Economists Urge Passage of Health Reform

by Dollars and Sense

From the Center for American Progress Action Fund

In Letter, Economists - Including 3 Nobel Laureates - Say Passing Health Reform Is "Critical To The Nation's Economic Growth And Prosperity"

November 24, 2009

Dear President Obama and Members of Congress,

Responsible reform will help slow the growth of health care spending and cover the uninsured - both of which are critical to the nation's economic growth and prosperity.

Our current health care system is riddled with inefficiencies. We spend much more per capita on health care than do other developed nations. Yet we don't do as well as these nations on four basic indicators of health care performance: coverage, health outcomes, cost control and choice of providers. According to a recent report by the Council of Economic Advisers, reducing the inefficiencies in our health care system could reduce health care spending by as much as 5 percent of GDP without compromising care outcomes and choice.

A more efficient health care system would free up resources that could be used to produce other goods and services, and to invest in the future. That would promote economic growth and jobs, along with higher wages and living standards.

Health care reform is also essential to preventing damaging and unsustainable increases in the federal budget deficit. Escalating health care costs are projected to be the primary driver of the deficit's future growth. Growing federal budget deficits mean higher interest rates, which will translate into less investment, slower growth, fewer jobs and lower living standards. If health care costs continue to climb at current rates, the deficit could eventually become so large that the government would be unable to borrow even at much higher interest rates. At that point, the nation would confront a fiscal emergency, forcing deep cuts in other government spending and significant increases in taxes to limit the deficit and prevent an outright default on government debt and a collapse of the dollar. Health system reform that curbs the growth of health care costs now can head off this future fiscal crisis and its painful ramifications.

Covering the uninsured will also yield significant economic benefits: improved health, reduced mortality, a more productive workforce and higher standard of living. More workers will be able to work, and those who are working will be able to work longer without disability. Ending the losses that health care providers incur from treating the uninsured will eliminate cost-shifting to their insured patients, and increase the quality of care they receive. Expanding coverage will reduce the financial disruption and bankruptcy caused by unexpected medical expenses. And expanding insurance options will increase the flexibility of the labor market by allowing workers to change jobs without fear of losing their insurance coverage.

The ethical case for reforming our health care system is compelling. So is the economic case. Enacting responsible health care reform now is essential to putting the economy on a sustainable path to a more prosperous future.

Signed,

Dr. Henry Aaron, Senior Fellow, Economic Studies, Bruce and Virginia MacLaury Chair, The Brookings Institution

Dr. George Akerlof, 2001 Nobel Laureate, Koshland Professor of Economics, University of California-Berkeley

Dr. Kenneth Arrow, 1972 Nobel Laureate, Joan Kenney Professor of Economics and Professor of Operations Research, Stanford University

Dr. Susan Athey, 2007 Recipient of the John Bates Clark Medal for the most influential American economist under age 40; Professor of Economics, Harvard University

Dr. Dean Baker, Co-Director, Center for Economic and Policy Research

Dr. Linda Blumberg, Senior Fellow, Urban Institute

Dr. Clair Brown, Professor of Economics, and Director, Center for Work, Technology, and Society, University of California, Berkeley

Dr. Len Burman, Daniel Patrick Moynihan Professor of Public Affairs, Maxwell School of Public Affairs, Syracuse University

Dr. David Cutler, Professor of Economics, Harvard University

Dr. John Holahan, Director, Health Policy Center, Urban Institute

Dr. Genevieve M. Kenney, Senior Fellow, Health Policy Center, The Urban Institute

Dr. Frank Levy, Rose Professor of Urban Economics, Department of Urban Studies and Planning, MIT

Dr. Peter Lindert, Distinguished Professor of Economics, University of California-Davis

Dr. Eric Maskin, 2007 Nobel Laureate, Albert O. Hirschman Professor of Social Science at the Institute for Advanced Study, Princeton University

Dr. Catherine G. McLaughlin, Director, Economic Research Initiative on the Uninsured at the Department of Health Management and Policy, University of Michigan

Dr. Richard Murnane, Juliana W. and William Foss Thompson Professor of Education and Society, Harvard University

