This afternoon, weather permitting (the East Coast will be rainswept all day), I am flying to Los Angeles, in order to participate in tomorrow's NYU-UCLA conference concerning tax policy and healthcare reform.
I'll be chairing the fourth and final panel, entitled "Health Care Reform and the Long-Term Fiscal Outlook." The papers, which will eventually appear in the Tax Law Review, are (1) Howard Gleckman, Healthcare and the Long-Term Fiscal Outlook, (2) Daniel Kessler, "Reforming Medicare," and (3) Mark Pauly, "The Real Burden of Tax-Financed Medical Care in the United States."
I won't have slides or a formal presentation, so there will likely be nothing to post here on Monday. During the session, however, I will be offering quick comments and reactions after the three presentations, mainly to focus and jump-start the broader discussion.
Everyone knows that the projected path of healthcare growth is at the heart of the grim long-term U.S. fiscal situation, and the question is what to do about it. I suspect that a central issue throughout the panel will relate to the basic fundamentals of why there is such a large government role (around the world) with respect to healthcare provision and financing, and how one should think about the relative defects of government provision on the one hand and market provision on the other. Plus, what happens when you mix them in different ways.
Healthcare's unique characteristics (especially when, but not only because, we decide that everyone should get basic care) inevitably will play a central role in this conversation. It hasn't been seriously disputed in economic circles for decades that, in a whole lot of consumer areas (say, cars or shoes or breakfast cereral), markets generally do better than government provision from the standpoint of efficiency and responsiveness to consumer demand. But is healthcare different, and if so then to what extent and in what ways? And if a critique of how markets work in the healthcare sector does not necessarily rebut pessimism about the informational and incentive issues raised by government involvement, then how do we navigate between various competing problems?