Controlling the costs of medial care : a dose of deregulation /

Saved in:
Bibliographic Details
Author / Creator:Epstein, Richard Allen, 1943- author.
Imprint:[Chicago, Illinois] : Law School, University of Chicago, 2008.
Description:1 online resource (36 pages)
Language:English
Series:John M. Olin Law & Economics Working Paper ; no. 418 (2d series)
John M. Olin Program in Law & Economics working paper ; 2nd ser., no. 418.
Subject:
Format: E-Resource Book
URL for this record:http://pi.lib.uchicago.edu/1001/cat/bib/8921902
Hidden Bibliographic Details
Varying Form of Title:Controlling the cost of medical care
Other authors / contributors:Hyman, David A., author.
Notes:"July 2008."
Includes bibliographical references.
Title from online title page (viewed October 18, 2012).
Summary:"In Beyond Learned Helplessness, Professor Gregg Bloche surveys the wreckage of past attempts at health care cost containment, and responds with a typical inside-the- Beltway solution: an expert independent agency. The agency will "set a national agenda for clinical outcomes research, support this research in dependable fashion, develop costbenefit trade-off principles for medical coverage, and formulate coverage protocols based on these principles. The resultant scheme would place 'binding' limits on covered services for Medicare and other federally-funded insurance programs, including extension of coverage to the uninsured. . . [and] a model for the private sector, state Medicaid programs, and state efforts to reduce the numbers of the uninsured." Count us doubtful. The history of expert independent agencies does not inspire optimism. Industrial policy has not succeeded in any other area in which it has been tried; price and wage controls, telecommunications, airlines, ground transportation, and agriculture all count as notable failures. If the history of administrative agencies has taught us anything, it is that expertise offers no shield against the corrosive effects of bias - particularly when government regulation is beset by the same problems with information and coordination that make markets difficult to operate. Decentralized market actors are often better able to identify and use relevant information than a single sclerotic government agency that is beset with administrative and political problems of its own. There is little to be gained by attacking the intractable problems of modern health care policy with process-oriented solutions. A direct attack on the substantive issues is necessary. In section I, we offer a brief critique of the system of positive rights and merit goods that underlie the case for most forms of universal health care coverage. In section II, we identify three practical problems that no working politician can wish away in the effort to implement universal health care coverage: the fundamental principle of diminishing marginal utility; the destabilizing impact of heavily subsidized governmentprovided coverage on the private market; and the treatment of the full range of existing regulations affecting the delivery of health care services as an exogenous given. We address each of these deficiencies in turn. In section III, we examine briefly six areas where we think massive deregulation is in order: medical malpractice, HIPAA, federal tax law, fraud and abuse, health insurance regulation, and certificate of need/scope of practice limitations. We anticipate that our proposals will be met by howls of protest from those who benefit from the status quo and their apologists. Such complaints should be seen for what they are - a defense of rent-seeking by incumbent providers. The whole point of deregulation is to limit the opportunity and rewards of rent-seeking, thereby increasing consumer surplus. No administrative agency or committee of experts, no matter how well intentioned and knowledgeable, will be able to do a better job of meeting consumer demands than the private market. To think otherwise is to repeat the mistakes of the past, instead of learning from them."

