The Healthcare Fix: Universal Insurance for All Americans

by Laurence J. Kotlikoff

A simple, straightforward, and foolproof proposal for universal health insurance from a noted economist. The shocking statistic is that forty-seven million Americans have no health insurance. When uninsured Americans go to the emergency room for treatment, however, they do receive care, and a bill. Many hospitals now require uninsured patients to put their treatment on a credit card which can saddle a low-income household with unpayably high balances that can lead to personal bankruptcy. Why don't these people just buy health insurance? Because the cost of coverage that doesn't come through an employer is more than many low- and middle-income households make in a year. Meanwhile, rising healthcare costs for employees are driving many businesses under. As for government-supplied health care, ever higher costs and added benefits (for example, Part D, Medicare's new prescription drug coverage) make both Medicare and Medicaid impossible to sustain fiscally; benefits grow faster than the national per-capita income. It's obvious the system is broken. What can we do? In The Healthcare Fix , economist Laurence Kotlikoff proposes a simple, straightforward approach to the problem that would create one system that works for everyone and secure America's fiscal and economic future. Kotlikoff's proposed Medical Security System is not the "socialized medicine" so feared by Republicans and libertarians; it's a plan for universal health insurance. Because everyone would be insured, it's also a plan for universal healthcare. Participants -- including all who are currently uninsured, all Medicaid and Medicare recipients, and all with private or employer-supplied insurance -- would receive annual vouchers for health insurance, the amount of which would be based on their current medical condition. Insurance companies would willingly accept people with health problems because their vouchers would be higher. And the government could control costs by establishing the values of the vouchers so that benefit growth no longer outstrips growth of the nation's per capita income. It's a "single-payer" plan, but a single payer for insurance. The American healthcare industry would remain competitive, innovative, strong, and private. Kotlikoff's plan is strong medicine for America's healthcare crisis, but brilliant in its simplicity. Its provisions can fit on a postcard and Kotlikoff provides one, ready to be copied and mailed to your representative in Congress.

Genres: Health, Nonfiction

116 pages, Hardcover

First published September 7, 2007

Reviews

[Jen Bojkov]

I only read a few pages in. The projections made by the author were so dire- I could not continue. I am very fearful about our future in this country if we do not fix our healthcare system. IMO- immigration is a big part of the answer. We have to find a way to balance the huge balloon of the boomers that are starting to retire.

[James · Rating 3 out of 5]

6/10

[Varun Munjal · Rating 4 out of 5]

It was a tad bit complex and diagrams would have helped. The recommendation, however, is foolproof.

[Jessica · Rating 3 out of 5]

This book was written around the 2008 presidential election and is basically just a 91 page policy proposal, not too different from the original Obamacare.

I had to read this for class, and it was hard to get beyond the first page. As my classmates promised, reading got easier as I went on. Kotlikoff begins the book with the impending doom of the economy. It's interesting to see his frantic perspective before the financial crisis really began, he insists that supporting Medicare, Medicaid, and Social Security is destroying our economy. The only way to fix this is through radical healthcare reform. Specifically, his proposal for a universal insurance voucher program, which he outlines in a convenient to cut out page to send to your congressman.

This is an easy book to read, because he meant for many people to read it, he wanted his policy proposal to make waves. There are fun moments of sarcasm and humanity in the book I'm sure he interjected because he did not want it to become too clinical. Overall, I'd say its a decent book that's VERY informative if your curious about the fiscal leech that is Medicare. The motives for the book are dated, but the information about the system remains relevant.

[Greer · Rating 2 out of 5]

I read this book for my Health Economics class. Kotlikoff does a good job elucidating the major problems facing U.S. healthcare today (rising Medicare/Medicaid costs, increasing growth in healthcare costs as a percentage of the GDP, an aging population, millions of uninsured Americans).

I won't get into the details of Kotlikoff's solution, the Medical Security System. I like some of his ideas, but don't possess the knowledge base to adequately assess the strengths and weaknesses of his plan. And I have my doubts that implementing them would be politically feasible.

What bothered me about his book wasn't the solution proposed by Kotlikoff but his arrogance. He describes his proposal as "foolproof," and I don't trust someone who can't see a single potential weakness or limitation in his own work. He also displays a barely concealed contempt for the elderly that is off-putting.

[nina · Rating 3 out of 5]

This is a good overview of the problems with the current system and a proposal for a solution. Kotlikoff identifies the 3 major problems of health care in America today - runaway Medicaid and Medicare costs and the uninsured adults and children. He also notes how most politicians address only the third point and often offers a solution that would only exacerbate the second one.

His universal insurance, coined the Medical Security System, is practical in its incentives and financing, but I would have liked to see more emphasis on what social/contextual changes would be needed (such as addressing the high cost of end of life care) and details on the feasibility of the suggested annual re-evaluation and distribution of vouchers perhaps analogous to car insurance renewal).

[Phil · Rating 2 out of 5]

He diagnoses the problem well and his arguments on how Medicare and Medicaid are going broke are sound. However, the book hinges on Prof. Kotlikoff's "voucher" concept for his Medical Security is whole lot of hooey. We need single-payer system of health insurance. A voucher system would be ripped to shreds by a cynical population and requires an impossible amount of administration. How can anyone determine how much healthcare a person will need from year to year? How many bean counters would the Federal Government need to determine the voucher amounts for 300 million people.

It's not very realistic. But, maybe realism is not Prof. Kotlikoff's thing. He is, after all, running for president this year.

[David · Rating 5 out of 5]

This book is a must read for anyone with even a passing interest in public policy or healthcare. No -- I take that back -- it's a must read for everyone. Our healthcare system is out of control, and the collision course it's on will affect all of us. Comprehensive proposals to fix all that's broken are rare. The dominant theme in the last 50 years has been incremental change built upon an inherently flawed system. Kotlikoff offers an insightful look at what's wrong with the system and how, with a little courage, we can see it changed. A fast read, and worth the attention it demands.

[Fred Kohn · Rating 3 out of 5]

I wondered whether this book would be worth reading, seeing as it was written before Obamacare. I'd say the answer is yes. Kotlikoff is hard to characterize as either liberal or conservative, combining aspects of both. I think his ideas for a government run universal health care program are great, but as they say, "You can't get there from here." Especially after the implementation of Obamacare.

[TJ · Rating 2 out of 5]

The author thinks too much of himself and is a tad naive, and then arrogant when he tries to defend himself against the naive critique.

Social Health Care Ethics