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• W2040230918 abstract "Prologue: Many voices joined in the health care reform debate of 1993-1994, and many of the difficulties that ultimately killed health reform legislation arose from the fact that not all of the parties understood, or cared to listen to, what the others were saying. Two prominent “teams,” if you willy were health economists and what Joseph Newhouse, borrowing from Paul Krugman, calls “policy entrepreneurs.” Although certain propositions in health care financing are widely accepted by economists, they did not fare well in the debate, which was dominated by the policy entrepreneurs?that is, those who purvey solutions (“magic bullets”) to social problems. Economists, on the other handy tend to focus more on diagnosis than on treatment, and maintain their reputation as “dismal scientists” by insisting that solutions are not possible most of the time. One central issue deemed important by the policy entrepreneurs, which overrode many other issues, was the cost of health care and of reform. Although many economists agreed that health costs were unacceptably high, they did not necessarily agree that costs were rising too fast; nonetheless, that view pervaded the debate and drove the quest for solutions. In this paper Newhouse suggests ways that economists might have framed the debate differently. The paper is based on Newhouse' s Carl Taube Memorial Lecture, delivered in September 1994 in conjunction with the National Institute of Mental Health's Biennial Conference on the Economics of Mental Health Care. Newhouse, who holds a doctorate in economics from Harvard, is the John D. MacArthur Professor of Health Policy and Management at Harvard University and directs Harvard's Division of Health Policy and Research Education. Abstract: Economists would have formulated several aspects of the health care reform debate differently than policy entrepreneurs did. Economists would have questioned whether health care costs must be contained and whether either competition or global budgets were a “magic bullet” for doing so. They also would have emphasized the distortive costs of subsidies and taxes necessary to reach universal coverage, as well as the shakiness of the arguments about international competitiveness and excess insurance industry profits." @default.
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• W2040230918 date "1995-01-01" @default.
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• W2040230918 title "Economists, Policy Entrepreneurs, and Health Care Reform" @default.
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• W2040230918 doi "https://doi.org/10.1377/hlthaff.14.1.182" @default.
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