One of the best entries in the health care reform genre.
A highly insightful examination of how to fix America’s woefully inadequate health care system.
Einav and Finkelstein, professors of economics at Stanford and MIT, respectively, manage the impressive feat of appearing neither liberal nor conservative, portraying the American health care system as not merely deplorable, but grotesque. Its patches, exceptions, complexities, and cutouts illustrate our “plug-the-leaks, squeaky-wheel-gets-the-grease approach of the past half century.” The authors make a compelling case for going back to the drawing board to do it right. The idea of universal health care is rooted in an unwritten social contract: to provide essential medical care regardless of resources. Most liberals and conservatives accept this concept, at least in theory. Current reforms miss the point by emphasizing the uninsured, ignoring the fact that 90% of insured Americans have problems. Even the coverage we do have is a mess. The authors argue for a fixed government health care budget to provide free universal coverage for basic services and the option to buy additional, supplemental coverage. Conservatives may be discomfited to learn that almost every high-income nation with free, “socialized” medicine operates under a fixed health care budget. America doesn’t and vastly outspends them all. Ironically, much of American health care is already socialized—i.e., paid for by the government with salaried doctors at the VA hospitals and community health centers. Taken as a whole, our taxes already pay for universal basic coverage, but basic coverage must be just that: basic. Some extras—private rooms, choice of doctors, good food, short wait times for routine care—don’t qualify. The authors’ vivid examples vary from tolerable (Australia, Singapore) to unpleasant (China). Their plan would create a two-tier system benefiting those with supplementary coverage, but we already have that. The advantage is that it would fulfill the social contract we all accept. Today’s basic coverage for the poor—i.e., Medicaid—is not only a failure; it’s often undeniably cruel.
One of the best entries in the health care reform genre.Pub Date: July 25, 2023
ISBN: 9780593421239
Page Count: 304
Publisher: Portfolio
Review Posted Online: May 17, 2023
Kirkus Reviews Issue: June 15, 2023
PERSPECTIVES
Cogent, well-timed ideas for meeting today’s biggest challenges.
Helping liberals get out of their own way.
Klein, a New York Times columnist, and Thompson, an Atlantic staffer, lean to the left, but they aren’t interrogating the usual suspects. Aware that many conservatives have no interest in their opinions, the authors target their own side’s “pathologies.” Why do red states greenlight the kind of renewable energy projects that often languish in blue states? Why does liberal California have the nation’s most severe homelessness and housing affordability crises? One big reason: Liberal leadership has ensnared itself in a web of well-intentioned yet often onerous “goals, standards, and rules.” This “procedural kludge,” partially shaped by lawyers who pioneered a “democracy by lawsuit” strategy in the 1960s, threatens to stymie key breakthroughs. Consider the anti-pollution laws passed after World War II. In the decades since, homeowners’ groups in liberal locales have cited such statutes in lawsuits meant to stop new affordable housing. Today, these laws “block the clean energy projects” required to tackle climate change. Nuclear energy is “inarguably safer” than the fossil fuel variety, but because Washington doesn’t always “properly weigh risk,” it almost never builds new reactors. Meanwhile, technologies that may cure disease or slash the carbon footprint of cement production benefit from government support, but too often the grant process “rewards caution and punishes outsider thinking.” The authors call this style of governing “everything-bagel liberalism,” so named because of its many government mandates. Instead, they envision “a politics of abundance” that would remake travel, work, and health. This won’t happen without “changing the processes that make building and inventing so hard.” It’s time, then, to scrutinize everything from municipal zoning regulations to the paperwork requirements for scientists getting federal funding. The authors’ debut as a duo is very smart and eminently useful.
Cogent, well-timed ideas for meeting today’s biggest challenges.Pub Date: March 18, 2025
ISBN: 9781668023488
Page Count: 320
Publisher: Avid Reader Press
Review Posted Online: Jan. 16, 2025
Kirkus Reviews Issue: Feb. 15, 2025
BOOK REVIEW
PERSPECTIVES
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...
A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.
The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.Pub Date: Nov. 1, 2011
ISBN: 978-0-374-27563-1
Page Count: 512
Publisher: Farrar, Straus and Giroux
Review Posted Online: Sept. 3, 2011
Kirkus Reviews Issue: Sept. 15, 2011
BOOK REVIEW
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