Free Market Perspectives on American Healthcare Reform Plans
While the primary ideological debate over healthcare reform in America is centered on the Democratic and Republican parties, a number of independent libertarians have also been vocal in expressing their reservations to current legislative options. Although few libertarians have been elected to Congress, a number of leading health and policy scholars have taken a market-based approach which suggests that government healthcare may be counter-productive. The academic debate over the merits of health reform incorporates these varying perspectives, which come from scholars across a variety of disciplines.
Economics of Health Care
Free market economists have been modeling the role of government in health markets since the 1960s, and have aimed to model the influences of government entry, irrational consumer decisions and the role of competition in the market. At the core of the issue is the role of policy in shaping incentives: while liberal economists such as Cass Sunstein argue government should encourage certain types of health behavior , other libertarian scholars have argued that providing more choices and less regulation should be the focus on improving health outcomes.
Research on Health Reform
Two major economic scholars active in health research today are MIT’s Jonathan Gruber and Harvard’s Richard Thaler. Both economists take a free-market approach to the subject but are careful to evaluate potential market failures, externalities and unintended constraints which lead to sub-optimal outcomes. Therefore, while scholars such as Robert Barro of Harvard have argued that private insurance markets can solve healthcare reform issues, centrist research has taken a more nuanced approach to the issue.
In a 2008 report on behavioral economics, Thaler argues that research into why people fail to make rational savings decisions can shed light on sub-par health care practices as well. One overlooked aspect, according to the paper, is the presentation of the options to consumers. While many consumers might agree that quality health care is important, the availability and presentation of choices is even more important. Providing consumers with a clear road map to selecting a plan, especially when they are not given one by their employer is crucially important. For uninsured families, therefore, providing coverage guidance should be a core part of the planning process. Gruber also argues in another paper that lessons from Massachusetts state health care reform can help policy makers better understand effective reform on a national level. In particular, his paper takes a deeper look at consumers budgets and how mandatory plans can encourage more investment in quality health care, including preventative options.