Priced Out: The Economic and Ethical Costs of American Health Care

by Uwe E. Reinhardt, Paul Krugman (Foreword by), Sen. William H. Frist (Foreword by), Tsung-Mei Cheng (Epilogue by)

Overview

From a giant of health care policy, an engaging and enlightening account of why American health care is so expensive—and why it doesn't have to be

Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of the U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it. Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America pays for health care, dispelling the confusion, ignorance, myths, and misinformation that hinder effective reform.

Product Details

ISBN-13:	9780691208534
Publisher:	Princeton University Press
Publication date:	09/01/2020
Pages:	232
Product dimensions:	5.40(w) x 7.90(h) x 0.50(d)

About the Author

Uwe E. Reinhardt (1937–2017) was the James Madison Professor of Political Economy and Professor of Economics and Public Affairs at Princeton University. He wrote a regular column for the New York Times blog Economix.

Table of Contents

Foreword Paul Krugman ix

Foreword Senator William H. Frist, MD xv

Prologue xxiii

Introduction 1

I A Visual Stroll through America's Health Care Wonderland

1 U.S. Health Spending and What Drives It 13

2 Pricing Americans Out of Health Care 41

3 Some Interesting or Curious Facts about Our Health Care System 47

4 Who Actually Pays for Health Care? 62

5 Value for the Money Spent on U.S. Health Care 69

II Ethical Perspectives on U.S. Health Care

6 The Social Role of Health Care 81

7 The Mechanics of Commercial Health Insurance from an Ethical Perspective 85

8 The Elephant in the Room and the Ethical Vision Baked into Health Reform Proposals 99

9 The Ethical Vision of the Affordable Care Act of 2010 (Obamacare) 102

10 The Ethical Vision of the Health Reform Proposals of 2017 110

Conclusion: A Novel (My Own) Reform Proposal 135

Epilogue Tsung-Mei Cheng 139

Acknowledgments Tsung-Mei Cheng 169

Notes 173

Index 191

What People are Saying About This

From the Publisher

"As always, Uwe Reinhardt has managed to make me smile as he's presenting a tragic story about U.S. health care. He couples an economist's mathematical graphs and analysis with his unique, unsparing wry commentary. You can hear him on every page of this book. Demonstrating the infeasibility of many—actually, almost all—of the recent attempts at health care reform, he avers that Republican loss of control of one or both houses in 2018 would 'change the debate on health care.' He predicts 'major competing initiatives on health care' from both parties in the 2020 campaign. It is a tragedy that he will not be here to analyze them."—Elisabeth Rosenthal, Editor-in-Chief, Kaiser Health News, and author of An American Sickness

"Uwe Reinhardt was the moral conscience of our health care system, reminding us with evidence, clarity, and stand-up act humor how it is failing. He was joined in this enterprise by another great health care expert, his wife, Tsung-Mei Cheng. Every health care group craved Reinhardt as their keynote speaker and felt more virtuous after he berated them about the many ways in which they were failing. But he did not want adulation; he wanted things to change. By reading this powerful book and making something in the health system better, we can all honor his legacy."—Drew Altman, President and CEO, Henry J. Kaiser Family Foundation

"With an economist's precision and a prophet's moral clarity, the late Uwe Reinhardt untangles our complex health care system for all to see and understand. Only Reinhardt could have done so much in such a short, penetrating volume. His brilliance as a teacher shines through. This will be a must-read for aspiring students of health care and for policymakers everywhere. How much we will miss him."—David Blumenthal, MD, President, The Commonwealth Fund

"In my forty-plus years of engagement with health care policy, I never encountered a mind more incisive or a character more compelling than Uwe Reinhardt's. With his clear voice, piercing intellect, hilarious wit, and unshakable ethics, he simply had no peer. Priced Out is one more testament to the gifts he gave us as a unique model of science and compassion in indissoluble embrace. If you want to understand the trouble that health care has come to, and where it must look for solutions, read this book."—Donald M. Berwick, MD, President Emeritus and Senior Fellow, Institute for Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services

Editorial Reviews

Winner of the Gold Medal in Business Ethics, Axiom Business Book Awards

"With the posthumous publication this month of his final work, a book entitled Priced Out: The Economic and Ethical Costs of American Health Care, Reinhardt’s reputation for cutting to the quick of the issues in U.S. healthcare reform is only enhanced. The book should be required reading for anyone who professes to have an interest in the debate — economists, journalists, legislators, doctors and patients."—-Michael Hiltzik, Los Angeles Times

"Reinhardt’s new book gives a cogent synthesis of all the reasons why ‘it’s the prices, stupid’—not the quantity of care we receive—that drives our high health spending."—-Adam Gaffney, Boston Review

"There are numerous moments in this book that will remind readers like myself how much we will miss both his colorful imagery and his brutal candor . . . . One wonders after reading it how to ensure that the book achieves the broad distribution it deserves, especially among the young people and newly minted legislators and members of Congress who will not get a chance to hear Reinhardt in person . . . . We owe Uwe Reinhardt a large debt of gratitude. Buy and read his last book. Then give it to a younger friend."—-Jeff Goldsmith, Health Affairs

"Wish I could afford to buy a copy for every adult in the U.S. If healthcare matters to you, please read it."—-Ted Kinni

"Uwe’s book can be enjoyed by, and be illuminating for, students, policymakers, the media, and the health care establishment. The only problem is that he can’t follow it up with a book tour and educate his audiences in person with the best PowerPoint presentations I have ever seen."—-Gerard Anderson, StatNews

"Priced Out . . . combines scholarly, in-depth analysis with rich insight, delightfully sharp humor, and deep moral seriousness — all in consistently clear, engaging prose."—-Donald Gilpin, Princeton Magazine

From the Publisher