Product Description

The shocking statistic is that forty-seven million Americans have no health insurance. When uninsured Americans go to the emergency room for treatment, however, they do receive care—and a bill. Many hospitals now require uninsured patients to put their treatment on a credit card—which can saddle a low-income household with unpayably high balances that can lead to personal bankruptcy. Why don't these people just buy health insurance? Because the cost of coverage that doesn't come through an employer is more than many low- and middle-income households make in a year. Meanwhile, rising healthcare costs for employees are driving many businesses under. As for government-supplied health care, ever higher costs and added benefits (for example, Part D, Medicare's new prescription drug coverage) make both Medicare and Medicaid impossible to sustain fiscally; benefits grow faster than the national per-capita income. It's obvious the system is broken. What can we do?

In The Healthcare Fix, economist Laurence Kotlikoff proposes a simple, straightforward approach to the problem that would create one system that works for everyone—and secure America's fiscal and economic future. Kotlikoff's proposed Medical Security System is not the "socialized medicine" so feared by Republicans and libertarians; it's a plan for universal health insurance. Because everyone would be insured, it's also a plan for universal healthcare.

Participants—including all who are currently uninsured, all Medicaid and Medicare recipients, and all with private or employer-supplied insurance—would receive annual vouchers for health insurance, the amount of which would be based on their current medical condition. Insurance companies would willingly accept people with health problems because their vouchers would be higher. And the government could control costs by establishing the values of the vouchers so that benefit growth no longer outstrips growth of the nation's per capita income. It's a "single-payer" plan—but a single payer for insurance. The American healthcare industry would remain competitive, innovative, strong, and private.

Kotlikoff's plan is strong medicine for America's healthcare crisis, but brilliant in its simplicity. Its provisions can fit on a postcard—and Kotlikoff provides one, ready to be copied and mailed to your representative in Congress. We're electing a new president in 2008; let's choose a new healthcare system, too—one that works.

Product Details

• Amazon Sales Rank: #662193 in Books
• Published on: 2007-10-31
• Original language: English
• Number of items: 1
• Binding: Hardcover
• 96 pages

Features

• ISBN13: 9780262113144
• Condition: NEW
• Notes: Brand New from Publisher. No Remainder Mark.
• Click here to view our Condition Guide and Shipping Prices

From Publishers Weekly
Taking off from the statistic that 47 million Americans have no health insurance, this treatise from Boston University economist Kotlikoff (The Coming Generational Storm) argues forcefully that on one hand, emergency room and other medical debt incurred by the uninsured is a crippling force in the economy, and that, on the other, Medicare and Medicaid benefits are spiraling beyond the system's ability to sustain them. Humanitarian concerns aside, Kotlikoff argues for a voucher-based "Medical Security System" that issues benefits to individuals (rather than doctors or hospitals) based on existing medical conditions. The plan's goal is the preservation of the existing private health care industry, in part through allowing the government to control costs by establishing the value of the vouchers. Kotlikoff's passionate exposition of the details of his plan is sure to add to the growing health care debate.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review
"Kotlikoff's book sends the strong message that all—not just the uninsured, the elderly, the middle class, or the politicians—are placing themselves and future generations in fiscal jeopardy through the current medical/financial free-for-all. Whether you agree with his solution or not, time is running out. Affordable medical care is everyone's problem. Most know John Donne's line, 'Send not to know for whom the bell tolls, it tolls for thee.' Fewer remember the more mundane words of the World War I trench ditty, "The bells of Hell go ding-a-ling-a-ling for you but not for me.... " The health care bells are ringing—not just for you, but for me. Read Kotlikoff's book, ponder his solution, and be warned."
— Markley H. Boyer, MD, DPhil, MPH, Tufts University School of Medicine, JAMA

"Kotlikoff's passionate exposition of the details of his plan is sure to add to the growing health care debate."
— PW Web Exclusive Reviews

"Laurence Kotlikoff has done it again. He presents in his usual fast-paced but understandable style the immense financial problems faced by the Medicare and Medicaid programs. But he goes further, introducing and defending a complete solution. Whether or not you agree with his proposals, the importance of the question, and the brilliant defense of his solution, make this book a must-read for both health policy professionals and interested citizens."
—Thomas R. Saving, Trustee of the Social Security and Medicare Trust Funds, and Department of Economics, Texas A & M University

