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We've Got You Covered: Rebooting American Health Care
From a MacArthur Genius MIT economist and pre-eminent Stanford economist comes a lively and provocative proposal for American health insurance reform
Few of us need convincing that the American health insurance system needs reform. But many of the existing proposals focus on expanding one relatively successful piece of the system or building in piecemeal additions. These proposals miss the point.
As the Stanford health economist Liran Einav and the MIT economist and MacArthur Genius Amy Finkelstein argue, our health care system was never deliberately designed, but rather pieced together to deal with issues as they became politically relevant. The result is a sprawling yet arbitrary and inadequate mess. It has left 30 million Americans without formal insurance. Many of the rest live in constant danger of losing their coverage if they lose their job, give birth, get older, get healthier, get richer, or move.
It's time to tear it all down and rebuild, sensibly and deliberately. Marshaling original research, striking insights from American history, and comparative analysis of what works and what doesn’t from systems around the world, Einav and Finkelstein argue for automatic, basic, and free universal coverage for everyone, along with the option to buy additional, supplemental coverage. Their wholly original argument and comprehensive blueprint for an American universal health insurance system will surprise and provoke.
We’ve Got You Covered is an erudite yet lively and accessible prescription we cannot afford to ignore.
Few of us need convincing that the American health insurance system needs reform. But many of the existing proposals focus on expanding one relatively successful piece of the system or building in piecemeal additions. These proposals miss the point.
As the Stanford health economist Liran Einav and the MIT economist and MacArthur Genius Amy Finkelstein argue, our health care system was never deliberately designed, but rather pieced together to deal with issues as they became politically relevant. The result is a sprawling yet arbitrary and inadequate mess. It has left 30 million Americans without formal insurance. Many of the rest live in constant danger of losing their coverage if they lose their job, give birth, get older, get healthier, get richer, or move.
It's time to tear it all down and rebuild, sensibly and deliberately. Marshaling original research, striking insights from American history, and comparative analysis of what works and what doesn’t from systems around the world, Einav and Finkelstein argue for automatic, basic, and free universal coverage for everyone, along with the option to buy additional, supplemental coverage. Their wholly original argument and comprehensive blueprint for an American universal health insurance system will surprise and provoke.
We’ve Got You Covered is an erudite yet lively and accessible prescription we cannot afford to ignore.
304 pages, Hardcover
Published July 25, 2023
33 people are currently reading
1022 people want to read
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Displaying 1 - 30 of 72 reviews
July 25, 2023
I have learned more about health economics from Amy Finkelstein than from anyone else in my generation (or younger). I learned some more from this book--and a lot of what I thought I knew was challenged as well. Overall, this was a very enjoyable read that is written in a broadly accessible and even chatty and informal style which is not burdened by all the learning underlying it.
Both Liran Einav and Finkelstein have largely confined themselves to research and not policy, which makes it exciting that they are drawing on their own work and their command of the literature to ask why we have health insurance and what that means about how we design it.
Any such undertaking is necessarily normative, being grounded in our values. They argue that in the case of health insurance that relatively minimal and widely shared values can be the basis for designing policy, specifically the idea that people should get treatment regardless of their ability to afford it. If someone is extremely ill hospitals are required to treat them whether or not they have insurance--and the recourse to collecting medical debt is considerably less onerous than, say, student debt or taxes.
Using this as their normative staring point they diagnosis the problems in the current system, many of which afflict the insured as much as the uninsured. Thus they argue that health reform should be about everyone not just filling in the gaps for the uninsured. (I agree with their normative frame and am impressed by how far it takes them, but also have a hard time separating my own views that health reform should be used as a way to achieve what I view as a more fair distribution of resources.)
For insurance to work on the terms they describe it needs to be automatic (because we automatically cover everyone in some way regardless). It can't be automatic without being free. And finally, for this to be affordable they argue it should be basic.
They do not define the "basic" and this is where I'm most worried in practice. "Basic" could easily end up being just about everything plus dental and vision--which would end up being extremely expensive. Absent a mechanism to link people's choices about what health insurance should cover to their own costs it is hard to understand how "basic" would be limited.
A way to partially do that is more cost sharing. The evidence (much of it from Finkelstein and co-authors) is that copays, deductibles and coinsurance can reduce spending and not necessarily worsen health outcomes. The authors argue that having thought about it more, and looked at the experience in other countries, that cost sharing is not viable when not everyone can afford it. They have a lot of compelling arguments but I'm also nervous that this interacts with the "basic" issue, that if you could really do basic you could avoid cost sharing but if not then you might need it. Also, it is hard to understand how a system is optimal that has cost sharing of either 0% or 100% (the later for everything not covered by the basic insurance) instead of intermediate values.
Finally, the book is really radical. It does not start from where we are now but instead tears down the entire system to rebuild a new one. That, of course, would make it harder to do in practice given all the vested interests. But it also increases the risks that what works on paper may not work in practice when compared to the many ways our system has evolved to address issues. As such, the book is not about next week's health debates but instead a marker for a longer-term debate and discussion. And that is a very productive and needed thing given the sorry state of much of American health insurance.
Both Liran Einav and Finkelstein have largely confined themselves to research and not policy, which makes it exciting that they are drawing on their own work and their command of the literature to ask why we have health insurance and what that means about how we design it.
Any such undertaking is necessarily normative, being grounded in our values. They argue that in the case of health insurance that relatively minimal and widely shared values can be the basis for designing policy, specifically the idea that people should get treatment regardless of their ability to afford it. If someone is extremely ill hospitals are required to treat them whether or not they have insurance--and the recourse to collecting medical debt is considerably less onerous than, say, student debt or taxes.
Using this as their normative staring point they diagnosis the problems in the current system, many of which afflict the insured as much as the uninsured. Thus they argue that health reform should be about everyone not just filling in the gaps for the uninsured. (I agree with their normative frame and am impressed by how far it takes them, but also have a hard time separating my own views that health reform should be used as a way to achieve what I view as a more fair distribution of resources.)
For insurance to work on the terms they describe it needs to be automatic (because we automatically cover everyone in some way regardless). It can't be automatic without being free. And finally, for this to be affordable they argue it should be basic.
They do not define the "basic" and this is where I'm most worried in practice. "Basic" could easily end up being just about everything plus dental and vision--which would end up being extremely expensive. Absent a mechanism to link people's choices about what health insurance should cover to their own costs it is hard to understand how "basic" would be limited.