Dr. Marilyn Moon, Vice President and Director, Health Program, American Institutes for Research

Dr. Matthew Rabin, 2001 Recipient of the John Bates Clark Medal for the most influential American economist under age 40; Edward G. and Nancy S. Jordan Professor of Economics University of California-Berkeley

Dr. James B. Rebitzer, Professor and Chair, Business Policy and Law Department, Boston University School of Management

Dr. Michael Reich, Professor of Economics and Director of the Institute for Research on Labor and Employment at University of California- Berkeley

Dr. Thomas Rice, Professor, School of Public Health, University of California-Los Angeles

Dr. Laura Tyson, S. K. and Angela Chan Chair in Global Management, Haas Business and Public Policy Group, University of California-Berkeley

Dr. Paul N. Van de Water, Senior Fellow, Center on Budget and Policy Priorities

Dr. Kenneth Warner, Dean of the School of Public Health and Avedis Donabedian Distinguished University Professor of Public Health, University of Michigan

Avedis Donabedian Distinguished University Professor of Public Health

Dr. Elliot K. Wicks, Senior Economist, Health Management Associates

Dr. Stephen Zuckerman, Senior Fellow, Heath Policy Center, The Urban Institute

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Labels: Economists, health care, health care reform, national health insurance

 

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11/24/2009 10:54:00 AM 1 comments

 

Insider Report on the Health Care Summit

by Dollars and Sense

Thanks to activist pressure, single-payer advocate Oliver Fein, MD, was allowed to participate in the White House health care summit. In his extensive post, Dr. Fein gives an inside account of the summit and lays out some reasons for cautious optimism for those pushing for a single-payer universal health care system.

The major single-payer bill in the House is HR 676. Dr. Fein reports that Senator Bernie Sanders is planning on proposing a counterpart bill in the Senate shortly.

From the Beaver County Blue website:

Thanks to many grassroots activists and physicians who called the White House and threatened to demonstrate outside its gates, I was at the Health Care Summit at the White House on March 5 along with Rep. John Conyers Jr. (D-Mich.). And it was good thing. It meant that the single-payer position was recognized as one pathway to health care reform. It also meant that one of our concerns was present: namely, that any health care reform that includes the for-profit, private health insurance companies will fail to provide universal coverage, will not be able to reduce heath care costs, and will increase the number of underinsured.

It’s important to note that there were others at the summit who are known to be sympathetic to single payer, including some past and present co-sponsors of H.R. 676 and Sen. Bernie Sanders of Vermont. (More on Sanders below.)

That said, it is true that the summit was carefully choreographed. The opening plenary featured Travis Ulerick, a 24-year-old firefighter from Dublin, Ind., who had sponsored a "health care community discussion" (house party) in his fire station in December. He read off the names of six other people who had hosted similar house parties who had been invited to participate in the summit.

Ulerick called attention to a booklet, "Report on Health Care Community Discussions," which was distributed to all summit participants. It focuses on cost, access, quality and system performance as the major problems facing the American health care system. As solutions, it offers creation of a health insurance exchange, reducing prescription drug costs, research and standards to improve quality and efficiency, simplification and information technology, education for wellness and the promotion of healthy lifestyles.

Interestingly, in the middle of the report, there is a box labeled Single-Payer System, which states: "Over one-quarter (27 percent) of the groups discussed the merits of a single-payer system, and the majority of those groups supported this idea. These groups argue that this radical change was a necessary step for reform."

Read the full post here.

Read Joel A. Harrison's article on how U.S. taxpayers aren't getting what they're paying despite massive health care spending (from our May/June 2008 issue), and go here for more D&S coverage of health care issues.

Labels: Bernie Sanders, health care, HR676, John Conyers, national health insurance, single-payer

 

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3/13/2009 11:16:00 AM 0 comments

 

Mass. Doctors Push for Single-Payer

by Dollars and Sense

We found a link to this on, of all places, Marginal Revolution—hardly a lefty site!—in a list of "Assorted Links" under the title "How is the Massachusetts health care plan working out?" The headline of the original link is a little misleading, since it suggests that (a majority of?) doctors in Massachusetts favor single-payer, but the report is really about Mass. docs who are members of Physicians for a National Health Program. But polls have shown that a majority of doctors in the United States favor single-payer, so I wouldn't be surprised if a majority in Mass. did too (especially given some of the snags of the new Mass. "universal" system).

