Here is a very nice interview with Nobel Laureate Ken Arrow. Note that despite his famous position on the impossibility of having a true free-market in health care, he does not in any way demagogue the issue. Indeed, his humility is refreshing. Here is one clip:
The truth is it’s very easy to rail against it, but it’s not easy to find a substitute.
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There is no easy way out of this conflict, though a better-regulated system could help. A better bargaining position will improve matters, but you have to be a little careful, because you don’t want to hurt innovation.
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I wouldn’t say I’m strongly in favor of a single payer system. I can find objections to it. But I still think it’s better than any other system. However, the idea of permitting private practice must not be ruled out. Similar to the UK, there can be a single payer system which everybody can go to, and private medical practices for those who want. In the UK, private medicine is about 20 percent of the total, so there is this escape valve for those who want it, but also a single payer system that anybody can join.
Read the rest. Here is one more good blip, I am sure this will get lots of airtime (I’d add that in fact we are the most socialized system on earth, with not just 50% paid by governments, but a total of about 90% paid by third parties):
In that 1963 paper you wrote that “the laissez-faire solution for medicine is intolerable.” 50 years later, do you still believe that to be true?
We don’t have a laissez-faire system. The intervention of the federal government, as measured by expenditures, is growing. It is not a private system at all. Roughly 50 percent of health costs are paid for by the government, and state governments are spending more and more on health. It’s crowding out education. State budget-support for education, especially higher education, is crowded out by two things: health and prisons. Nobody is prepared for the idea of a laissez-faire system, and we never really had one.
He has some very interesting insights on cognitive capture, the large size of the financial industry, and the paradox of monopoly.
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