Developed countries that have contained costs and maintained quality, while keeping a private health insurance industry, all require that ALL insurance providers (public and private) to accept all applicants, and require ALL of them to provide a standard basic policy. Is there any empirical evidence that the Hacker approach will work?

Stiglitz was also here over ten years ago (with Akerlof), in models related to those that describe the current financial market crisis. Without requiring that insurance providers take all applicants, and provide standard policies, there may be no stable economic equilibrium. If that is the case with the US health care insurance market, the creative destruction of unregulated free market competition will be merely a complicated machine tearing itself apart over time.

So, is there any theoretical or empirical evidence that the Hacker approach will work?

Of course there is no reason at all for there to be private, indemnity, insurance in a field that so cries out for social insurance that even the US, home of the worship of markets, has socialized the payment for medical care of the elderly, who generate most of the need for medical services. We call it Medicare, and of course extending it to all would be even cheaper, more rational, and less distortive of the medical care it pays for than any sort of hybrid system in which the private sector is allowed a carve-out for no reason other than to let the market have what we imagine is its due.

I know that the cynical will blame the fact that we will almost certainly end up with a hybrid system anyway on the Golden Rule, “He who has the Gold makes the Rules.” But while I would not discount the effect that campaign contributions from the industry have on Congressional votes in that great majority of issues that attract little or no public reaction, you would think that the medical coverage crisis is of sufficient magnitude that it will generate enough public attention that the politicians would find more votes demagoguing the issue than taking money from an industry that would, after all, be destroyed, and in no position to take campaign contribution vengeance on them if only they could find the courage to slay the beast.

I really think the problem is more basic. Market solutions aren’t the religion of the masses. They just want to keep their jobs, their retirements, their kids’ college funds and their health care; and any way that can be done is fine with them. So most of the electorate wants Medicare for All. But an unquestioned faith in markets is the opium of the educated classes. I really think that the average Congresscritter, and almost all of the folks in intellectual attendance on them and our public life, even those few whose paychecks are not signed by big business, just take it as axiomatic that, of course, a government-run anything will be badly run, compared to the much-vaunted free-market efficiency.

Single Payer to HCAN: We Will Not Not Be Listened To!

What HCAN is really about…

also, lot’s of good info from PNHP’s single payer resources and fact sheets

The purpose is to give the public a sense that they are actively involved . . .

Isn’t that the truth.