The Economics of Obamacare/ NY Review of Books

Marcia Angell (Harvard professor, writer and former NEJM editor) has penned another excellent book review for the NY Review of Books.  This time, she discusses Stephen Brill’s new book on Obamacare, “America’s Bitter Pill”.  Two excerpts follow:

… Practically every serious economic analysis of the American health system has concluded that the most efficient way to provide care to everyone is through some form of single-payer system, such as Medicare for all, and that any other approach will eventually be unsupportable. Why, then, was a single-payer system excluded from consideration and its proponents almost entirely barred from the discussion during the year Obamacare was written? That rejection can only reflect the enormous power of the health industry, which Brill reminds us has the largest lobby in Washington, D.C., and gave millions in campaign contributions to the key legislators. Indeed, Senator Baucus [who was responsible for drafting the Act] received more money from the health industry that year than anyone else in Congress.

… Until we begin to treat health care as a social good instead of a market commodity, there is simply no way to make health care universal, comprehensive, and affordable. Brill’s book is a superb, even gripping, description of the American health system and the creation of Obamacare, but he is misguided in his recommendation for reform by turning over the administration of the health care system to hospitals. The last thing we need is more foxes guarding the henhouse. 

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