A way to partially do that is more cost sharing. The evidence (much of it from Finkelstein and co-authors) is that copays, deductibles and coinsurance can reduce spending and not necessarily worsen health outcomes. The authors argue that having thought about it more, and looked at the experience in other countries, that cost sharing is not viable when not everyone can afford it. They have a lot of compelling arguments but I'm also nervous that this interacts with the "basic" issue, that if you could really do basic you could avoid cost sharing but if not then you might need it. Also, it is hard to understand how a system is optimal that has cost sharing of either 0% or 100% (the later for everything not covered by the basic insurance) instead of intermediate values.
Finally, the book is really radical. It does not start from where we are now but instead tears down the entire system to rebuild a new one. That, of course, would make it harder to do in practice given all the vested interests. But it also increases the risks that what works on paper may not work in practice when compared to the many ways our system has evolved to address issues. As such, the book is not about next week's health debates but instead a marker for a longer-term debate and discussion. And that is a very productive and needed thing given the sorry state of much of American health insurance.
January 24, 2024
This book lays out the data and logic of the only solution to fix the so called American ‘healthcare system’: free, accessible universal healthcare. Why is the wealthiest, most developed country in the world the most under developed when it comes to healthcare, and also the sickest?! Most of us are aware of this problem and have experienced its inequities. Many of us are cast into poverty and even die from it. It does not have to be this way. There are some stories in this book that will not surprise you but that will infuriate you, making you scream, WHY?!
April 2011: I was diagnosed with a deadly heart problem called Wolff-Parkinson-White Syndrome. I died that night and was brought back. Grateful that we had ‘good’ health insurance at the time from the job we had. My co-pay at the ER that night was $50. Some folx cannot even afford that. A few months later when we got the official bill, it asked us to pay $150. The rest of the bill that we didn’t have to pay, was $170,000 and change. What if we did not have this insurance at that time? What if they had refused to pay for it? In America, it’s often pay up or die…make your choice. I plead with those in power to make the moral choice they know we all need in this country. Universal Healthcare for all.
April 2011: I was diagnosed with a deadly heart problem called Wolff-Parkinson-White Syndrome. I died that night and was brought back. Grateful that we had ‘good’ health insurance at the time from the job we had. My co-pay at the ER that night was $50. Some folx cannot even afford that. A few months later when we got the official bill, it asked us to pay $150. The rest of the bill that we didn’t have to pay, was $170,000 and change. What if we did not have this insurance at that time? What if they had refused to pay for it? In America, it’s often pay up or die…make your choice. I plead with those in power to make the moral choice they know we all need in this country. Universal Healthcare for all.
November 18, 2023
Seasoned economists discussing healthcare insurance in a reasoned, principled manner? Good ideas that can’t be summarized in a snippy catchphrase for TV pundits to yell about?? Good ideas about healthcare reform??????? Who do these authors think they are? Did they forget that this is America? All jokes aside, Amy Finkelstein is one of my favorite economists. She and Liran wrote an earlier book about insurance in general that I loved. This book is full of great research and compelling policy insights. I can get on board with their blueprint for US healthcare for sure.
June 23, 2025
Illuminating! Worth a read for anyone interested in US health insurance markets (niche, I know).
February 2, 2024
[6] I assigned this book in my 4317: Sociology of Health Care class this year as an updated look at healthcare policy in the US on the recommendation of my behavioral economist friend @jonathan_corbin (Thanks, Jon!). Written by economists, the central question here is "How can we fix the US health-care system?" and their pretty straightforward solution is to offer free basic coverage to all US citizens. They propose that the first question to ask is “What is it that US health insurance policy is trying to accomplish?” and THEN you can move on to “Why and how can healthcare coverage in the United States can be improved?” They start with a brief overview of how we got to the piecemeal and problematic system we have today and then provide tons of empirical evidence as to why "basic coverage should provide minimalist (yet adequate) care, and no more. The social contract is about restoring essential function, not providing a high-end experience." [122] I think it'll generate good discussion in class and it's a good update to my previous favorite book on this topic -> Elizabeth Bradley and Lauren Taylor’s (2013) The American Health Care Paradox: Why Spending More Is Getting Us Less.
#WeveGotYouCovered #RebootingAmericanHealthCare #NonFictionOf2023 #MedicalSociology #Bookstagram #BookReview
#WeveGotYouCovered #RebootingAmericanHealthCare #NonFictionOf2023 #MedicalSociology #Bookstagram #BookReview
April 2, 2024
A nice summary of the push-and-pull effects of incremental insurance reform in the current system. Repetitive though; the book could’ve been condensed by half, and they could’ve dedicated the rest to other related topics such as implementation of the proposed policy, or what was on my mind the whole time I was reading: the reason healthcare costs are so high in the first place, digging into physician supply-side and the underbelly of the federal residency program bottleneck.
August 12, 2023
This was a very interesting and quick read. It got me thinking about gaps in health insurance coverage and potential solutions. It made me look at and study the the issue in a way that I think would be helpful for anyone.
January 27, 2025
Really quite good. An excellent starting point for learning about big issues in American healthcare. I'm not informed enough to endorse or shoot down the advocated approach, but I don't think you need to agree or disagree to get a lot from this book. I liked Jason Furman's review.
March 8, 2025
I liked the social contract argument for universal healthcare coverage. I wished they talked more about changes that need to be made to educating healthcare workers. Nonetheless, informative.
October 8, 2025
A valuable contribution to U.S. health care policy by two prominent economists. Instead of critiquing the current system, the authors start from first principles and describe what an ideal U.S. health care system might look like. Because they are economists, they are extremely attentive to cost pressures and trade-offs, but they also spend time thinking about the moral and philosophical foundations and what kind of system our shared values point toward. The book is informative and thought-provoking. The one part of their proposal that I think is not well thought out is the suggestion that Congress maintain a health care budget. I frankly don’t see how this could work well in practice.
December 11, 2025
It took me a good part of 2 years to finish this book which is not 200 pages in total. But I wanted to finish it even if I got angry at various points reading it, and took A LOT of notes in the margin as I was reading and reacting -- that was really what caused me to take so long with it, I couldn't read it before bed because I wanted to take notes so I had to make time for it.
This is a theory book, they even make a comment in the epilogue about not knowing even where to start politically to get their vision approved. But...they didn't even bother to think through implementation of their ideas and the actual impact to human lives their theories/ideas would cause. This was very much presented as numbers/concepts on how other countries do things with very little to no lens on the human impact of their ideas. My main sticking point is their repeated belief that the US should do away with long-term care facilities without spending one word discussing what the fuck we should do with those people who cannot live on their own and need constant professional care. I just dealt with this with my dad; the ONLY alternatives are: these people spend the rest of their lives in a hospital bed OR their families are forced to take them in as 'home health patients' and then stop their lives to provide around-the-clock care they probably cannot afford nor are trained to provide, not to mention any kind of residual animosity there might exist between the parties, deterioration of their personal relationship because of the stress of providing care, et cetera et cetera et cetera.
