Noted health care economist comes out for single payer

[eridani]

https://promarket.org/there-is-regulatory-capture-but-it-is-by-no-means-complete/

Arrow, Kenneth J., “Uncertainty and the Welfare Economics of Medical Care, The American Economic Review, December 1963: https://www.aeaweb.org/aer/top20/53.5.941-973.pdf

Q: It does sound like you are strongly in favor a single-payer system, though. Last year you signed, along with 266 other economists, a declaration that called on policymakers around the world to work toward universal health coverage.

I wouldn’t say I’m strongly in favor of a single payer system. I can find objections to it. But I still think it’s better than any other system. However, the idea of permitting private practice must not be ruled out. Similar to the UK, there can be a single payer system which everybody can go to, and private medical practices for those who want. In the UK, private medicine is about 20 percent of the total, so there is this escape valve for those who want it, but also a single payer system that anybody can join.

Q: Perhaps the way to fix the American health care system is simply to adopt the UK model?

I would say the Canadian model, rather than the UK model. But it’s so politically out of the question I don’t even think about it.

Q: So you’re saying that one answer to the influence of special interest groups in the health care system is to have the government intervene in a major way, whether it is through a single payer system or something more akin to the UK model?

That’s right. Of course, George Stigler would say that there could be regulatory capture, but so far it doesn’t seem to have happened really.

Comment by Don McCanne of PNHP: Nobody understands markets and health care better than Nobel laureate Kenneth Arrow who wrote the classic treatise on the topic over half a century ago. Based on his work, it is clear that the government must be involved if we are to improve efficiency in the system as we attempt to expand it to include everyone. So what does Kenneth Arrow think about single payer as a model for health care?

Although he understands that there are some deficiencies in the single payer model, he states, “it’s better than any other system.” He does say that he believes that private practice should be permitted as an option, like they have in the United Kingdom. But when asked if the United States should adopt the UK system, he says, “I would say the Canadian model, rather than the UK model.” That’s interesting in that Canada does not permit health care to be paid for privately if it is covered by their single payer Medicare program (although that continues to be challenged by the Canadian privatizers).

Kenneth Arrow is not an ideologue. He is a gifted, two-handed economist (i.e., looks at the options). He has stated that single payer is better than any other system, and we should listen to him.

[Hoyt]

1. There's little question Single Payer is best. Problem is, how do we get there with Congress, 40+‰ of

people who are opposed to it, etc. In this country, it is as doable as banning cancer. We'll get Single Payer faster by adding a public option to ACA.

[eridani]

2. Incrementalism isn't worth warm spit, unless--

--you have some clear vision of where you want to end up.

[Hoyt]

3. If the public option is the best plan, people will select it fairly quickly.

I certainly would, and I think most people would too. But, imposing SP on right wing Americans has no chance of passing Congress for the foreseeable future. But many of those ignorant wingers would choose a public option.

[eridani]

4. Not arguing against the strategy--just suggesting keeping end goal in mind n/t

[Hoyt]

5. Done.

[Vinca]

6. I've never understood why business doesn't lobby for single payer.

Having to provide health coverage for employees is one of the biggest costs of doing business in this country.

[djean111]

7. I think it is because the big businesses have their loopholes and tax breaks, and so many people

are invested in the health insurance industry and big pharma making huge profits, while not actually providing health care. Big Pharma would not keep hiking their prices up if the insurance industry refused to pay them. Quid pro quo. And I think the corporations are shifting costs to employees anyway, with big co-pays and out-of-pockets, under the protection of the ACA.

We are all, really, just grist for their profit mill.

[Vinca]

9. Good points.

[pampango]

8. I would prefer a government-run National Health Service, but this guy knows more about

the economics of providing health care than I do.

Q: Perhaps the way to fix the American health care system is simply to adopt the UK model?

I would say the Canadian model, rather than the UK model. But it’s so politically out of the question I don’t even think about it.

If I understood his response to the question, he may favor a national health service but hasn't really considered it because it is politically impossible in the US. I understand that the 'best' health care system only helps us if it is politically feasible. Perhaps we should scare the right by proposing a national health service and the 'settle' for single payer.

[eridani]

10. The way the UK got their national health system was to have their infrastructure----

--flattened in WW II. Canada is much more like the US politically, in that both provinces and states have a lot more independence than the political subunits of wither Britain or continental Europe.