Princeton Health Experts Weigh in on Texas, “Rationing,” and Why Strong Insurance Regulation Matters More than the Public Option

Two of America’s most prominent experts on the U.S. health care system shared insights over the long weekend that drill drown past the sound bites in the current reform debate. 

Inspired by recent statements by Senator Hutchison, Professor Uwe Reinhardt’s November 27th post at the New York Times’ Economix blog explains that rationing occurs whenever uninsured Texans choose between spending their cash on care or other necessities, when seniors on Medicare face uncovered “doughnut hole” medication costs or must pay one-quarter of the $700 cost to get a colonoscopy.  Reinhardt takes us back to Economics 101, reminding us that markets are designed to ration scarce resources by price, saying “free markets are not an alternative to rationing.  They are just one particular form of rationing.” 

Professor Paul Starr, probably the best-known scholar of the history of American Medicine, explains in his op-ed that Health Insurance Exchanges with strong reform regulation authority are key to “the basic aim of reform (which) is to create a more efficient and equitable system for health insurance and health care and to provide subsidies so everyone can afford coverage.  Those who obtain insurance individually or through small businesses now get a rotten deal in the market.”  Starr comments that the House’s Exchange provisions are far stronger than the Senate model, and he calls for speeding up the implementation of expanded coverage to 2012, instead of the House’s 2013 and the Senate’s 2014 timelines.