Meanwhile, in today's New York Times there's an article about closed-door sessions with the ailing Mass. Sen. Ted Kennedy to hammer out a consensus about what kind of health care reform congressional Democrats and the Obama administration should go for. "Lobbyists for a wide range of interest groups—some of which were involved in defeating national health legislation in 1993-4—are meeting with the staff of Mr. Kennedy, Democrat of Massachusetts, in a search for common ground." Lots of mention of insurance industry and big pharma lobbyists; no mention whatsoever of single-payer as an option. Forcing people to purchase insurance from private insurers is these folks' idea of universal health care. Similarly, Wednesday's Times reported that Kathleen Sibelius, governor of Kansas, is a leading candidate to be O.'s nominee for Secretary of Health and Human Services. The article quotes an insurance industry lobbyist as saying that she'd be a great pick: "Karen M. Ignagni, president of America's Health Insurance Plans, said Ms. Sebelius would be 'a very smart choice' for health secretary."

Check out this article we ran last year on the high costs of the current system, many of which would remain under a compulsory "universal" system of the sort O. seems to be moving toward. And our March/April issue will include an article on management costs and how single-payer does better.

Now here's that piece on the Mass. PNHP doctors:

Massachusetts doctors say single-payer or bust

By Sarah Arnquist

Massachusetts members of the Physicians for a National Health Program released a report today faulting the state's experiment with health reform for failing to achieve universal coverage, being too expensive and draining funds away from safety-net providers.

The doctors' punch line is that the reform has given private insurance companies more business and power without eliminating vast administrative waste. In fact, it says, the "Connector" in charge of administering the reform adds about 5 percent more in administrative expenses.

In summary, nothing less than single-payer national health reform will work, according to authors Drs. Rachel Nardin, David Himmelstein and Steffie Woolhandler, all professors at Harvard Medical School.



The report criticizes the Urban Institute's largely favorable report that found only 2.6 percent of Massachusetts' residents were uninsured in mid-2008 because it failed to sufficiently reach non-English speakers in its survey.

Reports in Health Affairs this winter also found significant positive support for the reform among employers and the public. There was little evidence of crowd-out.

The PNHP doctors' report says health plans people are forced to buy are not affordable and often skimp, making the mandate that individuals buy them regressive. And moreover, it says, peoples' experiences have shown that insurance does not guarantee access to care. The Boston Globe chronicled the long wait for primary care last September.

A final criticism the 19-page report offers is that the reform is financially unsustainable, as it does "nothing about a major driver of high health care costs, the overuse of high-technology care such as CT scanners and surgeries, and the underdevelopment of primary care."

Last winter, Himmelstein spoke about health reform to students at Johns Hopkins School of Public Health. I asked him if single-payer advocates would work against any national reform effort that wasn't single-payer, as the single-payer camp did in California.

Himmelstein said that if the reform plan looked like the Massachusett's reform he probably would prefer the status quo. He believes the reform has made most vulnerable patients in Massachusetts worse off.

It looks like health reform is going to be a battle on the Left and Right.

Labels: health care, insurance industry, Kathleen Sibelius, national health insurance, Physicians for a National Health Program, single-payer

 

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2/20/2009 11:04:00 AM 0 comments

 

Call-In For Single Payer

by Dollars and Sense

Healthcare Now, an organization dedicated to promoting national health insurance, has dedicated today as a national call-in day for Single-Payer health insurance. Specifically, they are urging Congress to support HR676, John Conyers’ National Health Insurance Act.

For more information, click here.

Labels: HR676, national health insurance, single-payer

 

Please consider donating to Dollars & Sense and/or subscribing to the magazine (both print and e-subscriptions now available!).
1/15/2009 11:34:00 AM 0 comments