields, we find a sea of mediocrity, punctuated by islands of excellence. Further, the islands of excellence appear to be randomly distributed. By and large, they are not correlated with anything. This is not only true in the United States. It is true all over the world.
The two sectors have two additional common features: (1) the individuals who receive the benefits of the services are separate from the entity that pays for them; and (2) we have completely suppressed the marketplace. As a result, there are no financial rewards for institutions to become excellent. In return for expending greater effort to improve performance, they receive the same (or even less) income.
After the publication of A Nation at Risk about a quarter of a century ago, alarmed reformers decided to study the best schools to determine what they do that works and to use various carrots and sticks to try to get all other schools to do the same. This is what I call the "demand-side approach" to education reform. How well has this approach worked? Miserably.
November 17, 2009
EMPLOYER TAXES MAY SPOOK SENATE ON HEALTH CARE
An employer mandate will result in job loss and it will encourage employers not to hire employees, says John Goodman, President, CEO and the Kellye Wright Fellow with the National Center for Policy Analysis...
WASHINGTON EXAMINER
Under House Speaker Nancy Pelosi's health care reform bill, Americans who don't maintain acceptable health insurance coverage and who choose not to pay a fine/tax of up to 2.5 percent of income are subject to fines of up to $250,000 and imprisonment of up to five years...
INVESTOR'S BUSINESS DAILY
CONGRESS WOULD COMPEL YOUNG ADULTS TO BUY HEALTH INSURANCE THEY DON'T NEED
Since about one-third of young adults already reject health insurance at current prices, even more of them would avoid coverage if Congress drives those prices higher, says Aaron Yelowitz, an associate professor of economics at the University of Kentucky...
CATO INSTITUTE
THE HOUSE'S EXPENSIVE MEDICINE
The House health care reform bill is about more than covering the nation's uninsured, it's about remaking the nation's health care system, say observers...
INVESTOR'S BUSINESS DAILY
MAINE FINDS A HEALTH CARE FIX ELUSIVE
Many of the health care reform proposals circulating on Capitol Hill have already been tried in Maine and failed, say observers...
NEW YORK TIMES
HOW TO CONTROL RISING HEALTH CARE COSTS? INCREASE CONSUMER CHOICE
To lower the costs of health care, we should open up state insurance markets to competition, says Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute...
NEW YORK TIMES
Lack of health insurance is a significant, persistent problem in New Jersey. In 2007, more than 1.3 million residents were uninsured - three-fourths were working-age adults 19 to 64 years old. About 15.6 percent of New Jersey residents are uninsured, which is close to the national average, and the U.S. Census Bureau recently ranked New Jersey 34th among states in the percentage of residents with insurance coverage.
One of the primary goals of health reform is to ensure that all Americans have health insurance. Yet it is generally overlooked that the proportion of Americans without health coverage has been relatively stable over time. According to the Census Bureau, in 2008 the number of individuals in the United States lacking health coverage rose from 45.7 million to 46.3 million. The proportion of uninsured Americans remained virtually unchanged, rising from 15.3 percent to 15.4 percent.
To confront America's health care crisis, we do not need more spending, more regulations or more bureaucracy. We do need to liberate every American, including every doctor and every patient, to use their intelligence, creativity and innovative abilities to make the changes needed to create access to low-cost, high-quality health care.
Health care spending per person varies widely across the country, but greater spending does not appear to produce better quality. A natural inference is that some areas of the country are less efficient in the use of health care resources.
The Massachusetts experiment in health care reform offers many lessons that are applicable to the current debate in Congress. The goals of the Massachusetts plan are similar to proposals supported by Democratic congressional leaders and the Obama administration: universal health insurance coverage through greater access to health insurance.