Their main thesis is: "Basic medical care must be provided to patients for free" but they do not come anywhere within 10feet of address the subject of, "what is basic medical care?" Because, as we know, 'basic medical needs' vary pretty wildly based on what your specific health issues/needs are.
They openly advocate for ending long-term care facilities. Now, I would argue that someone who cannot live independently, cannot go to the bathroom independently, requires help walking or sitting up in bed would define a long-term care facility as 'basic medical care.' And while they advocate for ending LTCs, there is NO MENTION of what to do with these patients who require near-constant support and help.
They don't mention moving those people into their children's homes and increasing the home health aid stipend so you can quit your job and provide 24/7 care. They don't discuss that at all. Close LTCs because they are cost drains -- ironically they address that 1/4 of all health care spending for an elderly patient is done in the last year of their life. Now, they're not advocating NOT treating people who are on hospice or experiencing some end-of-life needs...but they don't offer an alternative. Stay in a hospital bed until you finally die?
There were other minor bits that irked me: they described 'risk adjusted cost of care models' within Medicare/caid reimbursement models without every using the term which has been pretty widespread and common for 15-20 years now.
They didn't address the rising expenses in Medicaid as a result of ACA expansion which was experienced and discussed even before COVID, so I can excuse their inability to address that driver, but it was seen in state expenditures before then. They even cited that state Medicaid programs have a 'fixed' budget because of appropriations, but that isn't 100% true post expansion and COVID waiver programs. Medicaid costs are spiraling out of control for states to manage
And finally I'm not sure they wrote one sentence on practical issues with implementation of their ideas. They talk very pie in the sky that having supplemental plans 'cannot' deteriorate basic services but they themselves are too scared/uniformed/uncommitted to define what 'basic care' would be so OF COURSE there will be a reduction in "basic care" services to push those into the supplemental plans. Again, what I need as 'basic care' is vastly different than what my more senior neighbor needs, or even what my wife needs.
This is a theory book, they even make a comment in the epilogue about not knowing even where to start politically to get their vision approved. But...they didn't even bother to think through implementation of their ideas and the actual impact to human lives their theories/ideas would cause. This was very much presented as numbers/concepts on how other countries do things with very little to no lens on the human impact of their ideas. My main sticking point is their repeated belief that the US should do away with long-term care facilities without spending one word discussing what the fuck we should do with those people who cannot live on their own and need constant professional care. I just dealt with this with my dad; the ONLY alternatives are: these people spend the rest of their lives in a hospital bed OR their families are forced to take them in as 'home health patients' and then stop their lives to provide around-the-clock care they probably cannot afford nor are trained to provide, not to mention any kind of residual animosity there might exist between the parties, deterioration of their personal relationship because of the stress of providing care, et cetera et cetera et cetera.
Their main thesis is: "Basic medical care must be provided to patients for free" but they do not come anywhere within 10feet of address the subject of, "what is basic medical care?" Because, as we know, 'basic medical needs' vary pretty wildly based on what your specific health issues/needs are.
They openly advocate for ending long-term care facilities. Now, I would argue that someone who cannot live independently, cannot go to the bathroom independently, requires help walking or sitting up in bed would define a long-term care facility as 'basic medical care.' And while they advocate for ending LTCs, there is NO MENTION of what to do with these patients who require near-constant support and help.
They don't mention moving those people into their children's homes and increasing the home health aid stipend so you can quit your job and provide 24/7 care. They don't discuss that at all. Close LTCs because they are cost drains -- ironically they address that 1/4 of all health care spending for an elderly patient is done in the last year of their life. Now, they're not advocating NOT treating people who are on hospice or experiencing some end-of-life needs...but they don't offer an alternative. Stay in a hospital bed until you finally die?
There were other minor bits that irked me: they described 'risk adjusted cost of care models' within Medicare/caid reimbursement models without every using the term which has been pretty widespread and common for 15-20 years now.
They didn't address the rising expenses in Medicaid as a result of ACA expansion which was experienced and discussed even before COVID, so I can excuse their inability to address that driver, but it was seen in state expenditures before then. They even cited that state Medicaid programs have a 'fixed' budget because of appropriations, but that isn't 100% true post expansion and COVID waiver programs. Medicaid costs are spiraling out of control for states to manage
And finally I'm not sure they wrote one sentence on practical issues with implementation of their ideas. They talk very pie in the sky that having supplemental plans 'cannot' deteriorate basic services but they themselves are too scared/uniformed/uncommitted to define what 'basic care' would be so OF COURSE there will be a reduction in "basic care" services to push those into the supplemental plans. Again, what I need as 'basic care' is vastly different than what my more senior neighbor needs, or even what my wife needs.
April 30, 2024
The book leads with a very apropos quote from Walter Cronkite: “America’s healthcare system is neither healthy, caring, nor a system.” America is the only high-income country without universal health care coverage since 1916. It wasn’t always this way. Alexander Hamilton (recently made famous by the musical proposed policies to fulfill our healthcare commitments in 1798 (not a typo) which sadly were not implemented. Insurance is supposed to protect against financial loss, yet in America, you can only get it when you’re working, so when you get sick and actually need it, you lose not only your income but also your health insurance. The system won’t pay for an ounce of prevention, but it’ll pay for a pound of cure, which the patient then can’t afford to maintain (e.g., won’t watch and treat high-blood pressure but will stroke and kidney failure once they’re catastrophic but if the patient gets a kidney, they’re own their own for very expensive medication.) Hospitals have to stabilize you, they don’t have to treat you, so that’s not really healthcare. And then they bill at rates that most people can’t pay. Before COVID, there was more debt held by collection agencies for medical debt than held for *all other debt combined*. Three-fifths of those in debt had health insurance. Even if you qualify for insurance, there are so many hoops and ways for coverage to be discontinued without telling you that practically it’s hard to get and keep insurance. Medical debt often ruins people financially and they frequently still can’t pay it. People are literally being punished for getting sick. The US government spends more on healthcare than it does on national defense, so it’s not a matter of funding. The US taxpayer pays the same rate for health care as countries with automatic coverage (i.e., we all pay 7% of the economy), so we’re paying the cost of universal basic coverage but we’re not getting it. And we pay more overall: 17% vs 12% in next highest spending country in 2019 for less care. We’re not getting our money’s worth. We have a patchwork of exceptions that costs the US taxpayer more than universal coverage with less protection. After reviewing the data, they recommend that 1) health insurance reform reformed should happen separately from healthcare delivery and 2) everyone automatically have basic universal coverage that is adequately funded for bare bones covering both primary and preventative care as well as essential medical care for the critically ill. Those that want more amenities (but not the ability to jump the line as that undermines the basic insurance) can buy supplemental (not substitute) coverage (like an airplane where everyone gets from point A to B at the same time but some seats are nicer with fancier food and greater luggage allowance). “For those who fear that universal coverage is impossible, remember that the UK voted it down 21 times and Canada fought it. There are many examples of near failures abroad and near successes in the US, which indicates it’s possible even if difficult, rather than impossible.”
