Priceless: Curing the Healthcare Crisis (Independent Studies in Political Economy)
You have 122 highlighted passages
You have 114 notes
Last annotated on June 20, 2016
ContentsRead more at location 23
Note: Ricetta: far pagare il consumatore. 1) formazione di conti risparmio sanitario e franchigie elevate 2) il paziente: 1. paga attingendo all' conto 2. esaurito il conto tira fuori il contante e 3. superate le franchigie (alte) interviene l' assicurazione. Goodman non tiene conto di 1. Arrow, asimmetria informativa (+ protezione x il consumatore) 2. Stiglitz, selezione avversa (obbligo assicurativo) 3. Hanson, remore psicologiche (vogliamo che siano altri a pagare x illuderci della benevolenza dei dottori) Risposte possibili: 1: esiste un market failure + consistente che bilancia l' asimmetria: il visto/non vist (la competizione dà benefici diffusi mentre l' errore medico è concentrato 2: le evidenze smentiscono: i + sani sono i + inclini ad assicurarsi (causa carattere scrupoloso) 3: lotta al signalling Edit
Preface An Intellectual OdysseyRead more at location 48
Note: Necessità che il paziente spenda i suoi soldi (risparmiati forzatamente in un fondo). Anche l' offerta si liberera Costi d' agenzia: 3 pay non funziona I disaccordi non riguardano i fatti ma le opinioni: c' è gente che nn tollera che la salute abbia un prezzo Edit
Hillary Clinton's healthcare reform plan went down to inglorious defeat. What they probably will neglect to say is that a very similar proposal had the support of most Senate Republicans at the time.Read more at location 55
The Clinton health reform failed because of White House ineptitude and grass roots resistance.Read more at location 57
Patient Power was on freeing the patient. A good part of the book was devoted to the idea that when people are spending their own money they behave very differently than when they are spending other people's money.Read more at location 68
What I didn't anticipate was that the changes on the supply side of the market would be far more profoundRead more at location 70
When patients aren't spending their own money, there is no way doctors can compete for their patronage based on price. When they don't compete on price, they don't compete on quality either. The services they offer will be only those services the third parties pay for and only in settings and ways the third parties have blessed.Read more at location 74
Who do you think is going to be more creative about meeting unmet needs? Executives at a handful of insurance companies? Or 800,000 doctors dealing with real patients day in and day out?Read more at location 77
The orthodox view is that doctors are the problem. They have too much freedom, we are told. They need to be constrained and told what to do.Read more at location 80
What we need is a system in which the provider side of the market competes to provide value because it is in their self-interest to attract patients in that way. We will never solve America's healthcare crisis from the buyer side of the market. It can only be solved from the provider side.Read more at location 84
The second thing I missed the last time around was the importance of prices. The single worst public policy decision in all of heath care was the decision to eliminate money prices from the market for medical care. Have you ever wondered why the panhandler on the street corner has a cell phone, but no access to primary care? It's because he can buy a cell phone in a real marketplace, but he can't buy healthcare that way.Read more at location 87
enrolling children in the Children's Health Insurance Program (CHIP: essentially, Medicaid for children) does not result in their receiving more medical care.Read more at location 91
The third thing I failed to fully appreciate in the earlier book is the second biggest mistake in all of health policy: making it illegal for insurers to charge premiums that reflect real risks.Read more at location 101
This means that insurers have an economic self-interest in avoiding people with health problems and in failing to encourage them to seek optimal treatment once they do enroll.Read more at location 104
In a normal market, prices convey information. A high price tells innovators and entrepreneurs the market places a high value on getting a problem solved. It communicates that the reward for finding a solution could be high as well. When the price system is artificially suppressed, that information does not get communicated. Almost all of our problems in health policy stem from this central fact.Read more at location 122
Yet through the years I have discovered that the most important differences people have over health policy have little to do with facts, reasoning or logical argument. The most important differences stem from differences in fundamental world views. There are a very large number of people in this field who find the price system distasteful—at least for medical care.Read more at location 126
For well intentioned reasons perhaps, they are emotionally predisposed to favor the suppression of normal market processes.Read more at location 133
