Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Uwe Reinhardt, PhD

Uwe Reinhardt, PhD With approximately 45 million US residents lacking health insurance, improving access to care is on the minds of many experts. Among them is Princeton University's Uwe Reinhardt, PhD, one of the nation's leading authorities on health care economics and a member of JAMA's editorial board. JAMA spoke with Reinhardt recently about his thoughts on recently introduced health care proposals and how the country might mend its current system. Uwe Reinhardt, PhD (Photo credit: John Roemer/Princeton University) JAMA:What is your assessment of President Bush's proposal to reform the tax code with a standard deduction of $7500 for individuals and $15 000 for families who obtain health insurance on their own or through an employer? Dr Reinhardt: It's fiddling with the tax code at the margin, but it still perpetuates an inequity that's always been in that code—namely, that high-income people benefit more dollarwise from tax deductions of any sort than do poor people. Do we really want to make health care more expensive for the lower-middle class than for the upper-income classes? JAMA:What do you think about the President's proposal that federal funding will be provided to states that provide their citizens with access to basic, affordable private health insurance to help poor and hard-to-insure citizens? Dr Reinhardt: The President doesn't propose to put any new money into the system. Instead, [he] proposes to reallocate money already in the system. I personally asked someone on the inside what are these monies, and you cannot get an answer out of the White House. JAMA:Do any of the state plans have merit? In Massachusetts, employer sponsorship of health benefits will no longer be strictly voluntary, nor will the take-up of health insurance by employees. Dr Reinhardt: Massachusetts is imaginative. They do a little bit of everything: expanding the public programs, making vouchers available to low-income people to buy private insurance, reorganizing the insurance market, and then the revolutionary thought of mandating health insurance, which is essential for this to work. Massachusetts has some federal money, a little bit from what employers have to pay if they don't provide insurance, and some other taxes. But the plan, in my view, is underfunded. JAMA:Our current employer-based system leaves many Americans without access to affordable health insurance. What is needed to change that? Dr Reinhardt: It was a mistake to get into it, but now we’ve got it and you can't dismantle it until you put something in its place. To really get universal coverage, the political leaders would jointly have to put $100 billion a year of government money into any proposal for genuine universal coverage, and that allocation has to increase at about 7% to 8% per year. Anything short of that isn't really getting the full job done. If it's less than $50 billion for the nation, it's not worth talking about. Most of the politicians are trying to have universal coverage without putting additional money in. JAMA:Many critics say that there is too much wasteful health care spending going on—for example, for unnecessary procedures. Is there a way to scale back on these procedures and costs? Dr Reinhardt: We do waste billions of dollars, and the money we waste in health care would cover the uninsured more than twice over. We know that you can get health care much more cheaply without adverse effects on patients, and we’ve known this for 25 years. It's been estimated that we spend about 25% of the health care dollar on administration. We have a gazillion insurance plans, so that each doctor . . . has to deal with 25 or sometimes up to 60 different insurance contracts, and claiming reimbursement from the insurers is unbelievably complicated and expensive. JAMA:What do you think of other countries' health plans, such as Canada’s? Dr Reinhardt: Canada has queues some of which are unduly long, although Canadians will tell you that not having any queues requires substantial, wasteful excess capacity. On the other hand, they spend only half as much per capita on health care as we do. What I would tell the Canadians is, how about you spend 65% of what we Americans spend and then you’d have nirvana. You wouldn't have many queues and you’d have all of the care and resources you’d need, and you could do it with 65% because you don't blow so much on administration and all of the other ugly things in our health system. JAMA:Any other thoughts on moving forward and providing better access to health coverage in this country? Dr Reinhardt: We’ve been at this for 60 years now. There is hardly any excuse any more for inaction. I think the Massachusetts plan, coupled with $100 billion of federal funds, would get most of it done. People ask, ‘wouldn't $100 billion break the bank of the nation?’ Well, it's just a little over half of a year in Iraq. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Uwe Reinhardt, PhD

JAMA , Volume 297 (10) – Mar 14, 2007

Uwe Reinhardt, PhD

Abstract

With approximately 45 million US residents lacking health insurance, improving access to care is on the minds of many experts. Among them is Princeton University's Uwe Reinhardt, PhD, one of the nation's leading authorities on health care economics and a member of JAMA's editorial board. JAMA spoke with Reinhardt recently about his thoughts on recently introduced health care proposals and how the country might mend its current system. Uwe Reinhardt, PhD (Photo credit: John...
Loading next page...
 
