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 ACA is an ugly patch on an ugly system - and I don't think it's worth mentioning in the context of price or quality transparency.
Uwe ReinhardtWe have a nation where the elite thinks it's OK to advocate a war and send the lower-income people to do the fighting. It's natural for such a people to think that the lower-income people should also have a worse health care experience. And the other countries are not there - I always say, not there yet. I tell the Germans and the Swiss, "You're not there yet, but if you're not very, very careful, if we Americans come over there and rearrange ... your health care system, you will be just like us."
Uwe ReinhardtAmericans believe that the private sector is always more efficient and cheaper than big government, and particularly when you go among Republicans, even after five beers, they still believe it. But I always say, "If it's really true, why would they need that 12 percent extra on a traditional government program? Explain to me why something that costs more saves me money as a taxpayer.".
Uwe ReinhardtThere are libertarian values which say private property is the overarching value, the sanctity thereof, and there are egalitarians who say health care should be shared and so on. That's fair enough.
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 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 Reinhardt