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October 2, 2023An opinionated health policy book from two of the most eminent health economists working today on what their view of a better American health insurance system would look like.
As someone without a background in health economics, I found the parts on the history and issues with the current system highly informative but would like to reserve judgment on the specifics of the policy proposals. Unlike their previous book, on the microeconomics of insurance, which kept to a very narrow remit, this book is much more comprehensive but also less detailed. I do commend the authors for writing a policy book which actually focuses on a policy proposal, unlike a lot of popular books by academics which cram a set of poorly explicated policy proposals in a final chapter of a book mostly dedicated to laying out problems. They go over the motivation, alternatives, and pros and cons with sufficient clarity that a reader so inclined could at least start to engage with the arguments.
The most novel aspect of this book, from a set of economists, is the explicit articulation of a normative framework which is not the standard utilitarian one that many economists reach for reflexively nor the singleminded focus on efficiency that characterizes (or is a caricature of) certain perceptions of economists. The stance is a somewhat funny one: they recognize the moral intuition that we are compelled to help the most clearly desperate and deserving, but express substantial ambivalence over whether this stance is defensible. Instead, they describe it as some constant of human nature, that policy must design around if only because any system that does not do so will be repeatedly patched and amended as outrages to this intuition arise until it no longer resembles what either the efficiency minded (parody of an) economist or utilitarian Peter Singer type intended. It makes me think that somewhere they have written down a behavioral public finance model with time-inconsistent altruism and limited commitment and solved for constrained optimum, or at least sketched out something like it. If so[^1] I would like to see it, as this ambivalent mixture of intuitions and formalism seems to me neither intuitive nor easy to formalize. This is not to say the case can't be explained in plain language: they want a system that works reasonably well and is politically sustainable. But that still leaves a lot of space for overall design, over and above the more quantitative concerns that drive the detailed features they propose and defend based on more empirical arguments.
[1]: Or if someone much more willing than me to muck about with recursive contract theory wants to figure it out. It kills me to say this, but some grad student probably should go brush up on their promise-keeping constraints and get going on that dynamic programming squared problem.
As someone without a background in health economics, I found the parts on the history and issues with the current system highly informative but would like to reserve judgment on the specifics of the policy proposals. Unlike their previous book, on the microeconomics of insurance, which kept to a very narrow remit, this book is much more comprehensive but also less detailed. I do commend the authors for writing a policy book which actually focuses on a policy proposal, unlike a lot of popular books by academics which cram a set of poorly explicated policy proposals in a final chapter of a book mostly dedicated to laying out problems. They go over the motivation, alternatives, and pros and cons with sufficient clarity that a reader so inclined could at least start to engage with the arguments.
The most novel aspect of this book, from a set of economists, is the explicit articulation of a normative framework which is not the standard utilitarian one that many economists reach for reflexively nor the singleminded focus on efficiency that characterizes (or is a caricature of) certain perceptions of economists. The stance is a somewhat funny one: they recognize the moral intuition that we are compelled to help the most clearly desperate and deserving, but express substantial ambivalence over whether this stance is defensible. Instead, they describe it as some constant of human nature, that policy must design around if only because any system that does not do so will be repeatedly patched and amended as outrages to this intuition arise until it no longer resembles what either the efficiency minded (parody of an) economist or utilitarian Peter Singer type intended. It makes me think that somewhere they have written down a behavioral public finance model with time-inconsistent altruism and limited commitment and solved for constrained optimum, or at least sketched out something like it. If so[^1] I would like to see it, as this ambivalent mixture of intuitions and formalism seems to me neither intuitive nor easy to formalize. This is not to say the case can't be explained in plain language: they want a system that works reasonably well and is politically sustainable. But that still leaves a lot of space for overall design, over and above the more quantitative concerns that drive the detailed features they propose and defend based on more empirical arguments.
[1]: Or if someone much more willing than me to muck about with recursive contract theory wants to figure it out. It kills me to say this, but some grad student probably should go brush up on their promise-keeping constraints and get going on that dynamic programming squared problem.
December 19, 2025
Overall HIGHLY enjoyed! Very thought provoking. I am a bit confused but in a good way that makes me curious to learn more.
Summary:
- The US healthcare system does not have a unified strategy and is composed of a bunch of policies that have patched up problems (whilst simultaneously causing more)
- General argument is that healthcare should be automatically covered for everyone (free!) but at a very basic primary-care level
- Health insurance should not be tied to employment (!!!!!!!)
- They support a tiered healthcare system where you can buy your way to better services (such as private hospital rooms, choosing your physician, etc.)
- They argue that congress should have a defined healthcare budget (also shocked me that there isn’t one in the first place?!)
- Health insurance has limited influence on health outcomes because people will still go into debt regardless of whether they are insured or not
- Managing co-pays can have more administrative cost than the money co-pays would bring in
General Thoughts:
- This is a good book for some of the basics of health insurance! Like it feels very everyday approachable and examples are interesting.
- MY biggest qualm/confusion is this... their definition of “basic” is not clearly defined enough to be satisfying. Like they say that you should still be able to pay for private rooms/shorter wait times. But to what extent would their basic model cover specialty care? Or specific care beyond primary care? To be fair, that opens up an entire can of worms and would make this book infinitely long…. but I actually think answering this more clearly is key for their thesis to be compelling. Like I found this book very interesting but idk if I am fully convinced.
- I think it’s actually super interesting how they still support a tiered system of healthcare. But I don't understand the least generous version of what this tier system would be (which is how I think you would have to judge it...) becuase their examples make it sound like the tiered system would just be things like getting to choose your own doctor
- Very radical in that it proposes completely reimagining the entire healthcare system. I think this is hard task to take on but I wonder what that transition would look like from what we have now. I wish there was more emphasis or elaboration on the current players that keep health insurance the way that it is. To be fair, they have clear disclaimers that this is more theoretical.
- Shocked to learn that congress doesn’t have a healthcare budget?!?! But also confused about the benefit/drawbacks of having a clear budget in the first place...