"This book is essential reading for anyone who wants to enter the debate about how to achieve universal health care and fiscal responsibility at the same time. Kotlikoff lays out the problem and convincingly argues that the status quo is leading us to a catastrophe. Moreover, he offers a simple, yet radical solution." —John B. Shoven, Charles R. Schwab Professor of Economics, Stanford University and coauthor of The Real Deal: The History and Future of Social Security

"With the earnest tone of a teacher aching for his students to understand, Kotlikoff creates a stark picture of our looming financial straits."
— TIME

About the Author
Laurence J. Kotlikoff is Professor of Economics at Boston University. One of the nation's leading experts on fiscal policy, national saving, and personal finance, Kotlikoff is the author of Essays on Savings, Bequests, Altruism, and Life-Cycle Planning (2001), Generational Policy (2003), The Coming Generational Storm (2004), all published by The MIT Press, and other books.

Customer Reviews

Healthcare Fix? Maybe.

Book Review: The Healthcare Fix

Laurence Kotlikoff is an economics professor at Boston University. Mr. Kotlikoff thinks he's the Man with the Plan for universal healthcare in the U.S. The book he's written is a short, fast read which presents a straightforward message:

Medicare and Medicaid, because of their billing policies are bankrupting the country by feeding healthcare inflation. The fix, according to Kotlikoff is to scrap the two federal programs and replace them with universal health adjusted medical insurance vouchers. A young healthy individual would receive a small voucher say $5000 per year while an older less healthy individual would get a voucher of say $50,000 to buy a full private insurance policy.

This would incentivize private insurers to write policies for these insured as follows. If the oldser only needed $10,000 in health spending for the year the insurer profits by $40,000. OTOH if the youngster was hit with a $30,000 medical expense the insurer would take a -$25000 hit. The latter is less likely than the former. Also, the vouchers would be health history adjusted so that the older patient might get a lower voucher for having a good year.

What's attractive about Kotlikoff's fix is that the voucher system has a built in mechanism for monitoring spending, it eliminates cherry picking of patients and it's universal. However, as is the case with a short somewhat glib book Kotlikoff glosses quite a bit. He even glosses in error.

In one example he mischaracterizes Mitt Romney's role in signing a law that charges $300 per employer annually to fund health insurance for all in Massachusetts. The $300 fee was passed OVER Romney's line item veto. The main part of the bill is a punitive mandate that requires all taxpayers* acquire health insurance. Those who don't face monthly penalties enforced by Massachusetts' version of the IRS. The MA health insurance law funding comes in part from the $300 fee but mostly from shifting uncompensated healthcare funds to subsidizing premiums for poor and lower wage workers. The Massachusetts law does little to contain the soaring costs of the commonwealth's pet industry.

This kind of glossing is what troubles me about this otherwise interesting and provocative book. Kotlikoff is hardly naive about the economic and political realities facing his proposal. Libertarians don't like government programs. Healthcare professionals feel entitled to unlimited compensation. Patients want the best healthcare others' money can buy. Hospitals love their high tech profit centers. Then there are the miriad of big and small suppliers that profit from over priced products, waste and techno-churn.

America's healthcare problem is not the lack of universal healthcare. It's the lack of universal fairness in health insurance. Employer ensured workers, especially high income professionals, have their premiums paid. But they pay no taxes on this imputed income. An uninsured taxpayer showing up at the hospital had better have a bunch of high balance credit cards and be prepared for bankruptsy. Yet his taxes compensate for the lower taxes of his fortunate and better paid neighber. Kotlikoff would do away with this asymmetry and use the 'higher taxation' to help fund his scheme. One could expect Republicans to rail agaist this while Democrats knee-jerk against vouchers. He also suggests savings and thus funding could be found in reducing administrative costs in the healthcare system. Good luck on reducing hospital fat and red tape. One other loose end in Kotlikoff's plan is where do the insurer's profits go? Shareholders? High CEO pay? Into lower premiums?

Notwithstanding its holes and loose ends Kotlikoff has made a provocative case that is a must read piece of food for thought. Regardless what you think of his proposed fix, Kotlikoff is right about one thing ... Our profligate healthcare industrial complex is threatening our fiscal future.


* In Massachusetts a young tax cheat can earn buy one of the special subsidized young person's
policies which doesn't require proof of income.