We economists, in our classes, teach students that to some degree, price discrimination is actually a good thing; that it allows you to serve lower-income people. Take Africa, with AIDS. They could never finance what an AIDS cocktail costs here, over $10,000 a year. But if you sold it to them for $300 a year, which just barely covers cost, they could probably serve quite a few of their citizens, with World Bank help. We economists say that will be beneficial. But it's a two-tier system; yes, African people pay less than we would pay.
Uwe ReinhardtThe issue of universal coverage is not a matter of economics. Little more than 1 percent of GDP assigned to health could cover all. It is a matter of soul.
Uwe ReinhardtIf you want to look at a purely socialized health care, you would have to go to the United States, where we have it. In particular, that's the system we reserve for our veterans. So if I hear politicians run down socialized medicine - and I have done that before the Congress - I say: Do you hate your veterans? Why do you reserve purely socialized medicine - there's only the U.S. and Cuba that have that - for the veterans? So getting the terms right would be very, very helpful in our national conversation on health reform.
Uwe ReinhardtEverybody should have health care, on the one hand. But on the other hand, if you ask Americans, "Are you willing to pay for it?," they say no. So I've never been able to understand this contradiction.
Uwe ReinhardtAmericans keep telling me they hate government. I always tell them: "Man, I've got a country for you: Go to Afghanistan; they don't have one." So if you're of that ilk, yes, you can have your private paradise, but if you're comfortable with government, then go with government.
Uwe ReinhardtThe bad things are that our financing of health care is really a moral morass. It is a moral morass in the sense that it signals to the doctors and hospitals that human beings have different values depending on their income status.
Uwe ReinhardtThe bad things the U.S. health care system are that our financing of health care is really a moral morass in the sense that it signals to the doctors that human beings have different values depending on their income status. For example, in New Jersey, the Medicaid program pays a pediatrician $30 to see a poor child on Medicaid. But the same legislators, through their commercial insurance, pay the same pediatrician $100 to $120 to see their child. How do physicians react to it? If you phone around practices in Princeton, Plainsboro, Hamilton - none of them would see Medicaid kids.
Uwe Reinhardt