In Crisis of Abundance: Rethinking How We Pay for Health Care, economist Arnold Kling argues that the way we finance health care matches neither the needs of patients nor the way medicine is practiced. The availability of premium medicine, combined with patients who are insulated from costs, means Americans are not getting maximum value per dollar spent. Using basic economic concepts, Kling demonstrates that a greater reliance on private saving and market innovation would eliminate waste, contain health care costs and improve the quality of care. Kling proposes gradually shifting responsibility for health care for the elderly away from taxpayers and back to the individual. The idea of matching the health care funding system to needs is very simple, Kling writes. The very poor and the very sick need help paying for health care. The rest of us do not.
Crisis of Abundance: Rethinking How We Pay for Health Care
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Editorial Reviews
Review
"This is one of the most important books written on health care." -- Tyler Cowen, Professor of Economics, George Mason University, copublisher of Marginal Revolution.
I warmly recommend his book to general readers who want to understand what economics has to say about health care. -- Arnold S. Relman, The New England Journal of Medicine, September 2006
I warmly recommend his book to general readers who want to understand what economics has to say about health care. -- Arnold S. Relman, The New England Journal of Medicine, September 2006
From the Back Cover
His book is clear, concise, and eminently readable; he writes in straightforward English prose, not economic jargon; he is modest, posing questions more often than he answers them; and he considers alternatives to most of the policy options he discusses. I warmly recommend his book to general readers who want to understand what economics has to say about health care.
- Arnold S. Relman, M.D., Harvard Medical School, writing in The New England Journal of Medicine [Full text of review]
- Arnold S. Relman, M.D., Harvard Medical School, writing in The New England Journal of Medicine [Full text of review]
"Crisis of Abundance is full of useful insights, the best being Kling's schema for understanding the value of medical care. Kling offers some innovative ideas on how to introduce more consumerism into health care. It is ideas like these that will move us toward a more market-based system of health care and save us from the disaster that is a single-payer system."
- David Hogberg, The American Spectator [Full text of review]
For a fresh analysis of health care, people ought to look to economist Arnold Kling's new book, Crisis of Abundance. Although it offers no easy villain-versus-hero narrative or solution to the challenges of funding health care, it diagnoses the problem with precision.
- Sally Pipes, National Review Online, President of the Pacific Research Institute
This is a lucid and persuasive book--one of the most accessible guides I have ever seen to what is wrong with our health care system and how we might fix it. People of all ideological persuasions will find it enlightening and helpful.
- Daniel Shaviro, Wayne Perry Professor of Taxation, New York University School of Law, author of Who Should Pay for Medicare?
Crisis of Abundance pinpoints precisely where our health care spending has gone wrong. An emphasis on high-cost 'premium medicine' of marginal benefit, coupled with consumers shielded from its cost, has left us spending more for less. But Kling does more than offer criticisms--he also offers solutions. It's the Back to the Future of healthcare economics.
- Sydney Smith, publisher of Medpundit
This is one of the most important books written on health care.
- Tyler Cowen, Professor of Economics, George Mason University, copublisher of Marginal Revolution
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Customer Reviews
Most Helpful Customer Reviews
42 of 45 people found the following review helpful
Format:Hardcover
If you've ever wondered why health care is so expensive in America, Kling will fill you in. Despite what many of us believe(d), it's not because of greedy pharmas or wasteful paperwork - as Kling shows, those ideas just don't hold water to explain the obscene cost hikes in recent years. Kling makes a great case that what has caused our problems is what he calls "premium medicine" - or health care spending whose cost exceeds its benefit.
As for solutions to our problems, Kling does a good job of unraveling many of the claims made by single-payer advocates, most notably that they can control costs without reducing benefits.
And when it comes to his own solutions, I found them to be very sensible (although I think he deliberately keeps them general). For example, he proposes keeping the government involved in funding health care, but ONLY for the poor and chronically ill (unlike in its current form where it also funds the elderly rich). This idea is so sensible - and seems to appeal to those on both sides of the aisle - that I'm surprised we haven't already done it.
All in all, well worth the read. Even if you generally don't like libertarian solutions to today's problems, I think you'll find Kling's book very easy to read, with far less ideology than in most other books on anything as controversial as health care.
As for solutions to our problems, Kling does a good job of unraveling many of the claims made by single-payer advocates, most notably that they can control costs without reducing benefits.
