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 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 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 ReinhardtThe good things at the U.S. health care system are that we have a well-trained labor force, particularly physicians; I don't think any nation trains doctors better. We have the latest technology, simply because we throw so much money at it. We are really technology-hungry in this country. That's a good thing. Our system more treats patients like customers, which is a good thing; that it's very customer-friendly. And it's very innovative, both in the products we use, in the techniques we use and the organizational structures we use. Those are all very good things, highly competitive.
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