We’ve Got You Covered: Rebooting American Health Care
Nov 28, 2023
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Economists Liran Einav and Amy Finkelstein discuss their book advocating for universal taxpayer-funded basic health insurance. They critique the US health sector, propose comprehensive reform, and debate government's role in healthcare coverage. Topics include historical evolution, challenges in healthcare policy, cost containment strategies, resource allocation, and proposals to improve healthcare access.
Proposes universal, automatic, and free healthcare coverage for all Americans as a radical reform solution.
Addresses gaps in US health insurance system leading to financial insecurity for many.
Critiques US healthcare as inadequate and advocates for comprehensive reform over piecemeal changes.
Deep dives
Insights from Leading Health Economist
MIT's Amy Finkelstein and her colleague, Laurent Enov, delve into the critical issues in health economics, addressing gaps in the US health insurance system. Their book, 'We've Got You Covered,' outlines the need for radical reform given persistent challenges, such as a significant percentage of Americans facing periods without insurance over two years.
The Problems of US Health Insurance System
Finkelstein highlights the issues within the US health insurance landscape, citing the Affordable Care Act's failure to achieve universal coverage. Notably, a larger proportion of Americans experience gaps in coverage, leading to instability and financial insecurity when transitioning jobs or losing eligibility.
Challenges with Medical Debt and Coverage Gaps
The podcast discusses the staggering medical debt in the US, emphasizing that a substantial portion is incurred by individuals with existing health insurance. With flaws in the existing system, such as complex eligibility criteria and gaps in coverage, many Americans face financial burdens despite having insurance.
Proposing an Automatic, Free, and Basic Health Coverage
Finkelstein and Enov propose a transformative solution involving automatic, free, and basic health coverage for all Americans. By reimagining the current system and addressing the inadequacies present, they aim to provide universal access to essential medical care and establish a more coherent framework for healthcare provision.
Political Response to Systemic Healthcare Issues
The podcast delves into the challenges of the political system in addressing larger healthcare problems caused by government policies, particularly regarding the tax exclusion from employer-sponsored insurance. It highlights the tendency of the political system to address discrete issues with additional resources, while overlooking broader systemic issues. The conversation questions the effectiveness of government and political systems in addressing healthcare sector gaps and biases towards smaller, solvable issues.
Debating Government Role in Healthcare and Universal Coverage
The episode explores the implications of government intervention in healthcare and the debate around universal coverage. It discusses the concept of taxpayer-funded basic coverage and the challenges of defining 'basic' care. The conversation raises questions about the sustainability of increasing healthcare spending and the need to set budgets and make hard decisions within them. It also addresses the complex issues of deserving versus undeserving populations and the role of politics in shaping healthcare policies.
In their new book, We’ve Got You Covered: Rebooting American Health Care, economists Liran Einav (Stanford University) and John Bates Clark Medal winner Amy Finkelstein (Massachusetts Institute of Technology) note, “No one is actually uninsured.” They nevertheless critique the US health sector as “a sprawling yet arbitrary and inadequate mess.” Where many advocate piecemeal reform, Einav and Finkelstein urge policymakers to “tear it all down and rebuild.” They recommend that the government provide “automatic, basic, and free universal coverage for everyone.” Finkelstein will join Michael F. Cannon, Cato’s director of health policy studies, for a conversation about We’ve Got You Covered, the merits of incremental versus comprehensive change, and whether reform should involve greater or less government intervention.