- I think not enough mention or explanation of other main players in health insurance like pharmaceutical companies! Also would be interested to know about specific major health insurance companies.
Summary:
- The US healthcare system does not have a unified strategy and is composed of a bunch of policies that have patched up problems (whilst simultaneously causing more)
- General argument is that healthcare should be automatically covered for everyone (free!) but at a very basic primary-care level
- Health insurance should not be tied to employment (!!!!!!!)
- They support a tiered healthcare system where you can buy your way to better services (such as private hospital rooms, choosing your physician, etc.)
- They argue that congress should have a defined healthcare budget (also shocked me that there isn’t one in the first place?!)
- Health insurance has limited influence on health outcomes because people will still go into debt regardless of whether they are insured or not
- Managing co-pays can have more administrative cost than the money co-pays would bring in
General Thoughts:
- This is a good book for some of the basics of health insurance! Like it feels very everyday approachable and examples are interesting.
- MY biggest qualm/confusion is this... their definition of “basic” is not clearly defined enough to be satisfying. Like they say that you should still be able to pay for private rooms/shorter wait times. But to what extent would their basic model cover specialty care? Or specific care beyond primary care? To be fair, that opens up an entire can of worms and would make this book infinitely long…. but I actually think answering this more clearly is key for their thesis to be compelling. Like I found this book very interesting but idk if I am fully convinced.
- I think it’s actually super interesting how they still support a tiered system of healthcare. But I don't understand the least generous version of what this tier system would be (which is how I think you would have to judge it...) becuase their examples make it sound like the tiered system would just be things like getting to choose your own doctor
- Very radical in that it proposes completely reimagining the entire healthcare system. I think this is hard task to take on but I wonder what that transition would look like from what we have now. I wish there was more emphasis or elaboration on the current players that keep health insurance the way that it is. To be fair, they have clear disclaimers that this is more theoretical.
- Shocked to learn that congress doesn’t have a healthcare budget?!?! But also confused about the benefit/drawbacks of having a clear budget in the first place...
- I think not enough mention or explanation of other main players in health insurance like pharmaceutical companies! Also would be interested to know about specific major health insurance companies.
October 11, 2023
There are a million books around detailing the problems and dysfunctions in American health care, but this one seems different. Its key contribution, I think, is to establish that (1) we already, in practice, have a social contract in which we believe everyone is entitled to some form of basic health care, and (2) we already mostly have a system that provides...well, a lot of that care. But it does so in the most bass-ackward, inefficient way.
They often make apt comparisons to emergency management -- think of FEMA and insurance/relief programs for natural disasters -- and to public education.
They don't specifically mention this, but there's a strong analogy between the current US health care system and Peter Singer's "child in the pond" thought experiment, which compares coming across a child drowning in a pond; you're wearing a new, very expensive pair of shoes that cost, say, $200. Do you go into the pond, ruin your shoes and save the child? Sure you do! But would you spend, say, $50 to save the life of some child in a faraway country? Maybe not. But why? You're willing to in effect spend $200 to save the one child, but not $50 to save the other?
Our health care system, in this analogy, works far too often in a mode where it's saving a drowning child and paying $200 to do so -- when it could have spent $50 previously to make it so that the child never got into the pond in the first place. For example, we'll pay for a very, very expensive kidney transplant -- but won't pay for the primary care that might have prevented the patient's end-stage renal failure in the first place, which would have been much cheaper and safer for the patient.
Finkelstein and Einav also draw distinction between health access and equity, and make it clear that they are arguing for access. Achieving better health equality is a necessary and admirable goal, but they make it clear that it's not the same as access, and that their plan only addresses one of those things.
This book will give you a new way of looking at health care reform in the US. Highly recommended.
They often make apt comparisons to emergency management -- think of FEMA and insurance/relief programs for natural disasters -- and to public education.
They don't specifically mention this, but there's a strong analogy between the current US health care system and Peter Singer's "child in the pond" thought experiment, which compares coming across a child drowning in a pond; you're wearing a new, very expensive pair of shoes that cost, say, $200. Do you go into the pond, ruin your shoes and save the child? Sure you do! But would you spend, say, $50 to save the life of some child in a faraway country? Maybe not. But why? You're willing to in effect spend $200 to save the one child, but not $50 to save the other?
Our health care system, in this analogy, works far too often in a mode where it's saving a drowning child and paying $200 to do so -- when it could have spent $50 previously to make it so that the child never got into the pond in the first place. For example, we'll pay for a very, very expensive kidney transplant -- but won't pay for the primary care that might have prevented the patient's end-stage renal failure in the first place, which would have been much cheaper and safer for the patient.
Finkelstein and Einav also draw distinction between health access and equity, and make it clear that they are arguing for access. Achieving better health equality is a necessary and admirable goal, but they make it clear that it's not the same as access, and that their plan only addresses one of those things.
This book will give you a new way of looking at health care reform in the US. Highly recommended.
November 28, 2023
It feels like an oxymoron to say "I loved reading a treatise on health care." But I did. I am a high school guidance counselor so I have no skin in this game and relatively little knowledge on the subjet. After reading it I feel well informed, though sometimes the more you know the more you realize you don't know! Health care is infinitely complex. I love how the book discusses other countries and their evolutions with co-pays, universal coverage, universal mandates, etc. It gives you a good sense of what works and why. I would recommend this book to anyone who cares about the future of health care and/or likes to be informed about social, political and economic policy.
I have one criticism- the book talks so much about the "social contact" that our country has and that health care is a universal right. I don't even disagree with these points. But I think the authors missed an opportunity to co-opt their naysayers by harping on these issues. If their goal was to preach to the choir, they were spot on. If their goal is to affect change, I think these incessant references will alienate people who do not care about social contracts. Even I, a proponent of mass health care reform and who buys into what the authors are selling, am not moved by things that happened in the 1800 and 1900s that show that "we have always done things this way and therefore it isn't a stretch to continue doing so." I don't believe this is the argument by which change will happen. The hard economic facts and the anecdotal evidence of the mess that is our health care system are much more compelling. The book is fraught with cogent data that much better underscore the author's thesis. I hope their focus on social contracts and basic human rights do not alienate the people they need to be convincing. You know how people tend to pick one point and harp on it while losing the big picture and the truth...
I think the authors are brilliant and they put really dense material into digestible chunks. Read this book, for sure.