/lp/american-medical-association/uwe-reinhardt-phd-dCqoIgQFMA

References (0)

References for this paper are not available at this time. We will be adding them shortly, thank you for your patience.

Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.297.10.1049
Publisher site
See Article on Publisher Site

Abstract

With approximately 45 million US residents lacking health insurance, improving access to care is on the minds of many experts. Among them is Princeton University's Uwe Reinhardt, PhD, one of the nation's leading authorities on health care economics and a member of JAMA's editorial board. JAMA spoke with Reinhardt recently about his thoughts on recently introduced health care proposals and how the country might mend its current system. Uwe Reinhardt, PhD (Photo credit: John Roemer/Princeton University) JAMA:What is your assessment of President Bush's proposal to reform the tax code with a standard deduction of $7500 for individuals and $15 000 for families who obtain health insurance on their own or through an employer? Dr Reinhardt: It's fiddling with the tax code at the margin, but it still perpetuates an inequity that's always been in that code—namely, that high-income people benefit more dollarwise from tax deductions of any sort than do poor people. Do we really want to make health care more expensive for the lower-middle class than for the upper-income classes? JAMA:What do you think about the President's proposal that federal funding will be provided to states that provide their citizens with access to basic, affordable private health insurance to help poor and hard-to-insure citizens? Dr Reinhardt: The President doesn't propose to put any new money into the system. Instead, [he] proposes to reallocate money already in the system. I personally asked someone on the inside what are these monies, and you cannot get an answer out of the White House. JAMA:Do any of the state plans have merit? In Massachusetts, employer sponsorship of health benefits will no longer be strictly voluntary, nor will the take-up of health insurance by employees. Dr Reinhardt: Massachusetts is imaginative. They do a little bit of everything: expanding the public programs, making vouchers available to low-income people to buy private insurance, reorganizing the insurance market, and then the revolutionary thought of mandating health insurance, which is essential for this to work. Massachusetts has some federal money, a little bit from what employers have to pay if they don't provide insurance, and some other taxes. But the plan, in my view, is underfunded. JAMA:Our current employer-based system leaves many Americans without access to affordable health insurance. What is needed to change that? Dr Reinhardt: It was a mistake to get into it, but now we’ve got it and you can't dismantle it until you put something in its place. To really get universal coverage, the political leaders would jointly have to put $100 billion a year of government money into any proposal for genuine universal coverage, and that allocation has to increase at about 7% to 8% per year. Anything short of that isn't really getting the full job done. If it's less than $50 billion for the nation, it's not worth talking about. Most of the politicians are trying to have universal coverage without putting additional money in. JAMA:Many critics say that there is too much wasteful health care spending going on—for example, for unnecessary procedures. Is there a way to scale back on these procedures and costs? Dr Reinhardt: We do waste billions of dollars, and the money we waste in health care would cover the uninsured more than twice over. We know that you can get health care much more cheaply without adverse effects on patients, and we’ve known this for 25 years. It's been estimated that we spend about 25% of the health care dollar on administration. We have a gazillion insurance plans, so that each doctor . . . has to deal with 25 or sometimes up to 60 different insurance contracts, and claiming reimbursement from the insurers is unbelievably complicated and expensive. JAMA:What do you think of other countries' health plans, such as Canada’s? Dr Reinhardt: Canada has queues some of which are unduly long, although Canadians will tell you that not having any queues requires substantial, wasteful excess capacity. On the other hand, they spend only half as much per capita on health care as we do. What I would tell the Canadians is, how about you spend 65% of what we Americans spend and then you’d have nirvana. You wouldn't have many queues and you’d have all of the care and resources you’d need, and you could do it with 65% because you don't blow so much on administration and all of the other ugly things in our health system. JAMA:Any other thoughts on moving forward and providing better access to health coverage in this country? Dr Reinhardt: We’ve been at this for 60 years now. There is hardly any excuse any more for inaction. I think the Massachusetts plan, coupled with $100 billion of federal funds, would get most of it done. People ask, ‘wouldn't $100 billion break the bank of the nation?’ Well, it's just a little over half of a year in Iraq.

Journal

JAMAAmerican Medical Association

Published: Mar 14, 2007

Keywords: health insurance,health insurance, private,money,insurance,adverse effects

There are no references for this article.