And when it comes to his own solutions, I found them to be very sensible (although I think he deliberately keeps them general). For example, he proposes keeping the government involved in funding health care, but ONLY for the poor and chronically ill (unlike in its current form where it also funds the elderly rich). This idea is so sensible - and seems to appeal to those on both sides of the aisle - that I'm surprised we haven't already done it.
All in all, well worth the read. Even if you generally don't like libertarian solutions to today's problems, I think you'll find Kling's book very easy to read, with far less ideology than in most other books on anything as controversial as health care.
15 of 17 people found the following review helpful
Format:Hardcover|Amazon Verified Purchase
"Crisis of Abundance" should be read by any educated person who wants to understand the healthcare crisis in the U.S. and proposals to remedy it. This short, intelligent book reviews the various theories in play to explain why the U.S. spends so much more (as a percentage of GDP) on healthcare than other developed nations; looks at the "awkward facts" facing each theory; describes the trade-offs that any system for healthcare spending cannot avoid; and presents realistic policy considerations for improvement.
Even if you normally don't read "public policy" books, you should make time for this one. It will give you a solid foundation for evaluating what politicians and pundits say about the healthcare crisis and all the different fixes, both good and bad, that will be offered for your support.
Even if you normally don't read "public policy" books, you should make time for this one. It will give you a solid foundation for evaluating what politicians and pundits say about the healthcare crisis and all the different fixes, both good and bad, that will be offered for your support.
8 of 9 people found the following review helpful
Format:Hardcover
For this reader, "Crisis of Abundance" by Arnold Kling was difficult to read. Fortunately, it is very short, under 100 pages. In the end, it was well worth my brief persistence.
Anyone who wants to understand the healthcare crisis in the U.S. would benefit by reading this. The author is an economist, and the book is clearly told from an economic and public policy perspective. His goal was to write this book for the "concerned citizen," while at the same time making it credible to professional economists (p. ix). I rank this book lower than most other reviews because I believe the author partially fails in his attempt to write this book clearly for the concerned citizen.
He makes the point that what ails our national health care system is what he calls "premium medicine" -- or health care spending whose cost exceeds its benefit. He defines "premium medicine" as: "frequent referrals to specialists; extensive use of high-tech diagnostic procedures; and increased numbers and variety of surgeries" (p. 4). "If our high levels of health care spending are the result of so-called premium medicine, we should be demonstrably healthier. Yet when we attempt to examine average longevity at a national level, there seems to be no connection between American's high levels of health care spending and life span." (p. 25)
I found the book most difficult when the author was presenting policy issues. Kling states that his goal is "not to offer a package of solutions. It is to raise the level of understanding of the realities, issues and tradeoffs pertaining to health care policy" (p. 95). Here, for this reader, he succeeded. I now have a far better grasp of why the U.S. spends so much more on health care than other developed nations.
Kling is a libertarian, as is my husband, and that is how the book ended up in my hands. Generally I don't like libertarian solutions to current problems, but I found this book far less ideologic than others my husband has shared with me.
The book has piqued my interest, and I will no doubt read more on this topic in the future. Personally, I would love to find a book on this topic that also takes the environmental costs (see for example, "Plan B 2.0" by Lester Brown) of "premium medicine" into consideration when discussing the cost-benefit equations. Now that would be challenging and controversial!
Anyone who wants to understand the healthcare crisis in the U.S. would benefit by reading this. The author is an economist, and the book is clearly told from an economic and public policy perspective. His goal was to write this book for the "concerned citizen," while at the same time making it credible to professional economists (p. ix). I rank this book lower than most other reviews because I believe the author partially fails in his attempt to write this book clearly for the concerned citizen.
He makes the point that what ails our national health care system is what he calls "premium medicine" -- or health care spending whose cost exceeds its benefit. He defines "premium medicine" as: "frequent referrals to specialists; extensive use of high-tech diagnostic procedures; and increased numbers and variety of surgeries" (p. 4). "If our high levels of health care spending are the result of so-called premium medicine, we should be demonstrably healthier. Yet when we attempt to examine average longevity at a national level, there seems to be no connection between American's high levels of health care spending and life span." (p. 25)
I found the book most difficult when the author was presenting policy issues. Kling states that his goal is "not to offer a package of solutions. It is to raise the level of understanding of the realities, issues and tradeoffs pertaining to health care policy" (p. 95). Here, for this reader, he succeeded. I now have a far better grasp of why the U.S. spends so much more on health care than other developed nations.
