The Healthcare Fix

October 29, 2007
Taking off from the statistic that 47 million Americans have no health insurance, this treatise from Boston University economist Kotlikoff (The Coming Generational Storm) argues forcefully that on one hand, emergency room and other medical debt incurred by the uninsured is a crippling force in the economy, and that, on the other, Medicare and Medicaid benefits are spiraling beyond the system's ability to sustain them. Humanitarian concerns aside, Kotlikoff argues for a voucher-based "Medical Security System" that issues benefits to individuals (rather than doctors or hospitals) based on existing medical conditions. The plan's goal is the preservation of the existing private health care industry, in part through allowing the government to control costs by establishing the value of the vouchers. Kotlikoff's passionate exposition of the details of his plan is sure to add to the growing health care debate.

September 15, 2007
In the latest book proposing reform for Americas ailing health-care system, Kotlikoff (economics, Boston Univ.) convincingly argues that the system is unsustainable owing to two factors: the aging of the population and the resulting growing need for health-care services and the proliferation of health-care benefits provided by various government programs. To reform the system, Kotlikoff proposes to do away with Medicare, Medicaid, and employer-supplied insurance and to replace them with a government-sponsored universal voucher system to purchase health insurance. Under this plan, everyone in the nation would receive an annual insurance voucher that would vary in amount based on his or her age and medical status. Kotlikoffs plan is logical, but it is too simplistic and politically naive overall. The millions of seniors who receive Medicare and the even larger number of employees and their dependents who get work-based health insurance would be very reluctant to give up their current coverage for fear of losing benefits. These large, powerful voting groups will lobby Congress to block such a plan. The book may also prove daunting to those without a basic understanding of microeconomics. Recommended only for large academic and medical libraries.Ross Mullner, Sch. of Public Health, Univ. of Illinois at Chicago

Copyright 2007 Library Journal, LLC Used with permission.

October 15, 2007
The healthcare crisis in America exists not only for the 47 million who are uninsured but also for the country as a whole, as the 77 million baby boomers who are set to retire in the next 25 years will bankrupt the Medicare and Medicaid programs. It is projected that the difference between the governments future obligations and the amount of taxes it expects to collect is an unfathomable $70 trillion! This is just one of the many facts and figures that Kotlikoff, professor of economics at Boston University, presents in his plea for an immediate reorganization of the nations healthcare system. Kotlikoff proposes scrapping Medicare and Medicaid entirely and replacing them with a single universal care system. Under his Medical Security System, every American would receive a voucher for health insurance commensurate with his or her health-care needs. Employers would be relieved of the burden of providing health insurance, and everyone would get coverage. The plan is so brilliant and simple that the chances of our government adopting it are slim, but Kotlikoff provides a postcard to mail to your representative in Congress anyway.(Reprinted with permission of Booklist, copyright 2007, American Library Association.)