MARC

LEADER 00000nam a2200000 i 4500
001 8921902
003 ICU
005 20121019133000.0
006 m d
007 cr b||||||||||
008 121018s2008 ilu ob 000 0 eng c
035 |a (OCoLC)813318840 
040 |a CGU  |b eng  |e rda  |c CGU 
042 |a pcc 
043 |a n-us--- 
049 |a CGUA 
050 4 |a KF3825  |b .E67 2008 
100 1 |a Epstein, Richard Allen,  |d 1943-  |e author.  |0 http://id.loc.gov/authorities/names/n77013251  |1 http://viaf.org/viaf/108205709 
245 1 0 |a Controlling the costs of medial care :  |b a dose of deregulation /  |c Richard A. Epstein and David A. Hyman. 
246 3 |a Controlling the cost of medical care 
264 1 |a [Chicago, Illinois] :  |b Law School, University of Chicago,  |c 2008. 
300 |a 1 online resource (36 pages) 
336 |a text  |2 rdacontent  |0 http://id.loc.gov/vocabulary/contentTypes/txt 
337 |a computer  |2 rdamedia  |0 http://id.loc.gov/vocabulary/mediaTypes/c 
338 |a online resource  |2 rdacarrier  |0 http://id.loc.gov/vocabulary/carriers/cr 
490 1 |a John M. Olin Law & Economics Working Paper ;  |v no. 418 (2d series) 
500 |a "July 2008." 
504 |a Includes bibliographical references. 
520 |a "In Beyond Learned Helplessness, Professor Gregg Bloche surveys the wreckage of past attempts at health care cost containment, and responds with a typical inside-the- Beltway solution: an expert independent agency. The agency will "set a national agenda for clinical outcomes research, support this research in dependable fashion, develop costbenefit trade-off principles for medical coverage, and formulate coverage protocols based on these principles. The resultant scheme would place 'binding' limits on covered services for Medicare and other federally-funded insurance programs, including extension of coverage to the uninsured. . . [and] a model for the private sector, state Medicaid programs, and state efforts to reduce the numbers of the uninsured." Count us doubtful. The history of expert independent agencies does not inspire optimism. Industrial policy has not succeeded in any other area in which it has been tried; price and wage controls, telecommunications, airlines, ground transportation, and agriculture all count as notable failures. If the history of administrative agencies has taught us anything, it is that expertise offers no shield against the corrosive effects of bias - particularly when government regulation is beset by the same problems with information and coordination that make markets difficult to operate. Decentralized market actors are often better able to identify and use relevant information than a single sclerotic government agency that is beset with administrative and political problems of its own. There is little to be gained by attacking the intractable problems of modern health care policy with process-oriented solutions. A direct attack on the substantive issues is necessary. In section I, we offer a brief critique of the system of positive rights and merit goods that underlie the case for most forms of universal health care coverage. In section II, we identify three practical problems that no working politician can wish away in the effort to implement universal health care coverage: the fundamental principle of diminishing marginal utility; the destabilizing impact of heavily subsidized governmentprovided coverage on the private market; and the treatment of the full range of existing regulations affecting the delivery of health care services as an exogenous given. We address each of these deficiencies in turn. In section III, we examine briefly six areas where we think massive deregulation is in order: medical malpractice, HIPAA, federal tax law, fraud and abuse, health insurance regulation, and certificate of need/scope of practice limitations. We anticipate that our proposals will be met by howls of protest from those who benefit from the status quo and their apologists. Such complaints should be seen for what they are - a defense of rent-seeking by incumbent providers. The whole point of deregulation is to limit the opportunity and rewards of rent-seeking, thereby increasing consumer surplus. No administrative agency or committee of experts, no matter how well intentioned and knowledgeable, will be able to do a better job of meeting consumer demands than the private market. To think otherwise is to repeat the mistakes of the past, instead of learning from them." 
588 |a Title from online title page (viewed October 18, 2012). 
650 0 |a Medical care, Cost of  |x Law and legislation  |z United States. 
650 0 |a Health insurance  |x Law and legislation  |z United States.  |0 http://id.loc.gov/authorities/subjects/sh2008104710 
650 0 |a Medical care  |x Law and legislation  |z United States.  |0 http://id.loc.gov/authorities/subjects/sh2008107272 
650 7 |a Health insurance  |x Law and legislation.  |2 fast  |0 http://id.worldcat.org/fast/fst01715845 
650 7 |a Medical care, Cost of  |x Law and legislation.  |2 fast  |0 http://id.worldcat.org/fast/fst01013914 
650 7 |a Medical care  |x Law and legislation.  |2 fast  |0 http://id.worldcat.org/fast/fst01013817 
651 7 |a United States.  |2 fast  |0 http://id.worldcat.org/fast/fst01204155 
700 1 |a Hyman, David A.,  |e author.  |0 http://id.loc.gov/authorities/names/no2012137042  |1 http://viaf.org/viaf/38896117 
830 0 |a John M. Olin Program in Law & Economics working paper ;  |v 2nd ser., no. 418. 
856 4 0 |u http://www.law.uchicago.edu/files/files/418.pdf 
856 4 0 |u http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1158547 
903 |a HeVa 
929 |a cat 
999 f f |i 30ece56a-1674-55a7-8f47-d10dbc53326f  |s 86f7310e-8905-5159-b98b-550b23216ece 
928 |t Library of Congress classification  |a XXKF3825.E67 2008  |l Online  |c UC-FullText  |u http://www.law.uchicago.edu/files/files/418.pdf  |g ebooks  |i 7156436 
928 |t Library of Congress classification  |a XXKF3825.E67 2008  |l Online  |c UC-FullText  |u http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1158547  |g ebooks  |i 7518182