Economist and N.Y. Times columnist Paul Krugman provided a tribute to the late Uwe Reinhardt. Although I won’t get into any of Krugman’s comments of Reinhardt as a person, I did find Krugman’s comments about his perception of the field of health economics interesting. For instance:
In case you don’t know this, health economics is a hugely important subject that even now doesn’t get as much attention as it deserves. We talk endlessly about globalization and all that, yet America spends more on health than it does on imports – and spends it much worse: our health care system is hugely dysfunctional.
Krugman notes that simple solutions that often work in other markets may not work so well when applied to health economics.
…you need to know that health care is no country for simplistic men. There may be areas of economics where repeating easy slogans gets you somewhere; health economics, for a variety of reasons, isn’t one of those areas. The facts about health care tend to be complex, and they’re also stubbornly inconsistent with rigid ideologies of any kind.
As any reader of my blog knows, there are a lot of vested interests in health care, and reforming health care is not so simple. Krugman writes:
You might think that everyone would be eager to get health care facts right; that is, you might think that if you’ve been living in a cave for, I don’t know, the past 35 years or so. The reality is that policy debates over health care are, if anything, even uglier than average for U.S. economic debate, which is really saying something; the reason, I think, is because the facts – the kind of facts Uwe dedicated his working life to discovering – are so inconsistent with many forms of political orthodoxy.
Finding solutions to our countries health care problems is complex. Despite this complexity, I believe that rigorous health economics can help us find fact-based solutions to these problems.
You have my full agreement on these sentiments. Unfortunately, it appears that patient’s and physicians’ perspectives have been lost in the current literature, and the price of bureaucratic solutions has been discounted or overlooked. That is why I am pushing for moving beyond the Orwellian fall-out of the 1984 Hatch-Waxman Act. To balance of clinical autonomy, innovation stimulation, and rational cost growth is no doubt challenging. But, as many Supreme Court Justices have referenced in several seminal decisions, the Hatch-Waxman Act does lead to multiple perversions that can only be addressed by changing the law. An even playing field that can accommodate old and new without financial coercion is desperately needed.