George Halverson on health care reform

Ah, remember that topic?  Ezra Klein does.  The book is called Health Care Reform Now! and the author is CEO at Kaiser Foundation Health Plan.  That may not sound like an encouraging combination but in fact this is one of the most intelligent health care policy books around.  The analysis of cost inflation, lack of early care, and billing for procedures is perceptive throughout.  The policy proposals involve electronic medical records for everyone, legally required health insurance, enforcing that mandate through the tax system (will he really cut off EITC to kids?), high-deductible plans for the high-income insured, covering some of the uninsured through an expansion of Medicaid (expand SCHIP and cover the single poor), offering primary care-first health insurance plan to the remaining poor uninsured, and finance the whole thing through a health care sales tax.  I like that last part best of all.  Plus he wants to reform the entire infrastructure of health care and institute more pay for performance.

I’m puzzled as to how he avoids destructive "notches" (implicit high marginal tax rates) across different individual margins and what private insurance companies will do with perfect access to everyone’s electronic health care records.  And he doesn’t focus enough on encouraging innovation or dismantling bureaucracy and barriers to entry.  Still, this is one of the most substantive books out there on health care economics.  Recommended to anyone who might be tempted.

Addendum: I’ve now read through the comments and I have to admit I am a little disappointed.  I don’t favor Halverson’s solutions overall though I do favor a much greater role for integrated HMOs.  The more important point is that I should be able to cover a book, and discuss its virtues, without having to come down on it, or for it, in a partisan way.


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