In their new book, “We Got You Covered,” Amy Finkelstein and Liran Einav propose a total overhaul of our US health care system that would guarantee everyone basic health insurance coverage and allow people to buy private insurance for coverage upgrades. As they see it, we could spend our health care dollars more wisely and protect people from ever losing essential benefits.
No question that the US health care system needs an overhaul. Thirty million Americans each year are without any health insurance coverage. People lose health insurance all the time because of a change in jobs, a change in domicile, a change in income, a change in age or disability status and more. And, tens of millions of Americans with health insurance are underinsured, either unable to afford their care with insurance or, too often, facing enormous medical debt.
Finkelstein and Einav believe that basic coverage should not require copays or deductibles. Copays and deductibles discriminate against people based on their ability to pay for care. They lead people to forgo care. People should be able to get the care they need regardless of their ability to pay for it.
The US can afford to guarantee basic coverage to everyone. We spend about 18 percent of GDP on health care. Basic coverage would cost about nine percent of GDP, which is what other countries spend on guaranteeing health care to everyone.
So, what’s the likelihood that the Finkelstein Einav health care policy solution could ever come to pass? Finkelstein believes that there’s at least a chance because, she believes that it is not politically loaded. Republicans and Democrats alike seem to like it. And, some conservatives support universal health insurance coverage. But, Finkelstein doesn’t factor in the opposition of health insurers, who are making hundreds of billions of dollars a year on the current system and will do everything in their power to keep things the way they are.
While not saying he supports the Finkelstein-Einav prescriptions, one conservative scholar, N. Gregory Mankiw, the Robert M. Beren Professor of Economics at Harvard University, calls their book a “smart, cogent, and eminently readable look at the U.S. health care system and what can be done to fix it.”
For sure, we’re not going to see guaranteed universal health care in the US any time soon. The question is whether it’s even inevitable or whether our Congress will simply allow our health care system to continue on its Darwinian course of survival of the fittest.
Here’s more from Just Care:
- Congressional Budget Office reports benefits of Medicare for all over corporate health insurance
- Biden proposes to ban junk health plans
- Can we fix our broken health care system without reining in costs?
- Private equity buying up specialists and driving up health care costs
- Medicare patients with liver cancer face $10,000 in out-of-pocket costs
