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 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 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 ReinhardtThe American people are not ready for the idea that everyone has at least a moral right to good, timely health care. They do agree they have a moral right, in critical cases, to have anything done to save their life, but they don't believe that anyone has a right not to fall that sick to begin with. So if you ask me, "Are we ever succumbing to some notions of solidarity as a nation?," I would say, "Not at all." I would describe us as a group of people who share a geography. That's a better description of Americans than that we're a real nation with a sense of solidarity.
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