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Healthy, Wealthy, and Wise, 2nd Edition: Five Steps to a Better Health Care System (Hoover Institution Press Publication) [Kindle Edition]

R. Glenn Hubbard , John F. Cogan , Daniel P. Kessler
4.7 out of 5 stars  See all reviews (3 customer reviews)

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Book Description

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 Wise details 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.

 


Editorial Reviews

Review

"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

From the Inside Flap

Health care in the United States has made remarkable advances during the past fifty 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, all of which are the unintended consequences of a handful of public policies. Those policies share a common feature, now amplified by the Patient Protection and Affordable Care Act: they fail to promote the proper functioning of markets.

In this book, the authors offer market-based alternatives to recent health care reforms that can slow the rate of growth of health care costs, expand access to high-quality health care, and slow down runaway spending. They first outline the challenge facing public policy: retaining and continuing to achieve gains to society from the US health care system and minimizing its costs, both financial and otherwise. They then propose a market-based approach to accomplishing those goals, explaining why the most important problems with our health care system are due to five flawed public policies and showing how five sets of specific reforms can correct those flaws. They conclude by quantifying the expected consequences of their reforms, based on estimates of how consumers and providers have responded to past changes in markets for health care.

Since the book’s first edition was published, the authors have conducted additional research on the consequences of tax policy for health spending and health insurance. They present that work, along with updated estimates of the impact of their proposals on the federal budget, the number of insured, and health care spending. In combination, the reforms proposed in this book will reduce health care costs by approximately $90 billion per year without reducing the quality of care and will also improve the system’s productivity, fairness, and responsiveness.

The time to implement sensible reforms is now. Failure to do so will inevitably increase the pressure for more public intervention, with adverse consequences for the quality of health care and, more broadly, our country’s economic growth.


Product Details

  • File Size: 348 KB
  • Print Length: 176 pages
  • Publisher: Hoover Institution Press; 2nd edition (August 1, 2011)
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B0078XHA8C
  • Text-to-Speech: Enabled
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  • Lending: Enabled
  • Amazon Best Sellers Rank: #1,391,207 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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4.7 out of 5 stars
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2 of 2 people found the following review helpful
By James
Format:Hardcover|Verified Purchase
Calling the Patient Protection and Affordable Care Act "expansion of access within a system of flawed incentives," this book focuses on those incentives as a means of lowering the costs of health care.

The book reflects the point of view of conservative economists. It argues that to some extent the high cost of health care reflects the "unintended consequences of a handful of public policies... These policies share a common feature, now amplified by the PPACA: they fail to promote the proper functioning of markets."

The authors point how how World War II tax decisions created a policy where employer-provided health insurance benefits are not subject to tax, but those purchased by individuals are. As a result, the private insurance markets became predominantly employer-based, with 176 out of 201 million private insurance policies sponsored by employers.

The authors write: "The tax preference for employer health insurance has created a health care system in which doctors and patients bear few of the resource costs of their decisions...in this perverse world, true insurance, in the form of coverage for catastrophic health events, is the exception; prepaid health care, in the form of coverage with low deductibles and copayments, is the rule."

The authors cite studies from the RAND corporation showing that high deductible plans lower health care spending to 2/3 of what it would have been, and data from Wellpoint showing that when individuals pay their own premiums, they choose high deductible plans as a way of lowering the price of those premiums. The authors then propose ending the current tax unfairness to individuals. Currently, if the employer chooses not to provide health insurance, the individual must purchase it him or herself.
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2 of 2 people found the following review helpful
5.0 out of 5 stars The best short account of market reforms of health care November 16, 2011
Format:Hardcover|Verified Purchase
One of the key problems with the health care system is that unlike with most other goods and services, consumers do not pay the full price of health care. If you have health insurance, you probably only pay 20% or less of the true price of a doctor's visit. Naturally, the result is that you, me, and other people with health insurance visit the doctor more than we would if we had to pay the full tab. This problem is the key reason that U.S. health care spending is out of control. Nothing in the 2010 health care legislation addresses this problem. Although I'm not sure that I buy all of the authors' proposed reforms, at least they have attempted to come to grips with this key problem.
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1 of 1 people found the following review helpful
4.0 out of 5 stars Required reading for any voter. November 24, 2012
By Ad
Format:Kindle Edition|Verified Purchase
Easy to understand and well organized. I would recommend it to anyone trying to understand health care costs in America.
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More About the Author

John F. Cogan is the Leonard and Shirley Ely Senior Fellow at the Hoover Institution and a professor in the Public Policy Program at Stanford University, where he has had a continuing appointment since 1980.

Cogan is an expert in domestic policy. His current research is focused on US budget and fiscal policy, social security, and health care. He has published widely in professional journals in both economics and political science. His most recent book, Healthy, Wealthy, and Wise: Five Steps to a Better Health Care System (Hoover Institution Press, 2011), coauthored with Glenn Hubbard and Daniel Kessler, recommends federal policy changes to improve US health-care markets.

Cogan has devoted a considerable part of his career to public service. He served as assistant secretary for policy in the US Department of Labor from 1981 to 1983. From 1983 to 1986, he served as associate director in the US Office of Management and Budget (OMB). His responsibilities included developing and reviewing all health, housing, education, and employment training programs and policies.

Cogan has served on numerous congressional, presidential, and California state advisory commissions. He served on the California State Commission on the 21st Century Economy and the California Public Employee Post-Employment Benefits Commission. He served on President George W. Bush's Commission to Strengthen Social Security, the US Bipartisan Commission on Health Care (the Pepper Commission), the Social Security Notch Commission, and the National Academy of Sciences' Panel on Poverty and Family Assistance.

Cogan serves on the board of directors of Gilead Sciences and Venture Lending and Leasing. He also serves on the board of trustees of the Charles Schwab Family of Funds and Sacred Heart Schools in Atherton, CA.

Cogan received his AB in 1969 and his PhD in 1976 from the University of California at Los Angeles, both in economics. He was an associate economist at the RAND Corporation from 1975 to 1980. In 1979, Cogan was appointed a national fellow at the Hoover Institution; in 1980 he was appointed a senior research fellow; and in 1984 he became a senior fellow.

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