Kling is a libertarian, as is my husband, and that is how the book ended up in my hands. Generally I don't like libertarian solutions to current problems, but I found this book far less ideologic than others my husband has shared with me.
The book has piqued my interest, and I will no doubt read more on this topic in the future. Personally, I would love to find a book on this topic that also takes the environmental costs (see for example, "Plan B 2.0" by Lester Brown) of "premium medicine" into consideration when discussing the cost-benefit equations. Now that would be challenging and controversial!
Most Recent Customer Reviews
Clear and useful
I read this book in late 2010 - after the passage of Obamacare. The book is clearly written and helped me understand the issues driving health care costs up. Read more
Published 18 months ago by Hugh Watkins
Presents a very good framework for thinking about health care
I have read several books on the US health care "crisis" in the last six months. Crisis of Abundance is by far the most valuable. Read more
Published 23 months ago by Timothy D. Rowe
Best Book on Health Care I've Seen
This is the best source for understanding the health care I have come across. The book does a great job exploring the complexities of the health care problem and the inevitable... Read more
Published on December 26, 2009 by HVeinott
Fresh policy proposals
In an effort to get up to speed on healthcare economics, I purchase Victor Fuchs' Who Shall Live?: Health, Economics, and Social Choice (Economic Ideas Leading to the 21st Century... Read more
Published on July 17, 2009 by E. Husman
Excellent
Having been chasing the Health care debate for 15 years, and participating almost as long, I have to say that I was basically underinformed in the past. Read more
Published on July 15, 2009 by Aretae
Reading it on the Kindle
I'm reading this book on the Kindle (and writing this review from the Kindle, also). The content is well-presented and mostly understandable to a noneconomist. Read more
Published on March 2, 2009 by M. Chesebro
Crisis of ABundance
It's not as easy of a read as I expected but I believe that it is inciteful and accurate.
Published on October 18, 2008 by Toby
healthcare finance
Probably one of he best critiques of what ails the US healthcare system today. So-called health "insurance" isn't insurance. Read more
Published on May 3, 2008 by William H. Franklin Jr.
The antidote to Michael Moore
Kling does not leap to the quick fix, but he delineates the problems that must be considered in any attempt to restructure the health care system or its funding. Read more
Published on June 24, 2007 by Johnny & Riza
Another book from CATO
Taking out the redundancy, this (about) 100 page book could have been made into a 20 page pamphlet. The real point behind this book: expectation of medicine has been increasing... Read more
Published on May 9, 2007 by TJJ
Inside This Book
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Key Phrases - Statistically Improbable Phrases (SIPs):
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matching funding systems, premium medicine, health care finance system, real health insurance, invasive colonoscopy, true health insurance, health care spending, catastrophic health insurance, catastrophic insurance, nonmonetary costs Key Phrases - Capitalized Phrases (CAPs): (learn more)
United States, Private Insurance, David Cutler, Medical Expenditure Panel Survey, Policy Ideas, Remaining Lifetime Catastrophic Insurance, Needs Figure, The Rise of Premium Medicine, Medical Guidelines Commission, John Wennberg Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
matching funding systems, premium medicine, health care finance system, real health insurance, invasive colonoscopy, true health insurance, health care spending, catastrophic health insurance, catastrophic insurance, nonmonetary costs Key Phrases - Capitalized Phrases (CAPs): (learn more)
United States, Private Insurance, David Cutler, Medical Expenditure Panel Survey, Policy Ideas, Remaining Lifetime Catastrophic Insurance, Needs Figure, The Rise of Premium Medicine, Medical Guidelines Commission, John Wennberg Browse Sample Pages:
Front Cover | Table of Contents | First Pages | Index | Back Cover | Surprise Me!
Citations (learn more)
This book cites 8
books:
See all 8 books this book cites
- The UnderCover Economist by TIM HARFORD on page 19, and Back Matter
- The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions (National Bureau of Economic Research Conference Report) by David M. Cutler in Back Matter (1), and Back Matter (2)
- HEALTH POLICY (The Gildredge Social Policy Series) by Barry Owen in Back Matter
- The Congress of the United States (American Civics) by David Health in Back Matter
- Learning Economics by Arnold Kling in Back Matter
See all 8 books this book cites
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