I have one criticism- the book talks so much about the "social contact" that our country has and that health care is a universal right. I don't even disagree with these points. But I think the authors missed an opportunity to co-opt their naysayers by harping on these issues. If their goal was to preach to the choir, they were spot on. If their goal is to affect change, I think these incessant references will alienate people who do not care about social contracts. Even I, a proponent of mass health care reform and who buys into what the authors are selling, am not moved by things that happened in the 1800 and 1900s that show that "we have always done things this way and therefore it isn't a stretch to continue doing so." I don't believe this is the argument by which change will happen. The hard economic facts and the anecdotal evidence of the mess that is our health care system are much more compelling. The book is fraught with cogent data that much better underscore the author's thesis. I hope their focus on social contracts and basic human rights do not alienate the people they need to be convincing. You know how people tend to pick one point and harp on it while losing the big picture and the truth...
I think the authors are brilliant and they put really dense material into digestible chunks. Read this book, for sure.
November 17, 2023
I've certainly had health insurance and have both used and provided health care, but I'm no health economics expert, so some of this was news to me including (I'm embarrassed to admit as a US citizen) that Medicare has no budget -- they just define what they're going to cover, and then pay the bills that come in -- whereas Medicaid does, in part b/c administered by states that are required to balance their overall budgets and therefore need greater cost certainty on line items each year
They make a convincing case that patching things up has not worked well -- cycle of (a) horror story of lack of insurance coverage or access getting well-publicized and leading to (b) outrage and political pressure, leading to (c) micro-fixes (ok, you must cover children with such-and-such rare calamity) that have unintended bad consequences (ok, that kid gets kicked off coverage at age 18 even tho the problem still exists, and the treatment is still unaffordable) has not served to generate a system that makes any sense overall or functions particularly well.
Their suggested fix is to more or less start over, and they sketch what a new system would look like -- key aspects being automatic universal coverage with free (to patient) basic services, and then optional fancier coverage if patient wishes to pay for it. They acknowledge that any reform in this area is up against substantial and powerful opposing interests but optimistic it can eventually happen and would improve outcomes.
Some aspects of the history (post-WW II tethering of health insurance coverage to your employment situation) and current political economics (physician salaries, e.g.) got short shrift in my opinion, but overall a convincing and user-friendly (they summarize some research, but it's not all that technically dense) analysis. I'm a bit less optimistic than they are about big change happening soon, but who knows.
They make a convincing case that patching things up has not worked well -- cycle of (a) horror story of lack of insurance coverage or access getting well-publicized and leading to (b) outrage and political pressure, leading to (c) micro-fixes (ok, you must cover children with such-and-such rare calamity) that have unintended bad consequences (ok, that kid gets kicked off coverage at age 18 even tho the problem still exists, and the treatment is still unaffordable) has not served to generate a system that makes any sense overall or functions particularly well.
Their suggested fix is to more or less start over, and they sketch what a new system would look like -- key aspects being automatic universal coverage with free (to patient) basic services, and then optional fancier coverage if patient wishes to pay for it. They acknowledge that any reform in this area is up against substantial and powerful opposing interests but optimistic it can eventually happen and would improve outcomes.
Some aspects of the history (post-WW II tethering of health insurance coverage to your employment situation) and current political economics (physician salaries, e.g.) got short shrift in my opinion, but overall a convincing and user-friendly (they summarize some research, but it's not all that technically dense) analysis. I'm a bit less optimistic than they are about big change happening soon, but who knows.
November 16, 2024
I read this book because Furman recommended it, and his description is good. I admire the economist authors' ability to take a normative stand while staying clear-headed about measured realities. I'm on board.
The central claim of the book is that we should provide free basic health care to everyone. They support this by arguing that the US has been trying to do this: trying to honor an implicit social contract.
The issue then is that the US has been doing a very poor job of it. The authors propose that health insurance should instead be free and automatic for everyone, with no sign-up hoops or costs incurred for receiving care.
Problems with the current US system include its complexity itself, and health insurance being tied to employment (therefore subject to termination at any time) and medical costs being a potentially unbounded burden for individuals, sometimes even for those with insurance.
They point out that insurance doesn't actually have that much influence on health outcomes, because impact on health is dominated by behaviors that correlate with wealth, for example, and because people generally still get health care even if not insured, even if it also saddles them with debt. So universal health insurance won't resolve disparities in health outcomes. (This does appear somewhat at odds with the authors' frequent complaint that the US system often pays for treatment only after conditions become acute dangers, while earlier treatment might have been cheaper and prevented the worst health outcomes.)
The book is also full of interesting current and historical detail about the US and international health systems.
The central claim of the book is that we should provide free basic health care to everyone. They support this by arguing that the US has been trying to do this: trying to honor an implicit social contract.
The issue then is that the US has been doing a very poor job of it. The authors propose that health insurance should instead be free and automatic for everyone, with no sign-up hoops or costs incurred for receiving care.
Problems with the current US system include its complexity itself, and health insurance being tied to employment (therefore subject to termination at any time) and medical costs being a potentially unbounded burden for individuals, sometimes even for those with insurance.
They point out that insurance doesn't actually have that much influence on health outcomes, because impact on health is dominated by behaviors that correlate with wealth, for example, and because people generally still get health care even if not insured, even if it also saddles them with debt. So universal health insurance won't resolve disparities in health outcomes. (This does appear somewhat at odds with the authors' frequent complaint that the US system often pays for treatment only after conditions become acute dangers, while earlier treatment might have been cheaper and prevented the worst health outcomes.)
The book is also full of interesting current and historical detail about the US and international health systems.
May 4, 2025
Thoughtful first principles analysis of existing health insurance markets.
A couple issues. The authors argue there is a fundamental principle underlying public health insurance in the United States: that this country hates to see people suffering from treatable disease. But they're economists, Jim--not historians, political scientists, or moral philosophers--and they don't really support either contention beyond a few anecdotes and a breezy reference to Rawls. Their argument boils down to looking at various programs created through affirmative legislation, and deeming that these comprise American health insurance "policy", from which underlying principles can be discerned: seaman's insurance from the early Republic; the old age, disability, and low income insurance of Medicare / Medicaid; and various bolt-on programs for diseases that randomly captured public attention (ESRD).
But this doesn't reflect that health insurance "policy" is also comprised of all the gaps between those affirmative programs over time. And in the current day, how do the authors square their normative contention with the politics of pending Medicaid cuts and "Let them die!" chants?
On a lesser note, the authors don't get into practical issues in the Medicare Advantage program, presumably because their first principles policy preferences call for supplemental insurance options from private plans on top of minimal universal insurance, and, if you squint hard enough, you can conflate their abstract preference with existing MA plans.
A couple issues. The authors argue there is a fundamental principle underlying public health insurance in the United States: that this country hates to see people suffering from treatable disease. But they're economists, Jim--not historians, political scientists, or moral philosophers--and they don't really support either contention beyond a few anecdotes and a breezy reference to Rawls. Their argument boils down to looking at various programs created through affirmative legislation, and deeming that these comprise American health insurance "policy", from which underlying principles can be discerned: seaman's insurance from the early Republic; the old age, disability, and low income insurance of Medicare / Medicaid; and various bolt-on programs for diseases that randomly captured public attention (ESRD).
But this doesn't reflect that health insurance "policy" is also comprised of all the gaps between those affirmative programs over time. And in the current day, how do the authors square their normative contention with the politics of pending Medicaid cuts and "Let them die!" chants?
On a lesser note, the authors don't get into practical issues in the Medicare Advantage program, presumably because their first principles policy preferences call for supplemental insurance options from private plans on top of minimal universal insurance, and, if you squint hard enough, you can conflate their abstract preference with existing MA plans.
April 9, 2024
"We've Got You Covered" is an extraordinary look at how to create a sensible, affordable structure for providing universal basic health care to every American citizen. (I'll note that one of the things left unaddressed in their otherwise excellent book is how to treat resident aliens, but I'm so impressed by their work that I'm not inclined to nit-pick.) The authors, academic health care economists, start with first principles: what is the US health care funding system trying to do, reaching the conclusion, based on what the government actually does (vs. what politicians say they're doing), that government funding is attempting to ensure that everyone receives basic care that improves their quality of life regardless of their ability to pay for it. The rest of the book continues from those principles, developing a well-reasoned approach to institute universal basic coverage free of charge to every citizen. They point out that such an approach need not increase taxes, and show how a supplemental "upgrade" kind of insurance market could function to provide coverage to those able to pay more than the basic coverage. I wish every member of the Senate and House of Representatives would read this book.
September 22, 2023
Eminently readable conversational overview of the US health care quagmire. Of course this should be required reading for our thought leaders, both in the media and in politics, as life is more complicated than 15-second sound bites. The authors boil down quite realistic views of our approach to helping those in distress, and they deal with the uncomfortable fact that economics in only part of the story -- we are wonderfully human and irrational at times. The analysis is sprinkled with illustrative stories (including from their own lives), just enough to keep that analysis rooted in our narrative-minded brains. Co-pays, for example, do indeed reduce the number of doctor visits; but the total cost ends up being the same or greater because those who don't go to the doctor regularly end up going to the Very Expensive emergency room later. The historical review is sobering, noting that Alexander Hamilton introduced the first health insurance mandate in 1796, for merchant marine! And the first serious proposals for national health insurance started in the presidential campaign of 1916! Woe is us. I'm moving to Europe.
May 17, 2024
A great, multifaceted, non-partisan look at the healthcare system in the United States that brings out potential solutions that are feasible with the taxes we already pay for healthcare - it's not the money, but the allocation and budgeting (or actually, the lack of budgeting to my surprise!!) that needs restructuring.
I especially got a kick out of the authors' approach to the problem, which was to start with questions that aim at understanding what kind of a social agreement Americans support, both how it's codified into laws and on the levels of individuals, when it comes to taking care of each other, because trying to build a system that does not align with the social contract is probably prone to failure. And then next, to look at where the current healthcare system is actually following this, where it's failing, and what to do with the failures. (And I also got a kick out of them casually dropping "and don't call me Shirley" in the midst of it.)
Highly recommended reading for Americans and non-Americans alike (the latter to learn about how the healthcare system in the US works and doesn't currently).
I especially got a kick out of the authors' approach to the problem, which was to start with questions that aim at understanding what kind of a social agreement Americans support, both how it's codified into laws and on the levels of individuals, when it comes to taking care of each other, because trying to build a system that does not align with the social contract is probably prone to failure. And then next, to look at where the current healthcare system is actually following this, where it's failing, and what to do with the failures. (And I also got a kick out of them casually dropping "and don't call me Shirley" in the midst of it.)
Highly recommended reading for Americans and non-Americans alike (the latter to learn about how the healthcare system in the US works and doesn't currently).
March 7, 2025
Was solid. Honestly written well. Main concept was that health insurance need to be basic and automatic. Love this concept and learning how US tax spending is already 9% healthcare meaning it’s affordable for us. Also like the approach of preventive care rather than only when you have the disease
But..
- Book didn’t say what should be covered
- How reform should take place, just that it should (offered no timeline)
- Lots of historical context of OTHER countries and some of the US, but a chapter overview of American health insurance would be great
- Also would be cool to talk about private insurance and how other stakeholders would be effective
- Lots of redundancy imo
Overall was a simple read but for someone interested in this wish it was way more complex and had tangible ideas that could be worked on rather than just “oh gut the system and impose universal BASIC care with auto enroll and opportunity for supplemental insurance.” That’s the whole book if you were curious. But liked the writing style just wish content was deeper
But..
- Book didn’t say what should be covered
- How reform should take place, just that it should (offered no timeline)
- Lots of historical context of OTHER countries and some of the US, but a chapter overview of American health insurance would be great
- Also would be cool to talk about private insurance and how other stakeholders would be effective
- Lots of redundancy imo
Overall was a simple read but for someone interested in this wish it was way more complex and had tangible ideas that could be worked on rather than just “oh gut the system and impose universal BASIC care with auto enroll and opportunity for supplemental insurance.” That’s the whole book if you were curious. But liked the writing style just wish content was deeper
April 29, 2024
Recommended to me by Beth Silvers, cohost of the podcast Pantsuit Politics. 💯
Within the space of chapter one, the authors + researchers Einav + Finkelstein explain the immense weaknesses of the state-by-state Medicaid coverage for low income families and individuals, making it clear that if a person professes to care for how people are doing, they should probably advocate constantly for the broadening + simplification of the system, not the expansion of hurdles to prove they are 'poor enough' or 'disabled enough'.
"Does the form produce function?" Is a question they pose at the end of chapter 3, + I deeply appreciate it as someone who has had experience with only 3 different types of medical insurance throughout my life so far.
The authors walk us through the history of hospitals + medical insurance systems based in the United States, asking the readers what parts of the house they would like to keep before completely deconstructing + starting anew. This is not a remodel.
Within the space of chapter one, the authors + researchers Einav + Finkelstein explain the immense weaknesses of the state-by-state Medicaid coverage for low income families and individuals, making it clear that if a person professes to care for how people are doing, they should probably advocate constantly for the broadening + simplification of the system, not the expansion of hurdles to prove they are 'poor enough' or 'disabled enough'.
"Does the form produce function?" Is a question they pose at the end of chapter 3, + I deeply appreciate it as someone who has had experience with only 3 different types of medical insurance throughout my life so far.
The authors walk us through the history of hospitals + medical insurance systems based in the United States, asking the readers what parts of the house they would like to keep before completely deconstructing + starting anew. This is not a remodel.
October 6, 2024
I wish this book was longer.
It's refreshing to see a pair of economists share their research and what more they learned in writing this book for a general audience. I work in healthcare and I couldn't understand how it's so expensive to patients yet inadequate in what's provided. The authors explain that the U.S. system is a patchwork of laws and it's not merely a matter of more fixes but completely starting from the ground up. We could provide universal basic coverage for everyone with the same budget we're using now. It would be very basic, with longer wait times and uncomfortable facilities but we'd all get what we need. Beyond that, upgrades and shorter wait times would be available for a better price. They discuss how these models work abroad, highlighting successes and pitfalls. It's a tall order but their hope is to get the conversation going in a more productive direction so we can achieve the goal of universal care.
It's refreshing to see a pair of economists share their research and what more they learned in writing this book for a general audience. I work in healthcare and I couldn't understand how it's so expensive to patients yet inadequate in what's provided. The authors explain that the U.S. system is a patchwork of laws and it's not merely a matter of more fixes but completely starting from the ground up. We could provide universal basic coverage for everyone with the same budget we're using now. It would be very basic, with longer wait times and uncomfortable facilities but we'd all get what we need. Beyond that, upgrades and shorter wait times would be available for a better price. They discuss how these models work abroad, highlighting successes and pitfalls. It's a tall order but their hope is to get the conversation going in a more productive direction so we can achieve the goal of universal care.
January 31, 2024
An airport politics book for comfortable people looking for validation for why healthcare should be configured as a resource for those who can afford it. Proposes that a minimum of healthcare should be provided free of charge, while preserving the private healthcare industry for everything else. The book leaves many questions unanswered. If you are a liberal democrat who hated the discussion about healthcare during the 2016 democratic primary, you'll love this book. If you're a republican who thinks healthcare is something that should be relegated to the rich, you'll love this book. If you don't give a shit about disabled people but want to feel like you're not a bad person for that, you'll love this book. If you look for people with a lot of accolades who will justify your beliefs that the cost of healthcare should be the primary concern in healthcare, you'll love this book.
January 21, 2025
A book that uniquely describes the complex details of the US healthcare system and argues that it is broken beyond repair while giving ample evidence of just that. The books gives a blueprint for a universal basic healthcare model that is developed based on the "best practices" from various other countries in their own healthcare systems. While the book authors do not claim that their proposed system is perfect, the system would likely require tight regulation over healthcare and medical device corporations, as well as over physicians. Something like this may be difficult or impossible to implement in the United States due to cultural reasons, not to mention it would not be politically salient on either side of the aisle. The book proposes entirely gutting the current system and replacing it with a new system, as opposed to "fixing" the current system.
November 14, 2023
This book is well worth reading for anyone who is concerned about the failures and disparities in health care in the United States. The authors have done research of their own, and mined other studies to form their opinions from widely accumulated scientific data. Here's my takeaway from their discoveries and advice. 1. Provide Basic Health Care for all. Make it automatic. No patching. The existing model must be torn down and rebuilt from scratch. 2. No co-pays. It costs more to administer than collected fees provide. 3. For people who want more than "Basic Health Care," provide supplemental private insurance for things like private hospital rooms, choosing one's own physician instead of being assigned, etc. 4. In every country in the world, arriving at universal health care has resulted only after intense political battles. The same should be expected here in the USA.
February 1, 2025
I got introduced to the authoress (Amy Finklestein) through a few Freaknomoics podcast, so when hunting around for a book to read, I decided this to be the book. I was absolutely enthralled by the book from beginning to end, where they talk about the history of health insurance in the USA, why health insurance is the way it is, why its so hard to change, and why it probably will change inevitably into some form of universal healthcare (hint, its almost already there!).
The book is not just a history book, its also a book on how they would like to change healthcare if they were given god-like powers in the USA. It also talks about how close we were to getting universal health care a few times in the US history, and how actually both parties support some form of it for everyone (Romneycare, Obamacare).
This is one of those books on health insurance that did not leave me feeling more depressed about the system than when I started and I'm actually grateful for it. The book is quite well researched, quite well written, and has a central thesis that I feel everyone can support. The usual, "how are we going to pay for it" is actually well thought out, and the "what do we do with all the private insurance folks" is also somewhat addressed.
Probably the quote that I felt best about the American Health Care system from the late, great Walter Cronkite..
A former CBS anchorman, Walter Cronkite, characterized the American healthcare system as “neither healthy, caring, nor a system.”
Definitely a book worth reading if you have any interest at all that the mess of the American Healthcare Insurance market is like, with the bonus that there might actually be a fix!
Highly recommended.
The book is not just a history book, its also a book on how they would like to change healthcare if they were given god-like powers in the USA. It also talks about how close we were to getting universal health care a few times in the US history, and how actually both parties support some form of it for everyone (Romneycare, Obamacare).
This is one of those books on health insurance that did not leave me feeling more depressed about the system than when I started and I'm actually grateful for it. The book is quite well researched, quite well written, and has a central thesis that I feel everyone can support. The usual, "how are we going to pay for it" is actually well thought out, and the "what do we do with all the private insurance folks" is also somewhat addressed.
Probably the quote that I felt best about the American Health Care system from the late, great Walter Cronkite..
A former CBS anchorman, Walter Cronkite, characterized the American healthcare system as “neither healthy, caring, nor a system.”
Definitely a book worth reading if you have any interest at all that the mess of the American Healthcare Insurance market is like, with the bonus that there might actually be a fix!
Highly recommended.
January 28, 2025
I liked the cover's double-snake curled around an umbrella. I thought that was a clever way to symbolize health coverage.
I am glad I braved it and took the took the plunge into looking at what these two economic researchers dug up about public vs private insurance since that always confused me since I was ten years old, and it has been a few years since then.
Are you confused too?
It depends on employment in the US, and if you are not based there, then there are other options - for example, it was describing the NHS, which is what the UK has.
So since this book was incredibly straightforward, and fairly timely, I liked it very much.
Have a nice day.
I am glad I braved it and took the took the plunge into looking at what these two economic researchers dug up about public vs private insurance since that always confused me since I was ten years old, and it has been a few years since then.
Are you confused too?
It depends on employment in the US, and if you are not based there, then there are other options - for example, it was describing the NHS, which is what the UK has.
So since this book was incredibly straightforward, and fairly timely, I liked it very much.
Have a nice day.
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